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Marcinkevics Z, Rubins U, Aglinska A, Logina I, Glazunovs D, Grabovskis A. Contactless photoplethysmography for assessment of small fiber neuropathy. Front Physiol 2023; 14:1180288. [PMID: 37727661 PMCID: PMC10505793 DOI: 10.3389/fphys.2023.1180288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 08/02/2023] [Indexed: 09/21/2023] Open
Abstract
Chronic pain is a prevalent condition affecting approximately one-fifth of the global population, with significant impacts on quality of life and work productivity. Small fiber neuropathies are a common cause of chronic pain, and current diagnostic methods rely on subjective self-assessment or invasive skin biopsies, highlighting the need for objective noninvasive assessment methods. The study aims to develop a modular prototype of a contactless photoplethysmography system with three spectral bands (420, 540, and 800 nm) and evaluate its potential for assessing peripheral neuropathy patients via a skin topical heating test and spectral analyses of cutaneous flowmotions. The foot topical skin heating test was conducted on thirty volunteers, including fifteen healthy subjects and fifteen neuropathic patients. Four cutaneous nerve fiber characterizing parameters were evaluated at different wavelengths, including vasomotor response trend, flare area, flare intensity index, and the spectral power of cutaneous flowmotions. The results show that neuropathic patients had significantly lower vasomotor response (50%), flare area (63%), flare intensity index (19%), and neurogenic component (54%) of cutaneous flowmotions compared to the control group, independent of photoplethysmography spectral band. An absolute value of perfusion was 20%-30% higher in the 420 nm band. Imaging photoplethysmography shows potential as a cost-effective alternative for objective and non-invasive assessment of neuropathic patients, but further research is needed to enhance photoplethysmography signal quality and establish diagnostic criteria.
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Affiliation(s)
- Zbignevs Marcinkevics
- Department of Human and Animal Physiology, Faculty of Biology, University of Latvia, Riga, Latvia
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, Riga, Latvia
| | - Uldis Rubins
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, Riga, Latvia
| | - Alise Aglinska
- Department of Human and Animal Physiology, Faculty of Biology, University of Latvia, Riga, Latvia
| | - Inara Logina
- Department of Neurology and Neurosurgery, Riga Stradins University, Riga, Latvia
| | - Dmitrijs Glazunovs
- Department of Neurology and Neurosurgery, Riga Stradins University, Riga, Latvia
| | - Andris Grabovskis
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, Riga, Latvia
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2
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Cheng D, Wang J, Yokota T, Someya T. Spatiotemporal processing in photoplethysmography for skin microcirculatory perfusion imaging. BIOMEDICAL OPTICS EXPRESS 2022; 13:838-849. [PMID: 35284154 PMCID: PMC8884234 DOI: 10.1364/boe.442764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/16/2021] [Accepted: 10/27/2021] [Indexed: 05/09/2023]
Abstract
Technological advances in the real-time visualization of cutaneous microcirculation aim to realize benefits including high-resolution imaging, suppressed noise, and robust temporal coherence. Photoplethysmography (PPG), a noninvasive technique that measures single or multiple points of relative blood volume changes in blood vessels under the skin, shows potential as a signal candidate for visualizing blood vessels and tracking blood flow. However, challenges still remain, such as extracting/image reconstruction of the blood vessel/flow signal in a precise frequency window (<0.2 Hz) from a noisy image that is caused by the loss of spatial coherence of the light source in a turbid biological tissue. We attempted to overcome this challenge by adopting a combination of direct-contact-type, lens-less, conformable imagers and singular value decomposition (SVD) in this study. We focused on the numerical analysis of SVD for discriminating the tissue and vein blood flow in PPG for reconstructing blood fluidic images, followed by a complete demonstration of skin microcirculation blood tracking in the vessel visualization process when applying our lens-less, conformable, wearable imagers.
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Quotb A, Atashkhooei R, Magaletti S, Jayat F, Tronche C, Goechnahts J, Perchoux J. Methods and Limits for Micro Scale Blood Vessel Flow Imaging in Scattering Media by Optical Feedback Interferometry: Application to Human Skin. SENSORS 2021; 21:s21041300. [PMID: 33670276 PMCID: PMC7918789 DOI: 10.3390/s21041300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 12/02/2022]
Abstract
At the micrometric scale, vessels or skin capillaries network architecture can provide useful information for human health management. In this paper, from simulation to in vitro, we investigate some limits and interests of optical feedback interferometry (OFI) for blood flow imaging of skin vascularization. In order to analyze the tissue scattering effect on OFI performances, a series of skin-tissue simulating optical phantoms have been designed, fabricated and characterized. The horizontal (2D) and vertical (depth penetration) sensing resolution of the OFI sensor have been estimated. The experimental results that we present on this study are showing a very good accordance with theoretical models. In the case of a skin phantom of 0.5 mm depth with a scattering coefficient from 0 to 10.8 mm−1, the presented OFI system is able to distinguish a pair of micro fluidic channels (100 µm × 100 µm) spaced by 10 µm. Eventually, an in vivo test on human skin is presented and, for the first time using an OFI sensor, a 2D blood flow image of a vein located just beneath the skin is computed.
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Affiliation(s)
- Adam Quotb
- LAAS-CNRS, Université de Toulouse, CNRS, INP-ENSEEIHT, 31400 Toulouse, France; (S.M.); (F.J.); (C.T.); (J.G.); (J.P.)
- Correspondence:
| | - Reza Atashkhooei
- Centre for the Development of Sensors, Instruments and Systems, Universitat Politècnica deCatalunya (UPC-CD6), Rambla Sant Nebridi, 10, E08222 Terrassa, Spain;
| | - Simone Magaletti
- LAAS-CNRS, Université de Toulouse, CNRS, INP-ENSEEIHT, 31400 Toulouse, France; (S.M.); (F.J.); (C.T.); (J.G.); (J.P.)
| | - Francis Jayat
- LAAS-CNRS, Université de Toulouse, CNRS, INP-ENSEEIHT, 31400 Toulouse, France; (S.M.); (F.J.); (C.T.); (J.G.); (J.P.)
| | - Clement Tronche
- LAAS-CNRS, Université de Toulouse, CNRS, INP-ENSEEIHT, 31400 Toulouse, France; (S.M.); (F.J.); (C.T.); (J.G.); (J.P.)
| | - Julien Goechnahts
- LAAS-CNRS, Université de Toulouse, CNRS, INP-ENSEEIHT, 31400 Toulouse, France; (S.M.); (F.J.); (C.T.); (J.G.); (J.P.)
| | - Julien Perchoux
- LAAS-CNRS, Université de Toulouse, CNRS, INP-ENSEEIHT, 31400 Toulouse, France; (S.M.); (F.J.); (C.T.); (J.G.); (J.P.)
