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Respiratory variations in the reflection mode photoplethysmographic signal: relationships to peripheral venous pressure
Linköping University, Department of Medical and Health Sciences, Anesthesiology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Biomedical Engineering. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Anesthesiology. Linköping University, Faculty of Health Sciences.
2003 (English)In: Medical and Biological Engineering and Computing, ISSN 0140-0118, E-ISSN 1741-0444, Vol. 41, no 3, 249-254 p.Article in journal (Refereed) Published
Abstract [en]

Photoplethysmography (PPG) is a non-invasive optical way of measuring variations in blood volume and perfusion in the tissue, used in pulse oximetry for instance. Respiratory-induced intensity variations (RIIVs) in the PPG signal exist, but the physiological background is not fully understood. Respiration causes variations in the blood volume in the peripheral vascular bed. It was hypothesised that the filling of peripheral veins is one of the important factors involved. In 16 healthy subjects, the respiratory synchronous variations from a PPG reflection mode signal and the peripheral venous pressure (PVP) were recorded. Variations of tidal volume, respiratory rate and contribution from abdominal and thoracic muscles gave significant and similar amplitude changes in both RIIV and the respiratory variation of PVP (p<0.01). The highest amplitudes of both signals were found at the largest tidal volume, lowest respiratory rate and during mainly thoracic breathing, respectively. The coherence between PVP and RIIV signals was high, the median (quartile range) being 0.78 (0.42). Phase analysis showed that RIIV was usually leading PVP, but variations between subjects were large. Although respiratory-induced variations in PVP and PPG showed a close correlation in amplitude variation, a causal relationship between the signals could not be demonstrated.

Place, publisher, year, edition, pages
2003. Vol. 41, no 3, 249-254 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-26703DOI: 10.1007/BF02348428Local ID: 11295OAI: oai:DiVA.org:liu-26703DiVA: diva2:247253
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Respiratory monitoring using reflection mode photoplethysmography: clinical and physiological aspects
Open this publication in new window or tab >>Respiratory monitoring using reflection mode photoplethysmography: clinical and physiological aspects
2005 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Photoplethysmography (PPG) is a non-invasive optical technique for monitoring variations in blood volume and blood flow in skin and other tissues. Light from a light-emitting diode is absorbed, scattered and reflected from the skin, and detected by a photodetector as a plethysmogram. The plethysmogram contains variations of different frequencies. The most clinically utilised is the pulse synchronous variation in the PPG application pulse oximetry, but there is also a respiratory rate synchronous variation (PPGt).

The aims of this work were to evaluate PPG as a clinical method for detection of breaths during anaesthesia, postoperative and intensive care, and to investigate possible circulatory factors in the physiological background of the respiratory synchronous part of the reflection mode PPG signal.

It was concluded that respiratory variations in reflection mode PPG derived from the forearm could be detected with high sensitivity and specificity. PPG, was not significantly affected by awake or anaesthetised state, though indirect signs of reduced sympathetic tone in the anaesthetic state were present, or by spontaneous or positive pressure ventilation. There were no significant differences between men and women or between young and old subjects. Circulatory pressure variations in phase with respiration were present on both the arterial and venous side and they showed the same degree of variation, as did PPG when provoking respiration. Squared coherence, cross-correlation and visual techniques for evaluating time differences were equally good.

Respiratory monitoring in the clinical setting is challenging and no golden standard exists. Methods based on airflow are mostly considered advantageous in detecting apnoea, but are less well tolerated by patients. The results indicate that PPG has a potential as a tool for monitoring respiratory rate. It is non-invasive, well tolerated and can be used for continuous monitoring.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2005. 70 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 898
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-31535 (URN)17335 (Local ID)91-8529-905-7 (ISBN)17335 (Archive number)17335 (OAI)
Public defence
2005-05-26, Elsa Brändström-salen, Universitetssjukhuset, Linköping, 12:00 (Swedish)
Opponent
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2012-09-27Bibliographically approved

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Nilsson, LenaJohansson, AndersKalman, Sigga

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