Pulse oximetry-derived respiratory rate in general care floor patients

Abstract

Respiratory rate is recognized as a clinically important parameter for monitoring respiratory status on the general care floor (GCF). Currently, intermittent manual assessment of respiratory rate is the standard of care on the GCF. This technique has several clinically-relevant shortcomings, including the following: (1) it is not a continuous measurement, (2) it is prone to observer error, and (3) it is inefficient for the clinical staff. We report here on an algorithm designed to meet clinical needs by providing respiratory rate through a standard pulse oximeter. Finger photoplethysmograms were collected from a cohort of 63 GCF patients monitored during free breathing over a 25-min period. These were processed using a novel in-house algorithm based on continuous wavelet-transform technology within an infrastructure incorporating confidence-based averaging and logical decision-making processes. The computed oximeter respiratory rates (RRoxi) were compared to an end-tidal CO2 reference rate (RRETCO2). RRETCO2 ranged from a lowest recorded value of 4.7 breaths per minute (brpm) to a highest value of 32.0 brpm. The mean respiratory rate was 16.3 brpm with standard deviation of 4.7 brpm. Excellent agreement was found between RRoxi and RRETCO2, with a mean difference of −0.48 brpm and standard deviation of 1.77 brpm. These data demonstrate that our novel respiratory rate algorithm is a potentially viable method of monitoring respiratory rate in GCF patients. This technology provides the means to facilitate continuous monitoring of respiratory rate, coupled with arterial oxygen saturation and pulse rate, using a single non-invasive sensor in low acuity settings.

Probabilistic Estimation of Respiratory Rate from Wearable Sensors

“…The only significant age cohort omitted was the neonatal cohort. This is in keeping with recent work by Addison et al [2], who published a study of a RR algorithm for use with the PPG which was tested on data acquired from adult patients across the general care floor with a wide range of medical conditions and ages. This study is limited, however, by not including data from patients outside of the hospital setting, and by using data acquired from patients whilst being stationary, rather than truly ambulatory.…”

Multicenter Study Validating Accuracy of a Continuous Respiratory Rate Measurement Derived From Pulse Oximetry: A Comparison With Capnography

“…22,23 The algorithm has been incorporated into a commercially available software application that reports respiratory rate continuously from a standard pulse oximeter. We characterized the performance of this software application in healthy subjects and patients hospitalized in a low-acuity care setting to obtain regulatory clearance.…”

A Brief Review of Non-invasive Monitoring of Respiratory Condition for Extubated Patients with or at Risk for Obstructive Sleep Apnea after Surgery

“…The probe provided continuous simultaneous monitoring of SpO 2 , heart rate, and RR for patients general care floor, including seven OSA patients (44). They found out that PPG-derived RR is comparable to the rate derived from EtCO 2 waveform as reference.…”