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4
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Aloweni FAB, Ang SY, Chang YY, Ng XP, Teo KY, Choh ACL, Goh IHQ, Lim SH. Evaluation of infrared technology to detect category I and suspected deep tissue injury in hospitalised patients. J Wound Care 2020; 28:S9-S16. [PMID: 31825768 DOI: 10.12968/jowc.2019.28.sup12.s9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the use of an infrared thermography device in assessing skin temperature among category I pressure ulcer (PU) and/or suspected deep tissue injuries (SDTI) with intact skin. METHODS An observational cross-sectional study design was used. Adult inpatients (cases) who had a category I PU or suspected deep tissue injury (skin intact) on the sacral or heel during the study period (March to April 2018) were recruited. Patients without a PU were also recruited to act as control. Thermal images of the patient's PU site and non-PU site were taken within 24 hours of PU occurrence. Thermal images of the control patients (no PU) were also taken. Each PU case was matched to three control patients in terms of age, gender, race and anatomical sites. All thermal images were taken using a portable CAT S60 Thermal Imaging Rugged Smartphone (Caterpillar Inc., US) that provided readings of the skin temperature in degrees Celsius. RESULTS A total of 17 cases and 51 controls were recruited. Among the cases, the mean difference in skin temperature between the PU site (mean: 31.14°C; standard deviation [SD]: 1.54) and control site within the cases (mean: 28.93°C; SD: 3.47) was significant (difference: 2.21±3.66°C; p=0·024). When comparing between all cases and controls, the mean temperature difference was non-significant. When comparing between the category I PU and suspected deep pressure injury cases, the mean difference was also non-significant. CONCLUSION Using infrared thermography technology at the bedside to measure skin temperature will support the clinical diagnosis of patients with skin types I to III. However, there is a need for a more accurate and objective measurement to identify and diagnose early category I PU or suspected deep tissue injury in adult patients with darker skin types 4 and above, enabling early initiation of preventive measures in the hospital acute care setting.
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Affiliation(s)
| | - Shin Yuh Ang
- Division of Nursing, Singapore General Hospital, Singapore
| | - Yee Yee Chang
- Division of Nursing, Singapore General Hospital, Singapore
| | - Xin Ping Ng
- Division of Nursing, Singapore General Hospital, Singapore
| | - Kai Yunn Teo
- Division of Nursing, Singapore General Hospital, Singapore
| | | | - Ivy Hui Qi Goh
- Division of Nursing, Singapore General Hospital, Singapore
| | - Siew Hoon Lim
- Division of Nursing, Singapore General Hospital, Singapore
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Monteiro Rodrigues L, Rocha C, Ferreira HT, Silva HN. Lower limb massage in humans increases local perfusion and impacts systemic hemodynamics. J Appl Physiol (1985) 2020; 128:1217-1226. [PMID: 32191595 DOI: 10.1152/japplphysiol.00437.2019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Massage is commonly used as a complementary therapy for many different conditions. Demonstration of its physiological impact and understanding of its therapeutic mechanisms is still insufficient and often inconclusive. This study aims to characterize the physiological effects of effleurage, one of the most popular techniques, on human in vivo microcirculation and its impact on cardiovascular function. Two differently oriented variations of the technique, referred to influence physiological outcomes, were applied to 32 young (mean 19.8 ± 1.6 yr old) healthy volunteers of both sexes in a single, randomly chosen limb after informed written consent. Each protocol included a 10-min baseline (Phase I), a 5-min massage (Phase II), and a 10-min recovery (Phase III) register. A 30-min washout period separated both protocols. Perfusion was assessed by laser Doppler flowmetry (LDF) and reflection photoplethysmography (PPG), with their sensors applied distally in both feet. Blood pressure and pulse were also obtained. LDF signals were further analyzed in their components by the (Morlet) wavelet transform to probe the mechanisms involved. Results showed that effleurage consistently evoked a significant (P < 0.001) perfusion increase in the massaged limb, also visible in the contralateral limb (not significant) independently from the orientation (variant) used. No matter the perfusion differences known between sexes, the adaptive response was equivalent in both sexes. The component analysis of the LDF curves also suggests that these procedures, although brief and superficial, do modify multiple components of cardiovascular integration, with cardiac, respiratory, and myogenic components appearing to play a major role in reestablishing distal microcirculatory homeostasis.NEW & NOTEWORTHY The impact of effleurage, a well-known massage procedure used in human rehabilitation, in the lower limb hemodynamics, is demonstrated. When applied in a sole limb, massage increases skin microcirculatory flowmotion not only locally but also beyond, affecting systemic hemodynamics. This observation is an interesting example of the efficacy of cardiovascular integration mechanisms involving distal microcirculatory homeostasis. The proposed methodology allows a mechanistic view over skin flowmotion regulation, being applicable to further explore massage and its impact on microcirculatory physiology.
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Affiliation(s)
- Luis Monteiro Rodrigues
- CBIOS Research Center for Biosciences and Health Technologies, Universidade Lusófona, Lisbon, Portugal
| | - Clemente Rocha
- CBIOS Research Center for Biosciences and Health Technologies, Universidade Lusófona, Lisbon, Portugal
| | - Hugo T Ferreira
- Faculty of Sciences, Institute for Biophysics and Biomedical Engineering, Universidade de Lisboa, Lisbon, Portugal
| | - Henrique N Silva
- CBIOS Research Center for Biosciences and Health Technologies, Universidade Lusófona, Lisbon, Portugal.,Faculty of Pharmacy and Pharmacology, Science Department, Universidade de Lisboa, Lisbon, Portugal
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6
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A pilot study: Wavelet cross-correlation of cardiovascular oscillations under controlled respiration in humans. Microvasc Res 2020; 130:103993. [PMID: 32194083 DOI: 10.1016/j.mvr.2020.103993] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/10/2020] [Accepted: 03/10/2020] [Indexed: 12/16/2022]
Abstract
The influence of deep controlled respiration on cardiovascular oscillations in 13 healthy young volunteers was studied. A measurement system comprising electrocardiography, laser Doppler flowmetry (LDF) and photoplethysmography (PPG) was used to estimate heart rate variability (HRV), tissue blood volume and skin blood perfusion at spontaneous respiration and during three tests at controlled conditions. In the latter case, respiration was controlled in both rate (0.04, 0.1 and 0.25 Hz) and depth. During respiration at 0.04 and 0.1 Hz, the amplification of a respiratory-related component in the spectra of HRV and PPG signals turned out to be more significant than that at spontaneous respiration, and at 0.25 Hz this component remained unchanged. Controlled respiration caused a significant increase in correlation in HRV-PPG, HRV-LDF and PPG-LDF pairs of signals compared to spontaneous one. At 0.25 Hz controlled respiration, no significant increase in correlation in these pairs of signals was found. The differences observed in this study can be attributed to the effects of the sympathetic nerve activity on vascular tone regulation.
