Intraoperative monitoring of intestinal viability: Evaluation of a new combined sensor

A dual wavelength photoplethysmography (PPG) and laser Doppler flowmetry (LDF) sensor was developed to investigate the suitability of these techniques for monitoring bowel viability intraoperatively. Clinical measurements were obtained from thirty patients undergoing bowel surgery. Three measurements were performed at different stages of the operation. The amplitude of infrared PPG decreased from the baseline measurement to the pre-anastomosis measurement by 36% and LDF flux decreased by 21% for the same measurements. An increase of 33% in amplitude for infrared PPG was observed from the pre-anastomotic to post-anastomosis measurement; the equivalent increase was not seen for LDF flux. The results revealed that the sensor could potentially indicate changes in perfusion and blood flow at critical phases of surgery, thereby assisting in the early detection of inadequate blood supply in bowel tissue. The results also suggest that laser Doppler is more sensitive to movement artefact compared to PPG.

Integrating Sphere Finger-Photoplethysmography: Preliminary Investigation towards Practical Non-Invasive Measurement of Blood Constituents

The aim of this study was to compare conventional photoplethysmography (PPG) in a finger with PPG using an integrating sphere (_ISPPG) to enhance scattered light collection. Two representative wavelengths were used; 1160 nm, a window through the absorption spectra of water and alcohol, and 1600 nm around where water absorption is high and there is an absorption peak of blood glucose. Simultaneous transmission-type measurements were made with conventional PPG and with _ISPPG for each wavelength in the tips of index fingers of both hands in a total of 10 healthy young male and female volunteers (21.7 ± 1.6 years old). During a 5 min period in which subjects were in a relaxed state we determined the signal-to-noise ratio, SNR, and the PPG detectability (or sensitivity) by the two techniques. SNR during the test period was significantly higher with _ISPPG as compared with conventional PPG, especially for the 1600 nm wavelength. PPG signals with 1600 nm could scarcely be detected by conventional PPG, while they could be detected with good sensitively by _ISPPG. We conclude that under controlled conditions _ISPPG has better SNR and higher sensitivity than conventional transmission PPG, especially in wavelength regions where water absorption is high but where there is potential for practical measurement of blood constituents including glucose.

A Vision-Based Respiration Monitoring System for Passive Airway Resistance Estimation

OBJECTIVE

Airway resistance is the mechanical cause of most of the symptoms in obstructive pulmonary disease, and can be considered as the primary measure of disease severity. A low-cost and noninvasive method to measure the airway resistance that does not require patient effort could be of great benefit in evaluating the severity of lung diseases, especially in patient population that are unable to use spirometry, such as young children.

METHODS

The Vision-Based Passive Airway Resistance Estimation (VB-PARE) technology is a passive method to measure airway resistance noninvasively. The airway resistance is estimated from: 1) airflow extracted from processing depth data captured by a Microsoft Kinect, and 2) Pulsus Paradoxus extracted from a pulse oximeter (SpO ₂).

RESULTS

To verify the validity and accuracy of the VB-PARE, two phases of experiment were conducted. In Phase I, spontaneous breathing data was collected from 14 healthy participants with externally induced airway obstruction, and the accuracy of 76.2±13.8% was achieved in predicting three levels of obstruction severity. In Phase II, VB-PARE outputs were compared with the clinical results from 14 patients. VB-PARE estimated the tidal volume with an average error of 0.07±0.06 liter. Also, patients with airway obstruction were detected with 80% accuracy.

CONCLUSION

Using the information extracted from Kinect and SpO ₂ , here, we present a quantitative method to measure the severity of airway obstruction without requiring active patient involvement.

SIGNIFICANCE

The proposed VB-PARE system contributes to the state-of-art respiration monitoring methods by expanding the idea of passive and noninvasive airway resistance measurement.

