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Estimation of respiratory volumes from the photoplethysmographic signal. Part 2: a model study
Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
1999 (English)In: Medical and Biological Engineering and Computing, ISSN 0140-0118, E-ISSN 1741-0444, Vol. 37, no 1, 48-53 p.Article in journal (Refereed) Published
Abstract [en]

A Windkessel model has been constructed with the aim of investigating the respiratory-volume dependence of the photoplethysmographic (PPG) signal. Experimental studies show a correlation between respiratory volume and the peak-to-peak value of the respiratory-induced intensity variations (RIIV) in the PPG signal. The model compartments are organised in two closed chambers, representing the thorax and the abdomen, and in a peripheral part not directly influenced by respiration. Cardiac pulse and respiration are created by continuous adjustment of the pressures in the affected compartments. Together with the criteria for heart and venous valves, the model is based on a set of 17 differential equations. These equations are solved for varying thoracic and abdominal pressures corresponding to different respiratory volumes. Furthermore, a sensitivity analysis is performed to evaluate the properties of the model. The PPG signals are created as a combination of peripheral blood flow and pressure. From these signals, the respiratory synchronous parts are extracted and analysed. To study some important limitations of the model, respiratory type and rate are varied. From the simulations, it is possible to verify our earlier experimental results concerning the relationship between respiratory volume and the peak-to-peak value of the RIIV signal. An expected decrease in the amplitude of the respiratory signal with increased respiratory rate is also found, which is due to the lowpass characteristics of the vessel system. Variations in the relationship between thoracic and abdominal respiration also affect the RIIV signal. The simulations explain and verify what has been found previously in experimental studies.

Place, publisher, year, edition, pages
1999. Vol. 37, no 1, 48-53 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-32557DOI: 10.1007/BF02513265Local ID: 18470OAI: oai:DiVA.org:liu-32557DiVA: diva2:253380
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13
In thesis
1. Photoplethysmography in multiparameter monitoring of cardiorespiratory function
Open this publication in new window or tab >>Photoplethysmography in multiparameter monitoring of cardiorespiratory function
2000 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Photoplethysmography (PPG) is an optical, non-invasive method to assess tissue blood volume/perfusion. When measured on human skin, the PPG signal includes both cardiac synchronous variations (AC) and respiratory induced intensity variations (RIIV). This makes the PPG signal appropriate for cardiorespiratory monitoring, as a single non-invasive sensor extracts both cardiac and respiratory information.

In this thesis, the origin of the RIIV signal is discussed, and invasive measurements of pressures in the circulatory system support the hypothesis of a venous origin. Important factors are intrathoracic and intra-abdominal pressure fluctuations, affecting venous return from the extrathoracic veins and the peripheral venous bed.

Previous reports have demonstrated a possibility to extract the RIIV signal for assessing respiratory rates. A more effective and reliable monitoring would be achieved if tidal volumes could be estimated from the PPG signal in addition to respiratory rates. This would provide a possibility to calculate and detect ventilatory trends. A relationship between the RIIV amplitude and the tidal volume was hypothesised, demonstrated in healthy subjects and verified in a theoretical (Windkessel) model of the circulatory system. Other factors than tidal volume influence intrathoracic and intra-abdominal pressures. Effects of thoraco-abdominal separation, posture and respiratory rate were observed, and their influence in tidal volume/ventilation monitoring was discussed.

Monitoring the cardiorespiratory function is essential in the postoperative and neonatal care environments. Studies have been performed in clinical settings including comparisons between the PPG method and more established monitoring systems. PPG was found to be suitable for monitoring heart and respiratory rates in these environments.

The arterial blood pressure contains respiratory related information, including heart rate fluctuations (respiratory sinus arrhythmia, RSA) and respiratory variations in cardiac stroke volume. These phenomena are seen in the PPG signal as frequency and amplitude modulation of the AC signal. An algorithm based on pattern recognition (neural networking) is presented, in which these respiratory components are extracted and combined with the RIIV signal. As the respiratory components are of different origins, the neural network algorithm is robust and more accurate for breath detection than algorithms utilising the components separately.

The main purposes of cardiorespiratory monitoring are to detect pathologic minute ventilation, apnoea, hypoxaemia, cardiac arrest, arrhythmia, and trends in heart rate. By using PPG, simultaneous information about heart rate, respiratory rate and tidal volume is obtained. Furthermore, as the measurement of arterial oxygen saturation by PPG is well established, a good coverage of the cardiorespiratory function can be obtained from a single non-invasive sensor.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2000. 63 p.
Series
Linköping Studies in Science and Technology. Dissertations, ISSN 0345-7524 ; 629
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-29446 (URN)14793 (Local ID)91-7219-715-3 (ISBN)14793 (Archive number)14793 (OAI)
Public defence
2000-04-28, Elsa Brändströms sal, Universitetssjukhuset, Linköping, 13:15 (Swedish)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2013-02-19

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Johansson, AndersÖberg, Åke

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