Physiological measurement
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Physiological measurement · Oct 2014
Investigation of photoplethysmographs from the anterior fontanelle of neonates.
Photoplethysmography (PPG) signals have been investigated at a new anatomical site, the anterior fontanelle (ANTF), on the hypothesis that blood supply at this location is preferentially preserved during cases of poor peripheral circulation which might cause the commercial pulse oximeters to fail to estimate accurately arterial blood oxygen saturation (SpO2). Two custom built reflectance PPG sensors have been developed, one for placement on the fontanelle and one on the periphery (foot). A PPG processing system and software were also developed to process the raw PPG signals and to estimate SpO2. ⋯ PPG signals from the ANTF were of good quality and high signal-to-noise ratio. The amplitudes of the ANTF PPGs were found to be sensitive to changes in amplitude when amplitudes were observed at the reference PPG site. Bland-Altman analysis of the gold standard blood gas analysis reveals that all three sensors are inaccurate at SaO2 < 85-90 %, but the ANTF sensor shows better mean difference than the commercial device.
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Intradialytic hypotension (IDH) is the most common adverse complication during hemodialysis. Its early prediction and prevention will dramatically improve the quality of life for patients with an end stage renal disease. In a recent study, changes in the normalized envelope of the test statistic of the photoplethysmograpic (PPG) signal were found to predict acute symptomatic IDH. ⋯ From datasets with patients prone and resistant to IDH, the results show that symptomatic IDH could be correctly predicted in 9 out of 14 cases, while 5 out of 24 were falsely predicted. In a subset of the data containing only patients prone to IDH, acute symptomatic IDH could be correctly predicted in 5 out of 5 cases, with one false prediction out of 14. When testing the robustness of the predictor, no significant changes were observed in the test statistic when controlled changes occurred in dialysis fluid temperature, ultrafiltration rate and body position.
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Physiological measurement · Aug 2014
Improved motion robustness of remote-PPG by using the blood volume pulse signature.
Remote photoplethysmography (rPPG) enables contact-free monitoring of the blood volume pulse using a color camera. Essentially, it detects the minute optical absorption changes caused by blood volume variations in the skin. In this paper, we show that the different absorption spectra of arterial blood and bloodless skin cause the variations to occur along a very specific vector in a normalized RGB-space. ⋯ A simple peak detector in the frequency domain returns the correct pulse-rate for 68% of total measurements compared to 60% for the best previous method, while the SNR of the pulse-signal improves from - 5 dB to - 4 dB. For a large population of 117 stationary subjects we prove that the accuracy is comparable to the best previous method, although the SNR of the pulse-signal drops from + 8.4 dB to + 7.6 dB. We expect the improved motion robustness to significantly widen the application scope of the rPPG-technique.
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Physiological measurement · Jul 2014
Impact of lower body negative pressure induced hypovolemia on peripheral venous pressure waveform parameters in healthy volunteers.
Lower body negative pressure (LBNP) creates a reversible hypovolemia by sequestrating blood volume in the lower extremities. This study sought to examine the impact of central hypovolemia on peripheral venous pressure (PVP) waveforms in spontaneously breathing subjects. With IRB approval, 11 healthy subjects underwent progressive LBNP (baseline, -30, -75, and -90 mmHg or until the subject became symptomatic). ⋯ Changes in hemodynamic and PVP waveform parameters reached a maximum during the symptomatic phase. During the recovery phase, there was a significant reduction in HR together with a significant increase in HR variability, mean PVP and PVP cardiac modulation. Thus, in response to mild hypovolemia induced by LBNP, changes in cardiac modulation and other PVP waveform parameters identified hypovolemia before detectable hemodynamic changes.
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Physiological measurement · Jul 2014
Influence of physiological sources on the impedance cardiogram analyzed using 4D FEM simulations.
Impedance cardiography is a simple and inexpensive method to acquire data on hemodynamic parameters. This study analyzes the influence of four dynamic physiological sources (aortic expansion, heart contraction, lung perfusion and erythrocyte orientation) on the impedance signal using a model of the human thorax with a high temporal resolution (125 Hz) based on human MRI data. Simulations of electromagnetic fields were conducted using the finite element method. ⋯ It is shown that impedance changes due to lung perfusion and heart contraction compensate themselves, and that erythrocyte orientation together with the aortic impedance basically form the ICG signal while taking its characteristic morphology from the aortic signal. The model is robust to conductivity changes of tissues and organ displacements. In addition, it reflects the multi-frequency behavior of the thoracic impedance.