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7
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Rodrigues LM, Rocha C, Ferreira H, Silva H. Different lasers reveal different skin microcirculatory flowmotion - data from the wavelet transform analysis of human hindlimb perfusion. Sci Rep 2019; 9:16951. [PMID: 31740748 PMCID: PMC6861459 DOI: 10.1038/s41598-019-53213-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 10/29/2019] [Indexed: 12/17/2022] Open
Abstract
Laser Doppler flowmetry (LDF) and reflection photoplethysmography (PPG) are standard technologies to access microcirculatory function in vivo. However, different light frequencies mean different interaction with tissues, such that LDF and PPG flowmotion curves might have distinct meanings, particularly during adaptative (homeostatic) processes. Therefore, we analyzed LDF and PPG perfusion signals obtained in response to opposite challenges. Young healthy volunteers, both sexes, were assigned to Group 1 (n = 29), submitted to a normalized Swedish massage procedure in one lower limb, increasing perfusion, or Group 2 (n = 14), submitted to a hyperoxia challenge test, decreasing perfusion. LDF (Periflux 5000) and PPG (PLUX-Biosignals) green light sensors applied distally on both lower limbs recorded perfusion changes for each experimental protocol. Both techniques detected the perfusion increase with massage, and the perfusion decrease with hyperoxia, in both limbs. Further analysis with the wavelet transform (WT) revealed better depth-related discriminative ability for PPG (more superficial, less blood sampling) compared with LDF in both challenges. Spectral amplitude profiles consistently demonstrated better sensitivity for LDF, especially regarding the lowest frequency components. Strong correlations between components were not found. Therefore, LDF and PPG flowmotion curves are not equivalent, a relevant finding to better study microcirculatory physiology.
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Affiliation(s)
- L Monteiro Rodrigues
- CBIOS - Universidade Lusófona's Research Center for Biosciences and Health Technologies, Av Campo Grande, 1749 024, Lisboa, Portugal.
- Pharmacol. Sc Depart - Universidade de Lisboa, Faculty of Pharmacy, Av Prof Gama Pinto, 1649 003, Lisboa, Portugal.
| | - Clemente Rocha
- CBIOS - Universidade Lusófona's Research Center for Biosciences and Health Technologies, Av Campo Grande, 1749 024, Lisboa, Portugal
| | - Hugo Ferreira
- IBEB - Biophysics and Biomedical Engineering Institute, Universidade de Lisboa Faculty of Sciences, Campo Grande, 1749 016, Lisboa, Portugal
| | - Henrique Silva
- CBIOS - Universidade Lusófona's Research Center for Biosciences and Health Technologies, Av Campo Grande, 1749 024, Lisboa, Portugal
- Pharmacol. Sc Depart - Universidade de Lisboa, Faculty of Pharmacy, Av Prof Gama Pinto, 1649 003, Lisboa, Portugal
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8
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Javaid A, Chouhna H, Varghese B, Hammam E, Macefield VG. Changes in skin blood flow, respiration and blood pressure in participants reporting motion sickness during sinusoidal galvanic vestibular stimulation. Exp Physiol 2019; 104:1622-1629. [PMID: 31468621 DOI: 10.1113/ep087385] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 08/27/2019] [Indexed: 12/12/2022]
Abstract
NEW FINDINGS What is the central question of the study? We have previously shown that sinusoidal galvanic vestibular stimulation induces greater modulation of skin sympathetic nerve activity, but not muscle sympathetic nerve activity, in participants who report nausea during simulated motion, but the effects on skin blood flow and blood pressure are unknown. What is the main finding and its importance? During vestibular stimulation, nausea was associated with a greater increase in skin blood flow and a progressive reduction in skin sympathetic nerve activity, but no changes in muscle sympathetic nerve activity. This emphasizes the differential changes in sympathetic outflow to different tissues during nausea. ABSTRACT We tested the hypothesis that galvanic vestibular stimulation, which produces illusions of side-to-side swaying, causes a greater reduction in skin blood flow in participants who report stimulation-induced nausea. A retrospective analysis was performed on data obtained in 30 participants. Bipolar sinusoidal galvanic vestibular stimulation (sGVS) was applied across the mastoid processes (±2 mA, 0.08 Hz) for 21 min. ECG, continuous blood pressure, respiration and skin blood flow were recorded. Muscle sympathetic nerve activity was recorded in 17 participants and skin sympathetic nerve activity in 12. Ten participants reported motion sickness, whereas 20 did not. Both groups showed an initial reduction in skin (finger) blood flow during sGVS, followed by a sustained increase and a subsequent return towards baseline levels throughout the stimulation; the increase was greater in those who experienced nausea. The increase fits with the progressive reduction in skin sympathetic nerve activity observed in the nauseous group. Mean blood pressure was significantly lower in those who experienced nausea and showed a much larger increase at the onset of sGVS, compared with those who did not. Moreover, the respiratory rate was higher at the outset for the subjects who experienced nausea, decreasing progressively during sGVS, whereas respiratory rate remained constant in those who did not experience nausea. Heart rate was more labile in the subjects who experienced nausea, showing a sustained increase towards the end of stimulation. We have shown that several autonomic parameters change during the nausea induced by vestibular stimulation, but a sustained decrease in skin blood flow is not a hallmark of incipient motion sickness.
