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Related Concept Videos

Assessment of Ventilation II: Respiratory Depth and Rhythm01:29

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Using Near-Infrared Spectroscopy Wearable Devices to Identify Central Versus Peripheral Limitations During Exercise
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Respiratory effort from the photoplethysmogram.

Paul S Addison1

  • 1Minimally Invasive Therapies Group, Medtronic, The Technopole Centre, Edinburgh EH26 0PJ, Scotland, United Kingdom .

Medical Engineering & Physics
|January 28, 2017
PubMed
Summary

This pilot study explored using pulse oximeter signals to measure respiratory effort non-invasively. Six developed parameters from the photoplethysmogram (pleth) signal showed a strong link to airway pressure, suggesting a new method for assessing breathing effort.

Keywords:
Clinical monitoringPhotoplethysmogramPulse amplitude modulationPulse oximetryPulse transit timeRespiratory effortRespiratory sinus arrhythmia

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Area of Science:

  • Biomedical Engineering
  • Respiratory Physiology
  • Medical Devices

Background:

  • Non-invasive monitoring of respiratory effort is crucial for patient care.
  • Existing methods may be invasive or complex.
  • The photoplethysmogram (pleth) signal from pulse oximetry offers a potential, simple signal source.

Purpose of the Study:

  • To investigate the feasibility of using the pleth signal for non-invasive respiratory effort measurement.
  • To develop and validate parameters derived from the pleth signal correlated with respiratory effort.
  • To assess the reliability of these parameters across different conditions and probe sites.

Main Methods:

  • Developed thirteen candidate parameters from pleth signal modulations (amplitude, baseline, frequency, pulse transit times) and baseline shifts.
  • Collected data from healthy volunteers undergoing controlled respiratory maneuvers with varying resistances and rates.
  • Generated over three thousand pleth-based effort-airway pressure (EP) curves across diverse conditions.
  • Performed regression analysis to identify monotonic relationships between pleth parameters and airway pressure.

Main Results:

  • Six candidate parameters demonstrated a significant positive monotonic relationship (p<0.001) with increasing upper airway pressure.
  • These parameters included amplitude modulation (AM-Effort), baseline modulation (BM-Effort), respiratory sinus arrhythmia (RSA-Effort), two pulse transit time measures (P2E-Effort, P2-Effort), and baseline heart rate shifts (BL-HR-Effort).
  • The identified relationships were repeatable across different respiratory rates, flow constrictions, and tested probe sites.

Conclusions:

  • Several pleth-derived parameters show a clear, repeatable relationship with imposed respiratory loading.
  • These findings suggest the photoplethysmogram signal can potentially measure changing upper airway dynamics and breathing effort.
  • This non-invasive approach may offer a novel method for respiratory effort assessment.