Solar powered wrist worn acquisition system for continuous photoplethysmogram monitoring

We present a solar-powered, wireless, wrist-worn platform for continuous monitoring of physiological and environmental parameters during the activities of daily life. In this study, we demonstrate the capability to produce photoplethysmogram (PPG) signals using this platform. To adhere to a low power budget for solar-powering, a 574 nm green light source is used where the PPG from the radial artery would be obtained with minimal signal conditioning. The system incorporates two monocrystalline solar cells to charge the onboard 20 mAh lithium polymer battery. Bluetooth Low Energy (BLE) is used to tether the device to a smartphone that makes the phone an access point to a dedicated server for long term continuous storage of data. Two power management schemes have been proposed depending on the availability of solar energy. In low light situations, if the battery is low, the device obtains a 5-second PPG waveform every minute to consume an average power of 0.57 mW. In scenarios where the battery is at a sustainable voltage, the device is set to enter its normal 30 Hz acquisition mode, consuming around 13.7 mW. We also present our efforts towards improving the charge storage capacity of our on-board super-capacitor.

Laser speckle spatiotemporal variance analysis for noninvasive widefield measurements of blood pulsation and pulse rate on a camera-phone

Photoplethysmography is a well-established technique for the noninvasive measurement of blood pulsation. However, photoplethysmographic devices typically need to be in contact with the surface of the tissue and provide data from a single contact point. Extensions of conventional photoplethysmography to measurements over a wide field-of-view exist, but require advanced signal processing due to the low signal-to-noise-ratio of the photoplethysmograms. Here, we present a noncontact method based on temporal sampling of time-integrated speckle using a camera-phone for noninvasive, widefield measurements of physiological parameters across the human fingertip including blood pulsation and resting heart-rate frequency. The results show that precise estimation of these parameters with high spatial resolution is enabled by measuring the local temporal variation of speckle patterns of backscattered light from subcutaneous skin, thereby opening up the possibility for accurate high resolution blood pulsation imaging on a camera-phone. Camera-phone laser speckle imager along with measured relative blood perfusion maps of a fingertip showing skin perfusion response to a pulse pressure applied to the upper arm. The figure is for illustration only; the imager was stabilized on a stand throughout the experiments.

On Time Domain Analysis of Photoplethysmogram Signals for Monitoring Heat Stress

There are a limited number of studies on heat stress dynamics during exercise using the photoplethysmogram (PPG) and its second derivative (APG). However, we investigate the most suitable index from short PPG signal recordings for heat stress assessment. The APG waveform consists of a, b, c and d waves in systole and an e wave in diastole. Our preliminary results indicate that the use of the energy of aa area, derived from PPG signals measured from emergency responders in tropical conditions, is promising in determining the heat stress level using 20-s recordings. After examining 14 time domain features using leave-one-out cross-validation, we found that the aa energy extracted from PPG signals is the most informative feature for classifying heat-stressed subjects, with an overall accuracy of 79%. Moreover, the combination of the aa energy with the traditional heart rate variability index of heat stress (i.e., the square root of the mean of the squares of the successive aa intervals) improved the heat stress detection to an overall accuracy of 83%.

Photoplethysmography Revisited: From Contact to Noncontact, From Point to Imaging

Photoplethysmography (PPG) is a noninvasive optical technique for detecting microvascular blood volume changes in tissues. Its ease of use, low cost and convenience make it an attractive area of research in the biomedical and clinical communities. Nevertheless, its single spot monitoring and the need to apply a PPG sensor directly to the skin limit its practicality in situations such as perfusion mapping and healing assessments or when free movement is required. The introduction of fast digital cameras into clinical imaging monitoring and diagnosis systems, the desire to reduce the physical restrictions, and the possible new insights that might come from perfusion imaging and mapping inspired the evolution of the conventional PPG technology to imaging PPG (IPPG). IPPG is a noncontact method that can detect heart-generated pulse waves by means of peripheral blood perfusion measurements. Since its inception, IPPG has attracted significant public interest and provided opportunities to improve personal healthcare. This study presents an overview of the wide range of IPPG systems currently being introduced along with examples of their application in various physiological assessments. We believe that the widespread acceptance of IPPG is happening, and it will dramatically accelerate the promotion of this healthcare model in the near future.