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Affiliation(s)
- Anadil Javaid
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Houda Chouhna
- College of Medicine, Mohammed Bin Rashid University of Medicine & Health Sciences, Dubai, United Arab Emirates
| | - Ben Varghese
- College of Medicine, Mohammed Bin Rashid University of Medicine & Health Sciences, Dubai, United Arab Emirates
| | - Elie Hammam
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Vaughan G Macefield
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia.,Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
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9
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Ratnovsky A, Yanovich R, Kesner D, Ketko I, Schermann H, Heled Y, Ovadia-Blechman Z. The relation between central variables, electromyography signals and peripheral microcirculation during intensive treadmill exercise. Clin Biomech (Bristol, Avon) 2019; 67:52-60. [PMID: 31077977 DOI: 10.1016/j.clinbiomech.2019.04.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/29/2019] [Accepted: 04/30/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Aerobic exercise under muscle fatigue can lead to muscular damage and injuries. Finding the correlations between central and peripheral microcirculation variables, as well as with electromyography signals of leg muscles during aerobic exercise, may contribute to early muscle fatigue identification. The goal of this study was to characterize the peripheral compensation following intensive exercise for assessment of muscle performance based on non-invasive techniques. METHODS The experimental protocol included two days of measurements. Electrocardiography tests and anthropometric measurements of the volunteers (N = 14) were carried out. The maximal aerobic ability (first day), as well as electromyography and cutaneous hemodynamic variables (second day) were measured during treadmill run. A score-based Bayesian network machine-learning algorithm was used to predict ventilation values based on cutaneous hemodynamic measurements. FINDINGS Transcutaneous oxygen tension can be used to identify anaerobic threshold for both trained and untrained subjects during treadmill running, while electromyography can be used to identify anaerobic threshold only of trained subjects. Predicted values of ventilation, based on the transcutaneous oxygen tension, showed high correlation with actual values. Prediction accuracy was better among trained subjects, compared to the untrained ones. INTERPRETATION Transcutaneous oxygen tension could be used for prediction of maximal oxygen consumption during intense exercise and thus may provide improved assessment of premature fatigue during exercise.
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Affiliation(s)
- Anat Ratnovsky
- School of Medical Engineering, Afeka - Tel Aviv Academic College of Engineering, Israel
| | - Ran Yanovich
- The Institute of Military Physiology, The Warrior Health Research Institute, Israel Defense Forces, Medical Corps, Israel; Heller Institute of Medical Research, Sheba Medical Center, Tel Hashomer, Israel; The Zinman College of Physical Education and Sport Sciences, Wingate Institute, Israel
| | - Dikla Kesner
- School of Medical Engineering, Afeka - Tel Aviv Academic College of Engineering, Israel
| | - Itay Ketko
- The Institute of Military Physiology, The Warrior Health Research Institute, Israel Defense Forces, Medical Corps, Israel; Heller Institute of Medical Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Haggai Schermann
- The Institute of Military Physiology, The Warrior Health Research Institute, Israel Defense Forces, Medical Corps, Israel; Heller Institute of Medical Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Yuval Heled
- Heller Institute of Medical Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Zehava Ovadia-Blechman
- School of Medical Engineering, Afeka - Tel Aviv Academic College of Engineering, Israel.
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10
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Glasin J, Henricson J, Lindberg LG, Wilhelms D. Wireless vitals-Proof of concept for wireless patient monitoring in an emergency department setting. JOURNAL OF BIOPHOTONICS 2019; 12:e201800275. [PMID: 30306737 DOI: 10.1002/jbio.201800275] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/03/2018] [Accepted: 10/08/2018] [Indexed: 06/08/2023]
Abstract
Vital sign assessment is a common task in emergency medicine, but resources for continuous monitoring are restricted, data is often recorded manually, and entangled wires cause frustration. Therefore, we designed a small, wireless photoplethysmographic device capable of continuously assessing pulse, respiratory frequency and oxygen saturation on the sternum and tested the performance and feasibility in an emergency department setting. Fifty (56.3 ± 20.2 years), consenting emergency patients (29 male) were recruited. Heart rate, respiratory rate and oxygen saturation were recorded simultaneously using the device and standard monitoring equipment. Data was compared using Bland-Altman plotting (heart rate, respiratory rate) and mean difference (oxygen saturation). The bias for heart- and respiratory rate was 0.4 (limits of agreements -11.3, 12.2 and -6.1, 7.0). Mean difference for oxygen saturation was -0.21 ± 2.35%. This may be the first wireless device to use photoplethysmography on the sternum for vital sign assessment. We noted good agreement with standard monitors, but lack of standardization in data processing between monitoring systems may limit the generalizability of these findings. Although further improvements are needed, the feasibility of this approach provides proof of concept for a new paradigm of large scale, wireless patient monitoring.
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Affiliation(s)
- Joakim Glasin
- Division of Drug Research, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden
- Department of Emergency Medicine, Local Health Care Services in Central Östergötland, Sweden
| | - Joakim Henricson
- Division of Drug Research, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden
- Department of Emergency Medicine, Local Health Care Services in Central Östergötland, Sweden
| | - Lars-Göran Lindberg
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Daniel Wilhelms
- Division of Drug Research, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden
- Department of Emergency Medicine, Local Health Care Services in Central Östergötland, Sweden
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11
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Näslund E, Lindberg LG, Lund I, Näslund-Koch L, Larsson A, Frithiof R. Measuring arterial oxygen saturation from an intraosseous photoplethysmographic signal derived from the sternum. J Clin Monit Comput 2019; 34:55-62. [PMID: 30805761 PMCID: PMC6946764 DOI: 10.1007/s10877-019-00289-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 02/20/2019] [Indexed: 11/30/2022]
Abstract
Photoplethysmography performed on the peripheral extremities or the earlobes cannot always provide sufficiently rapid and accurate calculation of arterial oxygen saturation. The purpose of this study was to evaluate a novel photoplethysmography prototype to be fixed over the sternum. Our hypotheses were that arterial oxygen saturation can be determined from an intraosseous photoplethysmography signal from the sternum and that such monitoring detects hypoxemia faster than pulse oximetry at standard sites. Sixteen healthy male volunteers were subjected to incremental hypoxemia using different gas mixtures with decreasing oxygen content. The sternal probe was calibrated using arterial haemoglobin CO-oximetry (SaO2%). Sternal probe readings (SRHO2%) were then compared to SaO2% at various degrees of hypoxia. The time to detect hypoxemia was compared to measurements from standard finger and ear pulse oximeters. A significant association from individual regression between SRHO2% and SaO2% was found (r2 0.97), Spearman R ranged between 0.71 and 0.92 for the different inhaled gas mixtures. Limits of agreement according to Bland–Altman plots had a increased interval with decreasing arterial oxygen saturation. The sternal probe detected hypoxemia 28.7 s faster than a finger probe (95% CI 20.0-37.4 s, p < 0.001) and 6.6 s faster than an ear probe (95% CI 5.3–8.7 s, p < 0.001). In an experimental setting, arterial oxygen saturation could be determined using the photoplethysmography signal obtained from sternal blood flow after calibration with CO-oximetry. This method detected hypoxemia significantly faster than pulse oximetry performed on the finger or the ear.
