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The wavelength dependence of the photoplethysmogram and its implication to pulse oximetry

Since the early 1980s the increase in use of pulse oximeters in many clinical situations has been quite remarkable, turning it into one of the most important methods of monitoring in use today. Pulse oximetry essentially uses photoplethysmography to calculate oxygen saturation. Consequently the wavelength dependence of the photoplethysmogram (PPG) is of direct relevance in the performance of pulse oximeters. The experimental results obtained on the wavelength dependence of the AC, DC and AC/DC PPG components for the 450 - 1000nm range are undoubtedly different to the ones predicted by the current simple pulse oximeter model based on the Lambert-Beer law. Moreover, they show unexpected phenomena regarding the magnitude of the above components over the whole range, with distinct differences between the reflection and transmission modes. This is of significance to the technique of pulse oximetry suggesting that perhaps other wavelengths should be considered for use, and that use of both "reflection" and "transmission" probes on the same oximeter may lead to inaccurate readings in one of the modes. A finger model was developed and results from Monte Carlo simulations of photon propagation obtained. The results did not correspond to the experimental results, this is most probably due to either wrong parameters or model. Recent advances in the use of reflection pulse oximeters on fetal monitoring during labour, have raised the question of possible artifacts which may arise due to inadequate probe application in the birth canal. The importance of complete opposition of the reflectance probe was examined on an adult finger. False low oxygen saturation readings were recorded with malpositioned probes. A new probe with modified geometry was designed which offered an improved performance in reducing this artifact and further suggestions were given for its possible elimination. Finally, a proposal for a novel, visible multi-wavelength reflection pulse oximeter is presented with the aim of replacing current pulse oximeters in certain situations where their use is questionable.

Identiferoai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:515614
Date January 1995
CreatorsDamianou, Damianos
PublisherUniversity of Nottingham
Source SetsEthos UK
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation
Sourcehttp://eprints.nottingham.ac.uk/11400/

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