Validation of a wrist monitor for accurate estimation of RR intervals during sleep

While the incidence of sleep disorders is continuously increasing in western societies, there is a clear demand for technologies to asses sleep-related parameters in ambulatory scenarios. The present study introduces a novel concept of accurate sensor to measure RR intervals via the analysis of photo-plethysmographic signals recorded at the wrist. In a cohort of 26 subjects undergoing full night polysomnography, the wrist device provided RR interval estimates in agreement with RR intervals as measured from standard electrocardiographic time series. The study showed an overall agreement between both approaches of 0.05 ± 18 ms. The novel wrist sensor opens the door towards a new generation of comfortable and easy-to-use sleep monitors.

Advances in photoplethysmography: beyond arterial oxygen saturation

PURPOSE

Photoplethysmography permits continuous measurement of heart rate and peripheral oxygen saturation and has been widely used to inform clinical decisions. Recently, a myriad of noninvasive hemodynamic monitoring devices using this same technology have been increasingly available. This narrative review aims to summarize the principles that form the basis for the function of these devices as well as to comment on trials evaluating their accuracy and clinical application.

PRINCIPAL FINDINGS

Advanced monitoring devices extend photoplethysmography technology beyond measuring oxygen concentration and heart rate. Quantification of respiratory variation of the photoplethysmographic waveform reflects respiratory variation of the arterial pressure waveform and can be used to gauge volume responsiveness. Both the volume-clamp and physiocal techniques are extensions of conventional photoplethysmography and permit continuous measurement of finger arterial blood pressure. Finger arterial pressure waveforms can subsequently inform estimations of cardiac output.

CONCLUSIONS

Although respiratory variations of the plethysmographic waveform correlate only modestly with the arterial blood pressure waveform, fluid responsiveness can be relatively consistently assessed using both approaches. Continuous blood pressure measurements obtained using the volume-clamp technique may be as accurate as conventional brachial noninvasive blood pressure measurements. Most importantly, clinical comparative effectiveness studies are still needed in order to determine if these technologies can be translated into improvement of relevant patient outcomes.

Simultaneous analysis system for blood pressure and flow using photoplethysmography and ultrasonic-measurement-integrated simulation

We developed a simultaneous analysis system for blood pressure and flow using photoplethysmography and ultrasonic-measurement-integrated simulation. The validity of the system was confirmed by analysis of blood flow field in a carotid artery and corresponding wave intensity (WI) values.

Devepopment of an optical probe to investigate the suitability of measuring photoplethysmographs and blood oxygen saturation from the human auditory canal

Pulse oximetry has become a standard for patient monitoring in the operating room, and the finger is the most common site used for monitoring blood oxygen saturation (SpO2). However, SpO2 measurements made from extremities such as the finger, ear lobe and toes become susceptible to inaccuracies, when patients become hypothermic, hypovolemic and vasoconstrictive. This is due to the week arterial pulsations detected in these conditions. To overcome this limitation, the external auditory canal has been proposed as an alternative monitoring site for estimating SpO2, on the hypothesis that this central site will be better perfused. A dual wavelength optoelectronic sensor along with a processing system was developed to investigate the suitability of measuring photoplethysmographic (PPG) signals and SpO2 values in the human auditory canal. A pilot study was conducted on 12 healthy volunteers to validate the developed sensor. The red and infrared PPG signals obtained from all the volunteers were of very good quality. The SpO2 values recorded from the ear canal were compared with simultaneously acquired data from a commercial finger pulse oximeter. The results show good correlation between the commercial pulse oximeter and the custom made ear canal sensor (r(2) = 0.825).

Evaluation of a combined reflectance photoplethysmography and laser Doppler flowmetry surface probe

This study presents evaluation of a system combining laser Doppler flowmetry and photoplethysmography (PPG) in a single probe for the simultaneous measurement of perfusion and blood flow in the finger. A cuff sphygmomanometer was used to partially occlude the arteries supplying the hand to investigate the effect of low pressure on photoplethysmographic and laser Doppler signals and also on calculated arterial blood oxygen saturation values (SpO2). Red and infrared PPG and Doppler signals were recorded from six healthy volunteers at various pressures. Good quality signals were recorded in all subjects at low cuff pressures; however both PPG and Doppler signals showed a gradual decrease in amplitude at higher pressures. SpO2 values calculated from the PPG signals showed higher deviation from measurements made on the contralateral hand using a commercial pulse oximeter at higher cuff pressures.

