Respiratory variations in the photoplethysmographic waveform amplitude depend on type of pulse oximetry device

Høiseth, Lars Øivind; Hoff, Ingrid Elise; Hagen, Ove Andreas; Kirkebøen, Knut Arvid; Landsverk, Svein Aslak

doi:10.1007/s10877-015-9720-9

Cited by 7 publications

(4 citation statements)

References 26 publications

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“…The presence of baseline modulations in the PPG signal has been described by Shelley et al [17, 25]. Moreover, its impact on PAV was discussed recently in a simulation by Høiseth et al [27]. In the present work, we demonstrated, by computing and comparing BV, that the baseline modulation in the ABP signal was much weaker than that in the PPG signals.…”

Section: Discussionsupporting

confidence: 70%

Finger and forehead photoplethysmography-derived pulse-pressure variation and the benefits of baseline correction

Sun

Peeters

Bezemer

et al. 2018

J Clin Monit Comput

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To non-invasively predict fluid responsiveness, respiration-induced pulse amplitude variation (PAV) in the photoplethysmographic (PPG) signal has been proposed as an alternative to pulse pressure variation (PPV) in the arterial blood pressure (ABP) signal. However, it is still unclear how the performance of the PPG-derived PAV is site-dependent during surgery. The aim of this study is to compare finger-and forehead-PPG derived PAV in their ability to approach the value and trend of ABP-derived PPV. Furthermore, this study investigates four potential confounding factors, (1) baseline variation, (2) PPV, (3) ratio of respiration and heart rate, and (4) perfusion index, which might affect the agreement between PPV and PAV. In this work, ABP, finger PPG, and forehead PPG were continuously recorded in 29 patients undergoing major surgery in the operating room. A total of 91.2 h data were used for analysis, from which PAV and PPV were calculated and compared. We analyzed the impact of the four factors using a multiple linear regression (MLR) analysis. The results show that compared with the ABP-derived PPV, finger-derived PAV had an agreement of 3.2 ± 5.1%, whereas forehead-PAV had an agreement of 12.0 ± 9.1%. From the MLR analysis, we found that baseline variation was a factor significantly affecting the agreement between PPV and PAV. After correcting for respiration-induced baseline variation, the agreements for finger-and foreheadderived PAV were improved to reach an agreement of − 1.2 ± 3.8% and 3.3 ± 4.8%, respectively. To conclude, finger-derived PAV showed better agreement with ABP-derived PPV compared to forehead-derived PAV. Baseline variation was a factor that significantly affected the agreement between PPV and PAV. By correcting for the baseline variation, improved agreements were obtained for both the finger and forehead, and the difference between these two agreements was diminished. The tracking abilities for both finger-and forehead-derived PAV still warrant improvement for wide use in clinical practice. Overall, our results show that baseline-corrected finger-and forehead-derived PAV may provide a non-invasive alternative for PPV.

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Section: Discussionsupporting

confidence: 70%

Finger and forehead photoplethysmography-derived pulse-pressure variation and the benefits of baseline correction

Sun

Peeters

Bezemer

et al. 2018

J Clin Monit Comput

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“…These adaptive filters may function over a short time scale, comparable to that of breathing, therefore potentially affecting extracted respiratory signals. Indeed, a recent study reported that the AM signals extracted from PPG signals acquired from two clinical monitors were not interchangeable (Høiseth et al 2015). Since monitors' filtering characteristics are not usually published (Feldman 2010), it is not clear how extracted respiratory signals are affected by this process.…”

Section: Technical Factorsmentioning

confidence: 99%

Extraction of respiratory signals from the electrocardiogram and photoplethysmogram: technical and physiological determinants

et al. 2017

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“…Different pulse oximeters use proprietary algorithms and produce different photoplethysmographic waveforms. Thus, dPOP from different pulse oximeters may give different results [40]. dPP was derived by the volume-clamp method, which is based on the photoplethysmographic technology.…”

Section: Discussionmentioning

confidence: 99%

Respiratory variations in pulse pressure and photoplethysmographic waveform amplitude during positive expiratory pressure and continuous positive airway pressure in a model of progressive hypovolemia

et al. 2019

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PurposeRespiratory variations in pulse pressure (dPP) and photoplethysmographic waveform amplitude (dPOP) are used for evaluation of volume status in mechanically ventilated patients. Amplification of intrathoracic pressure changes may enable their use also during spontaneous breathing. We investigated the association between the degree of hypovolemia and dPP and dPOP at different levels of two commonly applied clinical interventions; positive expiratory pressure (PEP) and continuous positive airway pressure (CPAP).Methods20 healthy volunteers were exposed to progressive hypovolemia by lower body negative pressure (LBNP). PEP of 0 (baseline), 5 and 10 cmH2O was applied by an expiratory resistor and CPAP of 0 (baseline), 5 and 10 cmH2O by a facemask. dPP was obtained non-invasively with the volume clamp method and dPOP from a pulse oximeter. Central venous pressure was measured in 10 subjects. Associations between changes were examined using linear mixed-effects regression models.ResultsdPP increased with progressive LBNP at all levels of PEP and CPAP. The LBNP-induced increase in dPP was amplified by PEP 10 cmH20. dPOP increased with progressive LBNP during PEP 5 and PEP 10, and during all levels of CPAP. There was no additional effect of the level of PEP or CPAP on dPOP. Progressive hypovolemia and increasing levels of PEP were reflected by increasing respiratory variations in CVP.ConclusiondPP and dPOP reflected progressive hypovolemia in spontaneously breathing healthy volunteers during PEP and CPAP. An increase in PEP from baseline to 10 cmH2O augmented the increase in dPP, but not in dPOP.

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Respiratory variations in the photoplethysmographic waveform amplitude depend on type of pulse oximetry device

Cited by 7 publications

References 26 publications

Finger and forehead photoplethysmography-derived pulse-pressure variation and the benefits of baseline correction

Finger and forehead photoplethysmography-derived pulse-pressure variation and the benefits of baseline correction

Extraction of respiratory signals from the electrocardiogram and photoplethysmogram: technical and physiological determinants

Respiratory variations in pulse pressure and photoplethysmographic waveform amplitude during positive expiratory pressure and continuous positive airway pressure in a model of progressive hypovolemia

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