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Affiliation(s)
- Erik Näslund
- Department of Surgical Sciences, Section of Anaesthesia & Intensive Care, Uppsala University, Uppsala, Sweden. .,Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden. .,Department of Anaesthesia, Gävle Hospital, 801 87, Gävle, Sweden.
| | - Lars-Göran Lindberg
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Iréne Lund
- Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | | | - Agneta Larsson
- Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden.,Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Robert Frithiof
- Department of Surgical Sciences, Section of Anaesthesia & Intensive Care, Uppsala University, Uppsala, Sweden
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12
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Tamura T. Current progress of photoplethysmography and SPO 2 for health monitoring. Biomed Eng Lett 2019; 9:21-36. [PMID: 30956878 PMCID: PMC6431353 DOI: 10.1007/s13534-019-00097-w] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 01/05/2019] [Accepted: 01/15/2019] [Indexed: 11/28/2022] Open
Abstract
A photoplethysmograph (PPG) is a simple medical device for monitoring blood flow and transportation of substances in the blood. It consists of a light source and a photodetector for measuring transmitted and reflected light signals. Clinically, PPGs are used to monitor the pulse rate, oxygen saturation, blood pressure, and blood vessel stiffness. Wearable unobtrusive PPG monitors are commercially available. Here, we review the principle issues and clinical applications of PPG for monitoring oxygen saturation.
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Affiliation(s)
- Toshiyo Tamura
- Future Robotics Institute, Wadeda University, Tokyo, Japan
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Kudo Y, Sasaki M, Kikuchi Y, Sugiyama R, Hasebe M, Ishii N. Effects of a warm hand bath on the blood flow in the shoulder, skin and deep body temperature, autonomic nervous activity, and subjective comfort in healthy women: An experimental cross-over trial. Jpn J Nurs Sci 2018; 16:88-100. [PMID: 29920941 DOI: 10.1111/jjns.12216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 04/04/2018] [Indexed: 12/01/2022]
Abstract
AIM The present study was conducted in order to clarify the effects of a warm hand bath at 40°C for 10 min on the blood flow in the shoulder, skin and deep body temperature, autonomic nervous activity, and subjective comfort in healthy women. METHODS The study's participants were 40 healthy adult women who were randomly assigned to either a structured hand bath first and no hand bath second (Group A) or to no hand bath first and a hand bath second (Group B). The blood flow in the shoulder, skin and deep body temperature, autonomic nervous activity, and subjective comfort then were recorded in all the participants. RESULTS A repeated-measures ANOVA revealed no significant difference in the blood flow in the right shoulder or deep body temperature between groups. The skin temperature of the hands, forearms, and arms was significantly increased, but not of the face and upper back. The skin temperature of the forearms was maintained at 0.5°C-1°C higher for 30 min in the hand bath group, compared with the no hand bath group. The hand bath group had a significantly higher heart rate while bathing and a significantly lower parasympathetic nerve activity level during bathing. No significant difference was seen in the sympathetic activity level between groups. The hand bath group had a significantly higher subjective comfort level. CONCLUSION Hand baths can improve the level of subjective comfort and increase the heart rate and might affect autonomic nervous activity. The skin temperature of the forearms was maintained for 30 min in the hand bath group.
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Affiliation(s)
- Yukiko Kudo
- Akita University Graduate School of Health Sciences, Akita, Japan
| | - Makiko Sasaki
- Akita University Graduate School of Health Sciences, Akita, Japan
| | - Yukiko Kikuchi
- Akita University Graduate School of Health Sciences, Akita, Japan
| | - Reiko Sugiyama
- Akita University Graduate School of Health Sciences, Akita, Japan
| | - Makiko Hasebe
- Akita University Graduate School of Health Sciences, Akita, Japan
| | - Noriko Ishii
- Faculty of Health Sciences, Hokkaido University of Science, Hokkaido, Japan
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Källman U, Bergstrand S, Ek AC, Engström M, Lindgren M. Blood flow responses over sacrum in nursing home residents during one hour bed rest. Microcirculation 2018; 23:530-539. [PMID: 27534925 PMCID: PMC5096247 DOI: 10.1111/micc.12303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 08/11/2016] [Indexed: 11/29/2022]
Abstract
Objectives To describe individual BF responses in a nursing home resident population for one‐hour periods of bed rest. Methods BF was measured for one hour over the sacrum in 0° supine position and 30° supine tilt position in 25 individuals aged 65 y or older while lying on a pressure‐redistributing mattress. Measurements were made at three tissue depths (1, 2, and 10 mm) using the noninvasive optical techniques, LDF and PPG. Results Eleven participants had a PIV response at 1 mm depth in both positions and seven participants had a lack of this response at this depth and positions. The BF response at 1 mm depth appeared immediately and remained over, or below, baseline for the entire 60 min of loading in both positions. These BF patterns were also seen in deeper tissue layers. Conclusions The cutaneous BF response among the nursing home residents was distinct, appeared early, and remained during the one hour of loading.
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Affiliation(s)
- Ulrika Källman
- Department of Medical and Health Sciences, Division of Nursing Linköping University, Linköping, Sweden. .,Department of Research, Södra Älvsborgs Sjukhus, Borås, Sweden.