Reflective oxygen saturation monitoring at hypothenar and its validation by human hypoxia experiment

BACKGROUND

Pulse oxygen saturation (SpO2) is an important parameter for healthcare, and wearable sensors and systems for SpO2 monitoring have become increasingly popular. The aim of this paper is to develop a novel SpO2 monitoring system, which detects photoplethysmographic (PPG) signals at hypothenar with a reflection-mode sensor embedded into a glove.

METHODS

A special photo-detector section was designed with two photodiodes arranged symmetrically to the red and infrared light-emitting diodes (LED) to enhance the signal quality. The reflective sensor was placed in a soft silicon substrate sewn in a glove to fit the surface of the hypothenar. To lower the power consumption, the LED driving current was reduced and energy-efficient electronic components were applied. The performance for PPG signal detection and SpO2 monitoring was evaluated by human hypoxia experiments. Accelerometer-based adaptive noise cancellation (ANC) methods applying the least mean squares (LMS) and recursive least squares (RLS) algorithms were studied to suppress motion artifact.

RESULTS

A total of 20 subjects participated in the hypoxia experiment. The degree of comfort for wearing this system was accepted by them. The PPG signals were detected effectively at SpO2 levels from about 100-70%. The experiment validated the accuracy of the system was 2.34%, compared to the invasive measurements. Both the LMS and RLS algorithms improved the performance during motion. The total current consumed by the system was only 8 mA.

CONCLUSIONS

It is feasible to detect PPG signal and monitor SpO2 at the location of hypothenar. This novel system can achieve reliable SpO2 measurements at different SpO2 levels and on different individuals. The system is light-weighted, easy to wear and power-saving. It has the potential to be a solution for wearable monitoring, although more work should be conducted to improve the motion-resistant performance significantly.

An Ear-Worn Vital Signs Monitor

This paper presents a wearable vital signs monitor at the ear. The monitor measures the electrocardiogram (ECG), ballistocardiogram (BCG), and photoplethysmogram (PPG) to obtain pre-ejection period (PEP), stroke volume (SV), cardiac output (CO), and pulse transit time (PTT). The ear is demonstrated as a natural anchoring point for the integrated sensing of physiological signals. All three signals measured can be used to obtain heart rate (HR). Combining the ECG and BCG allows for the estimation of the PEP, while combining the BCG and PPG allows for the measurement of PTT. Additionally, the J-wave amplitude of the BCG is correlated with the SV and, when combined with HR, yields CO. Results from a clinical human study on 13 subjects demonstrate this proof-of-concept device.

A Comparative Study of Physiological Monitoring with a Wearable Opto-Electronic Patch Sensor (OEPS) for Motion Reduction

This paper presents a comparative study in physiological monitoring between a wearable opto-electronic patch sensor (OEPS) comprising a three-axis Microelectromechanical systems (MEMs) accelerometer (3MA) and commercial devices. The study aims to effectively capture critical physiological parameters, for instance, oxygen saturation, heart rate, respiration rate and heart rate variability, as extracted from the pulsatile waveforms captured by OEPS against motion artefacts when using the commercial probe. The protocol involved 16 healthy subjects and was designed to test the features of OEPS, with emphasis on the effective reduction of motion artefacts through the utilization of a 3MA as a movement reference. The results show significant agreement between the heart rates from the reference measurements and the recovered signals. Significance of standard deviation and error of mean yield values of 2.27 and 0.65 beats per minute, respectively; and a high correlation (0.97) between the results of the commercial sensor and OEPS. T, Wilcoxon and Bland-Altman with 95% limit of agreement tests were also applied in the comparison of heart rates extracted from these sensors, yielding a mean difference (MD: 0.08). The outcome of the present work incites the prospects of OEPS on physiological monitoring during physical activities.

Estimation of respiratory rate from photoplethysmographic imaging videos compared to pulse oximetry

We present a study evaluating two respiratory rate estimation algorithms using videos obtained from placing a finger on the camera lens of a mobile phone. The two algorithms, based on Smart Fusion and empirical mode decomposition (EMD), consist of previously developed signal processing methods to detect features and extract respiratory induced variations in photoplethysmographic signals to estimate respiratory rate. With custom-built software on an Android phone, photoplethysmographic imaging videos were recorded from 19 healthy adults while breathing spontaneously at respiratory rates between 6 to 32 breaths/min. Signals from two pulse oximeters were simultaneously recorded to compare the algorithms' performance using mobile phone data and clinical data. Capnometry was recorded to obtain reference respiratory rates. Two hundred seventy-two recordings were analyzed. The Smart Fusion algorithm reported 39 recordings with insufficient respiratory information from the photoplethysmographic imaging data. Of the 232 remaining recordings, a root mean square error (RMSE) of 6 breaths/min was obtained. The RMSE for the pulse oximeter data was lower at 2.3 breaths/min. RMSE for the EMD method was higher throughout all data sources as, unlike the Smart Fusion, the EMD method did not screen for inconsistent results. The study showed that it is feasible to estimate respiratory rates by placing a finger on a mobile phone camera, but that it becomes increasingly challenging at respiratory rates greater than 20 breaths/min, independent of data source or algorithm tested.

On the benefits of alternative color spaces for noncontact heart rate measurements using standard red-green-blue cameras

Existing video plethysmography methods use standard red-green-blue (sRGB) video recordings of the facial region to estimate heart pulse rate without making contact with the person being monitored. Methods achieving high estimation accuracy require considerable signal-processing power and result in significant processing latency. High processing power and latency are limiting factors when real-time pulse rate estimation is required or when the sensing platform has no access to high processing power. We investigate the use of alternative color spaces derived from sRGB video recordings as a fast light-weight alternative to pulse rate estimation. We consider seven color spaces and compare their performance with state-of-the-art algorithms that use independent component analysis. The comparison is performed over a dataset of 41 video recordings from subjects of varying skin tone and age. Results indicate that the hue channel provides better estimation accuracy using extremely low computation power and with practically no latency.

Reflectance Photoplethysmography as Noninvasive Monitoring of Tissue Blood Perfusion

In the last decades, photoplethysmography (PPG) has been used as a noninvasive technique for monitoring arterial oxygen saturation by pulse oximetry (PO), whereas near-infrared spectroscopy (NIRS) has been employed for monitoring tissue blood perfusion. While NIRS offers more parameters to evaluate oxygen delivery and consumption in deep tissues, PO only assesses the state of oxygen delivery. For a broader assessment of blood perfusion, this paper explores the utilization of dual-wavelength PPG by using the pulsatile (ac) and continuous (dc) PPG for the estimation of arterial oxygen saturation (SpO2) by conventional PO. Additionally, the Beer-Lambert law is applied to the dc components only for the estimation of changes in deoxyhemoglobin (HHb), oxyhemoglobin (HbO2), and total hemoglobin (tHb) as in NIRS. The system was evaluated on the forearm of 21 healthy volunteers during induction of venous occlusion (VO) and total occlusion (TO). A reflectance PPG probe and NIRS sensor were applied above the brachioradialis, PO sensors were applied on the fingers, and all the signals were acquired simultaneously. While NIRS and forearm SpO2 indicated VO, SpO2 from the finger did not exhibit any significant drop from baseline. During TO, all the indexes indicated the change in blood perfusion. HHb, HbO2, and tHb changes estimated by PPG presented high correlation with the same parameters obtained by NIRS during VO (r(2) = 0.960, r(2) = 0.821, and r(2) = 0.974, respectively) and during TO (r(2) = 0.988, r(2) = 0.940, and r(2) = 0.938, respectively). The system demonstrated the ability to extract valuable information from PPG signals for a broader assessment of tissue blood perfusion.