| | - Sara Bergstrand
- Department of Medical and Health Sciences, Division of Nursing Linköping University, Linköping, Sweden
| | - Anna-Christina Ek
- Department of Medical and Health Sciences, Division of Nursing Linköping University, Linköping, Sweden
| | - Maria Engström
- Department of Medical and Health Sciences, Division of Nursing Linköping University, Linköping, Sweden
| | - Margareta Lindgren
- Department of Medical and Health Sciences, Division of Nursing Linköping University, Linköping, Sweden
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Effect of Direct Glare on Orbicularis Oculi and Trapezius During Computer Reading. Optom Vis Sci 2016; 93:738-49. [DOI: 10.1097/opx.0000000000000855] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Bergstrand S, Källman U, Ek AC, Engström M, Lindgren M. Microcirculatory responses of sacral tissue in healthy individuals and inpatients on different pressure-redistribution mattresses. J Wound Care 2015; 24:346-58. [DOI: 10.12968/jowc.2015.24.8.346] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- S. Bergstrand
- Department of Hand Surgery, Plastic Surgery and Burns and the Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - U. Källman
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Dermatology, Södra Älvsborgs Sjukhus, Borås, Sweden
| | - A-C. Ek
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - M. Engström
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - M. Lindgren
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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A new look at the essence of the imaging photoplethysmography. Sci Rep 2015; 5:10494. [PMID: 25994481 PMCID: PMC4440202 DOI: 10.1038/srep10494] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 04/16/2015] [Indexed: 11/23/2022] Open
Abstract
Photoplethysmography (PPG) is a noninvasive optical method accepted in the clinical use for measurements of arterial oxygen saturation. It is widely believed that the light intensity after interaction with the biological tissue in vivo is modulated at the heartbeat frequency mainly due to pulsatile variations of the light absorption caused by arterial blood-volume pulsations. Here we report experimental observations, which are not consistent with this model and demonstrate the importance of elastic deformations of the capillary bed in the formation of the PPG waveform. These results provide new insight on light interaction with live tissue. To explain the observations we propose a new model of PPG in which pulse oscillations of the arterial transmural pressure deform the connective-tissue components of the dermis resulting in periodical changes of both the light scattering and absorption. These local changes of the light-interaction parameters are detected as variations of the light intensity returned to a photosensitive camera. Therefore, arterial pulsations can be indirectly monitored even by using the light, which slightly penetrates into the biological tissue.
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Quandt BM, Scherer LJ, Boesel LF, Wolf M, Bona GL, Rossi RM. Body-monitoring and health supervision by means of optical fiber-based sensing systems in medical textiles. Adv Healthc Mater 2015; 4:330-55. [PMID: 25358557 DOI: 10.1002/adhm.201400463] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 09/24/2014] [Indexed: 11/11/2022]
Abstract
Long-term monitoring with optical fibers has moved into the focus of attention due to the applicability for medical measurements. Within this Review, setups of flexible, unobtrusive body-monitoring systems based on optical fibers and the respective measured vital parameters are in focus. Optical principles are discussed as well as the interaction of light with tissue. Optical fiber-based sensors that are already used in first trials are primarily selected for the section on possible applications. These medical textiles include the supervision of respiration, cardiac output, blood pressure, blood flow and its saturation with hemoglobin as well as oxygen, pressure, shear stress, mobility, gait, temperature, and electrolyte balance. The implementation of these sensor concepts prompts the development of wearable smart textiles. Thus, current sensing techniques and possibilities within photonic textiles are reviewed leading to multiparameter designs. Evaluation of these designs should show the great potential of optical fibers for the introduction into textiles especially due to the benefit of immunity to electromagnetic radiation. Still, further improvement of the signal-to-noise ratio is often necessary to develop a commercial monitoring system.
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Affiliation(s)
- Brit M. Quandt
- Empa-Swiss Federal Laboratories for Materials Science and Technology; Laboratory for Protection and Physiology; Lerchenfeldstrasse 5, 9016 St. Gallen Switzerland
- ETH Zurich, Department of Information Technology and Electrical Engineering; Gloriastrasse 35 8092 Zurich Switzerland
| | | | - Luciano F. Boesel
- Empa-Swiss Federal Laboratories for Materials Science and Technology; Laboratory for Protection and Physiology; Lerchenfeldstrasse 5, 9016 St. Gallen Switzerland
| | - Martin Wolf
- Division of Neonatology; University Hospital Zurich; Frauenklinikstrasse 10 8091 Zurich Switzerland
| | - Gian-Luca Bona
- ETH Zurich, Department of Information Technology and Electrical Engineering; Gloriastrasse 35 8092 Zurich Switzerland
- Empa-Swiss Federal Laboratories for Materials Science and Technology; Überlandstrasse 129 8600 Dübendorf Switzerland
| | - René M. Rossi
- Empa-Swiss Federal Laboratories for Materials Science and Technology; Laboratory for Protection and Physiology; Lerchenfeldstrasse 5, 9016 St. Gallen Switzerland
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Abe M, Yoshizawa M, Obara K, Sugita N, Homma N, Yambe T. Evaluation of Baroreflex Function Using Green Light Photoplethysmogram in Consideration of Resistance to Artifacts. ADVANCED BIOMEDICAL ENGINEERING 2015. [DOI: 10.14326/abe.4.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Makoto Abe
- Graduate School of Engineering, Tohoku University
| | | | - Kazuma Obara
- Graduate School of Engineering, Tohoku University
| | | | | | - Tomoyuki Yambe
- Institute of Development, Aging and Cancer, Tohoku University
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Bergstrand S, Källman U, Ek AC, Lindberg LG, Engström M, Sjöberg F, Lindgren M. Pressure-induced Vasodilation and Reactive Hyperemia at Different Depths in Sacral Tissue Under Clinically Relevant Conditions. Microcirculation 2014; 21:761-71. [DOI: 10.1111/micc.12160] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 07/31/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Sara Bergstrand
- Department of Hand Surgery, Plastic Surgery and Burns and Department of Medical and Health Sciences; Linköping University; Linköping Sweden
| | - Ulrika Källman
- Department of Medical and Health Sciences; Linköping University; Linköping Sweden
- Department of Dermatology; Södra Älvsborgs Sjukhus; Borås Sweden
| | - Anna-Christina Ek
- Department of Medical and Health Sciences; Linköping University; Linköping Sweden
| | - Lars-Göran Lindberg
- Department of Biomedical Engineering; Linköping University; Linköping Sweden
| | - Maria Engström
- Department of Medical and Health Sciences; Linköping University; Linköping Sweden
| | - Folke Sjöberg
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| | - Margareta Lindgren
- Department of Medical and Health Sciences; Linköping University; Linköping Sweden
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Abstract
PURPOSE Orbicularis oculi muscle tension and muscle blood flow have been shown to be objective measures of eyestrain during visually demanding activities, such as computer work. In line with this, positive associations between eye-related pain and muscle blood flow in orbicularis oculi have been observed. A hypothesis regarding work situations with cognitive tasks and low-level muscle activity, such as computer work, proposes that muscle pain originates from the blood vessel-nociceptor interactions of the connective tissue of the muscle. Noninvasive muscle blood flow measurements in the orbicularis oculi muscle are preferable to using an invasive technique. The aim of this study was to test reproducibility and stability of muscle blood recordings in orbicularis oculi using photoplethysmography. METHODS In the reproducibility tests, 12 subjects were tested twice within 1 to 5 weeks. To study the stability of the method, six of the subjects were randomly selected and tested four more times within 2 to 6 weeks. Test subjects were doing identical visually demanding computer work for 10 minutes in each test. RESULTS The short-term repeatability of muscle blood flow measurements was considered good, but the stability of blood flow recordings over time in orbicularis oculi was low because of a greater within-subject maximum variability compared with between-subject average variability. CONCLUSIONS Investigators should be aware of the effect of time, possibly attributed to confounding factors such as environmental changes and mental stress, when comparing photoplethysmography muscle blood flow recordings.