iPhysioMeter: a smartphone photoplethysmograph for measuring various physiological indices

iPhysioMeter is a new smartphone application ("App") for the Apple iPhone and iPod touch that allows photoplethysmography (PPG) to be implemented without the need for any additional devices. The resulting signal, the photoplethysmogram, allows the calculation of basic but valuable and frequently used physiological indices such as heart rate (HR) and pulse volume (PV). The design of iPhysioMeter has very much been influenced by a consideration of usability, as is immediately evident from ones first experience with it. However, its apparent simplicity in use should not disguise the need for correct operation, which otherwise might lead to collection of invalid or inaccurate data. There are several unexpected pitfalls that might not only produce inaccurate values, but, under some circumstances, could also damage the device or present a hazard to the user or subject. We therefore describe here, firstly, the core technology that makes it possible to perform PPG and to calculate HR and normalized PV (NPV) from the photoplethysmogram using only a smartphone, secondly, the correct and optimum methods and procedures for using iPhysioMeter that will help to ensure safety and the derivation of valid data under real operational conditions. We hope that these descriptions will help facilitate any activities related to physiological measurement when using only a smartphone.

Exploiting spatial redundancy of image sensor for motion robust rPPG

Remote photoplethysmography (rPPG) techniques can measure cardiac activity by detecting pulse-induced color variations on human skin using an RGB camera. State-of-the-art rPPG methods are sensitive to subject body motions (e.g., motion-induced color distortions). This study proposes a novel framework to improve the motion robustness of rPPG. The basic idea of this paper originates from the observation that a camera can simultaneously sample multiple skin regions in parallel, and each of them can be treated as an independent sensor for pulse measurement. The spatial redundancy of an image sensor can thus be exploited to distinguish the pulse signal from motion-induced noise. To this end, the pixel-based rPPG sensors are constructed to estimate a robust pulse signal using motion-compensated pixel-to-pixel pulse extraction, spatial pruning, and temporal filtering. The evaluation of this strategy is not based on a full clinical trial, but on 36 challenging benchmark videos consisting of subjects that differ in gender, skin types, and performed motion categories. Experimental results show that the proposed method improves the SNR of the state-of-the-art rPPG technique from 3.34 to 6.76 dB, and the agreement ( ±1.96σ) with instantaneous reference pulse rate from 55% to 80% correct. ANOVA with post hoc comparison shows that the improvement on motion robustness is significant. The rPPG method developed in this study has a performance that is very close to that of the contact-based sensor under realistic situations, while its computational efficiency allows real-time processing on an off-the-shelf computer.

A new device for continuous assessment of gut perfusion: proof of concept on a porcine model of septic shock

INTRODUCTION

We evaluate an innovative device consisting of an enteral feeding tube equipped with a photoplethysmography (PPG) sensor in contact with the duodenal mucosa. This study aims to determine if the PPG signal, composed of a continuous (PDC) and a pulsatile part (PAC), is a reliable method to assess gut perfusion in a porcine model of septic shock.

METHOD

Fourteen piglets were anesthetized and mechanically ventilated. They were randomly assigned to two groups: the nonseptic (NS) group received an infusion of Ringer's lactate solution (RL) alone, the septic (S) group received in addition a suspension of live Pseudomonas aeruginosa. Heart rate (HR), pulse oximetry (SpO2), mean arterial pressure (MAP), cardiac index (CI) and serum lactates were recorded and gut microcirculation (GM) was monitored with a laser Doppler probe applied on the duodenal serosa. PDC and PAC were given by the PPG probe inserted in the duodenum. Data was collected every 15 minutes (t0, t15…) during 150 minutes (t150). After administration of the bacteria suspension (t0), resuscitation maneuvers were performed following a defined algorithm. GM PAC, and PDC were expressed as variation from baseline (GMvar, PACvar, PDCvar). Analysis of variance (ANOVA) with repeated measures was performed to compare hemodynamic variables, with Bonferroni correction as post hoc analysis on t0, t60 and t150.