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Källman U, Engström M, Bergstrand S, Ek AC, Fredrikson M, Lindberg LG, Lindgren M. The Effects of Different Lying Positions on Interface Pressure, Skin Temperature, and Tissue Blood Flow in Nursing Home Residents. Biol Res Nurs 2014; 17:142-51. [DOI: 10.1177/1099800414540515] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Although repositioning is considered an important intervention to prevent pressure ulcers, tissue response during loading in different lying positions has not been adequately explored. Aim: To compare the effects of different lying positions on interface pressure, skin temperature, and tissue blood flow in nursing home residents. Method: From May 2011 to August 2012, interface pressure, skin temperature, and blood flow at three tissue depths were measured for 1 hr over the sacrum in 30° supine tilt and 0° supine positions and over the trochanter major in 30° lateral and 90° lateral positions in 25 residents aged 65 years or older. Measurement of interface pressure was accomplished using a pneumatic pressure transmitter connected to a digital manometer, skin temperature using a temperature sensor, and blood flow using photoplethysmography and laser Doppler flowmetry. Results: Interface pressure was significantly higher in the 0° supine and 90° lateral positions than in 30° supine tilt and 30° lateral positions. The mean skin temperature increased from baseline in all positions. Blood flow was significantly higher in the 30° supine tilt position compared to the other positions. A hyperemic response in the post pressure period was seen at almost all tissue depths and positions. Conclusion: The 30° supine tilt position generated less interface pressure and allowed greater tissue perfusion, suggesting that this position is the most beneficial.
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Affiliation(s)
- Ulrika Källman
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Dermatology, Södra Älvsborgs Sjukhus, Borås, Sweden
| | - Maria Engström
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Sara Bergstrand
- Department of Hand Surgery, Plastic Surgery and Burns and Department of Medical and Health Sciences, Linköping University
| | - Anna-Christina Ek
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Mats Fredrikson
- Division of Occupational and Environmental Sciences, Department of Clinical and Experimental Sciences, Linköping University, Linköping, Sweden
- Linköping Academic Research Centre (LARC), Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Lars-Göran Lindberg
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Margareta Lindgren
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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Jacquet-Lagrèze M, Bonnet-Garin JM, Allaouchiche B, Vassal O, Restagno D, Paquet C, Ayoub JY, Etienne J, Vandenesch F, Daulwader O, Junot S. A new device for continuous assessment of gut perfusion: proof of concept on a porcine model of septic shock. Crit Care 2014; 18:R153. [PMID: 25030376 PMCID: PMC4223372 DOI: 10.1186/cc13992] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 06/24/2014] [Indexed: 12/13/2022] Open
Abstract
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.
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Affiliation(s)
- Matthias Jacquet-Lagrèze
- Service d’Anesthésie-Réanimation, Hospices Civils de Lyon, hôpital Edouard-Herriot, 5 place d’Arsonval, 69437 Lyon, Cedex 03, France
| | - Jeanne-Marie Bonnet-Garin
- Université de Lyon, EA 4174 Hémostase, Inflammation et Sepsis, VetAgro Sup - Campus Vétérinaire de Lyon, 1 Avenue Bourgelat, 69280 Marcy l'Étoile, France
| | - Bernard Allaouchiche
- Service d’Anesthésie-Réanimation, Hospices Civils de Lyon, hôpital Edouard-Herriot, 5 place d’Arsonval, 69437 Lyon, Cedex 03, France
- Université Claude Bernard, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, Lyon, France
| | - Olivia Vassal
- Service d’Anesthésie-Réanimation, Hospices Civils de Lyon, hôpital Edouard-Herriot, 5 place d’Arsonval, 69437 Lyon, Cedex 03, France
| | - Damien Restagno
- Université de Lyon, EA 4174 Hémostase, Inflammation et Sepsis, VetAgro Sup - Campus Vétérinaire de Lyon, 1 Avenue Bourgelat, 69280 Marcy l'Étoile, France
| | - Christian Paquet
- Université de Lyon, EA 4174 Hémostase, Inflammation et Sepsis, VetAgro Sup - Campus Vétérinaire de Lyon, 1 Avenue Bourgelat, 69280 Marcy l'Étoile, France
| | - Jean-Yves Ayoub
- Université de Lyon, EA 4174 Hémostase, Inflammation et Sepsis, VetAgro Sup - Campus Vétérinaire de Lyon, 1 Avenue Bourgelat, 69280 Marcy l'Étoile, France
| | - Jérôme Etienne
- Université Claude Bernard, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, Lyon, France
- Laboratoire de Microbiologie, Groupement Hospitalier Est, Lyon, France
| | - François Vandenesch
- Université Claude Bernard, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, Lyon, France
- Laboratoire de Microbiologie, Groupement Hospitalier Est, Lyon, France
| | - Olivier Daulwader
- Laboratoire de Microbiologie, Groupement Hospitalier Est, Lyon, France
| | - Stéphane Junot
- Université de Lyon, EA 4174 Hémostase, Inflammation et Sepsis, VetAgro Sup - Campus Vétérinaire de Lyon, 1 Avenue Bourgelat, 69280 Marcy l'Étoile, France
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Seyed Jafari SM, Schawkat M, Van De Ville D, Shafighi M. Relative indexes of cutaneous blood perfusion measured by real-time laser Doppler imaging (LDI) in healthy volunteers. Microvasc Res 2014; 94:1-6. [DOI: 10.1016/j.mvr.2014.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 04/03/2014] [Accepted: 04/18/2014] [Indexed: 10/25/2022]
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Edner A, Lindberg LG, Broström H, Bergh A. Does a magnetic blanket induce changes in muscular blood flow, skin temperature and muscular tension in horses? Equine Vet J 2014; 47:302-7. [DOI: 10.1111/evj.12291] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 04/08/2014] [Indexed: 11/28/2022]
Affiliation(s)
- A. Edner
- Department of Clinical Sciences; Faculty of Veterinary Medicine and Animal Science; University of Agricultural Sciences; Uppsala Sweden
| | - L.-G. Lindberg
- Department of Medical Engineering; Linköping University; Sweden
| | - H. Broström
- Department of Clinical Sciences; Faculty of Veterinary Medicine and Animal Science; University of Agricultural Sciences; Uppsala Sweden
| | - A. Bergh