RESULTS

One piglet was withdrawn from analysis due to a defective probe. S group (six piglets) received resuscitation therapy while NS group (seven piglets) did not. A significant group effect was found for the all parameters except HR. Post hoc analysis found a significant decrease for GM and PAC at t60. The correlation between PAC, PDC and microcirculatory parameters were as follows: rPACvar-GMvar = 0.496, P <0.001, rPDCvar-GMvar = 0.244; P = 0.002. In the septic group, correlations were as follows: rPAC-lactate = -0.772, P <0.001; rPDC-lactate = -0.681, P <0.01). At the onset of shock, a decrease of PAC, PDC and GM occurred before the alteration of MAP.

CONCLUSIONS

PAC and PDC decreased at the onset of shock and were correlated with GM and lactate. These results confirm that PPG signal reliably reflects the early perfusion alteration of the gut. Further studies should assess the clinical use of this device.

Individualized biomonitoring in heart failure--Biomon-HF "Keep an eye on heart failure--especially at night"

In the project "Individualized Biomonitoring in Heart Failure (Biomon-HF)," innovative sensors and algorithms for measuring vital signs, i.e., during the nocturnal sleep period, have been developed and successfully tested in five clinical feasibility studies involving 115 patients. The Biomon-HF sensor concepts are an important step toward future patient-customized telemonitoring and sensor-guided therapy management in chronic heart failure, including early detection of upcoming HF exacerbation and comorbidities at home. The resulting preventable disease complications and emergencies and reduction of consequences of disease are very important advantages for the patients, causing relief for medical staff and, thus, offer an enormous potential for improvements and cost savings in healthcare systems.

Stretchable optoelectronic circuits embedded in a polymer network

Stretchable optoelectronic circuits, incorporating chip-level LEDs and photodiodes in a silicone membrane, are demonstrated. Due to its highly miniaturized design and tissue-like mechanical properties, such an optical circuit can be conformally applied to the epidermis and be used for measurement of photoplethysmograms. This level of optical functionality in a stretchable substrate is potentially of great interest for personal health monitoring.

Improved signal quality indication for photoplethysmographic signals incorporating motion artifact detection

Wearable monitoring systems have gained tremendous popularity in the health-care industry, opening new possibilities in diagnostic routines and medical treatments. Numerous hardware systems have been presented since, which allow for continuous acquisition of various biosignals like the ECG, PPG, EMG or EEG and which are suited for ambulatory settings. Unfortunately, these flexible systems are liable to motion artifacts and especially photoplethysmographic signals are seriously distorted when the patient is not at rest. A lot of work has been done to reduce artifacts and noise, ranging from simple filtering methods to very complex statistical approaches. With regard to the PPG, certain quality indices have been proposed to evaluate the signal conditions. As movements are the primary source of signal disturbances, the relation between the output of a signal quality estimator and acceleration data captured directly on the PPG sensor is focused in this work. It will be shown that typical motions can be detected on-line, thereby providing additional information which will significantly improve signal quality assessments.

Investigation of photoplethysmography and near infrared spectroscopy for the assessment of tissue blood perfusion

Pulse Oximetry (PO) and Near Infrared Spectroscopy (NIRS) are among the most widely adopted optical techniques for the assessment of tissue perfusion. PO estimates arterial oxygen saturation (SpO2) by exploiting light attenuations due to pulsatile arterial blood (AC) and constant absorbers (DC) at two different wavelengths. NIRS processes the attenuations of at least two wavelengths to calculate concentrations of Deoxygenated ([HHb]), Oxygenated ([HbO2]), Total Haemoglobin ([tHb]) and Tissue Oxygenation Index (TOI). In this work we present the development and evaluation of a reflectance PPG probe and processing system for the assessment of tissue perfusion. The system adopts both Pulse Oximetry and NIRS principles to calculate SpO2, [HHb], and [HbO2] and [tHb]. The system has been evaluated on the forearm of 10 healthy volunteers during cuff-induced vascular occlusions. The presented system was able to estimate SpO2, [HHb], [HbO2] and [tHb], showing good agreement with state-of-the-art NIRS and conventional PO.