- Department of Anatomy, Physiology and Biochemistry; Faculty of Veterinary Medicine and Animal Science; University of Agricultural Sciences; Uppsala Sweden
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Fifty years of publishing in biomedical engineering: reflections after 7-year editorship. Med Biol Eng Comput 2012. [DOI: 10.1007/s11517-012-1000-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hagblad J, Folke M, Lindberg LG, Lindén M. Technical issues related to the long-term monitoring of blood flow at different depths using LDF and PPG. Physiol Meas 2012; 33:985-96. [DOI: 10.1088/0967-3334/33/6/985] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Källman U, Bergstrand S, Ek AC, Engström M, Lindberg LG, Lindgren M. Different lying positions and their effects on tissue blood flow and skin temperature in older adult patients. J Adv Nurs 2012; 69:133-44. [DOI: 10.1111/j.1365-2648.2012.06000.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Review of laser speckle-based analysis in medical imaging. Med Biol Eng Comput 2012; 50:547-58. [PMID: 22476712 DOI: 10.1007/s11517-012-0902-z] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 03/17/2012] [Indexed: 10/28/2022]
Abstract
Speckle pattern forms when a rough object is illuminated with coherent light (laser) and the backscattered radiation is imaged on a screen. The pattern changes over time due to movement in the object. Such time-integrate speckle pattern can be statistically analyzed to reveal the flow profile. For higher velocity the speckle contrast gets reduced. This theory can be utilized for tissue perfusion in capillaries of human skin tissue and cerebral blood flow mapping in rodents. Early, the technique was suffered from low resolution and computational intricacies for real-time monitoring purpose. However, modern engineering has made it feasible for real-time monitoring in microcirculation imaging with improved resolution. This review illustrates several modifications over classical technique done by many researchers. Recent advances in speckle contrast methods gain major interest, leading towards practical implementation of this technique. The review also brings out the scopes of laser speckle-based analysis in various medical applications.
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Humeau-Heurtier A, Buard B, Mahe G, Abraham P. Laser speckle contrast imaging of the skin: interest in processing the perfusion data. Med Biol Eng Comput 2011; 50:103-5. [DOI: 10.1007/s11517-011-0856-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 12/13/2011] [Indexed: 10/14/2022]
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Effects of static contraction and cold stimulation on cardiovascular autonomic indices, trapezius blood flow and muscle activity in chronic neck-shoulder pain. Eur J Appl Physiol 2011; 111:1725-35. [PMID: 21221987 DOI: 10.1007/s00421-010-1813-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Accepted: 12/24/2010] [Indexed: 10/18/2022]
Abstract
The aim of the present study was to investigate reactions in trapezius muscle blood flow (MBF), muscle activity, heart rate variability (HRV) and systemic blood pressure (BP) to autonomic tests in subjects with chronic neck-shoulder pain and healthy controls. Changes in muscle activity and blood flow due to stress and unfavourable muscle loads are known underlying factors of work-related muscle pain. Aberration of the autonomic nervous system (ANS) is considered a possible mechanism. In the present study, participants (n = 23 Pain, n = 22 Control) performed autonomic tests which included a resting condition, static hand grip test (HGT) at 30% of maximal voluntary contraction, a cold pressor test (CPT) and a deep breathing test (DBT). HRV was analysed in time and frequency domains. MBF and muscle activity were recorded from the upper trapezius muscles using photoplethysmography and electromyography (EMG). The pain group showed reduced low frequency-HRV (LF) and SDNN during rest, as well as a blunted BP response and increased LF-HRV during HGT (∆systolic 22 mm Hg; ∆LF(nu) 27%) compared with controls (∆systolic 27; ∆LF(nu) 6%). Locally, the pain group had attenuated trapezius MBF in response to HGT (Pain 122% Control 140%) with elevated trapezius EMG following HGT and during CPT. In conclusion, only HGT showed differences between groups in systemic BP and HRV and alterations in local trapezius MBF and EMG in the pain group. Findings support the hypothesis of ANS involvement at systemic and local levels in chronic neck-shoulder pain.
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Peripheral photoplethysmography variability analysis of sepsis patients. Med Biol Eng Comput 2010; 49:337-47. [PMID: 21153887 DOI: 10.1007/s11517-010-0713-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Accepted: 10/27/2010] [Indexed: 01/20/2023]
Abstract
Sepsis is associated with impairment in autonomic regulatory function. This work investigates the application of heart rate and photoplethysmogram (PPG) waveform variability analysis in differentiating two categories of sepsis, namely systemic inflammatory response syndrome (SIRS) and severe sepsis. Electrocardiogram-derived heart period (RRi) and PPG waveforms, measured from fingertips (Fin-PPG) and earlobes (Ear-PPG), of Emergency Department sepsis patients (n = 28) with different disease severity, were analysed by spectral technique, and were compared to control subjects (n = 10) in supine and 80° head-up tilted positions. Analysis of covariance (ANCOVA) was applied to adjust for the confounding factor of age. Low-frequency (LF, 0.04-0.15 Hz), mid-frequency (MF, 0.09-0.15 Hz) and high-frequency (HF, 0.15-0.60 Hz) powers were computed. The normalised MF power in Ear-PPG (MFnu(Ear)) was significantly reduced in severe sepsis patients with hyperlactataemia (lactate > 2 mmol/l), compared to SIRS patients (P < 0.05). Moreover, in a group of normal controls, MFnu(Ear) was not altered by head-up tilting (P > 0.05), suggesting that there may be a link between 0.1 Hz ear blood flow oscillation and tissue metabolic changes in sepsis, in addition to autonomic factors. The study highlighted the value of PPG spectral analysis in the non-invasive assessment of peripheral vascular regulation in sepsis patients, with potential implications in monitoring the progression of sepsis.
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Can we see epithelium tissue structure below the surface using an optical probe? Med Biol Eng Comput 2010; 49:85-96. [PMID: 20809187 DOI: 10.1007/s11517-010-0672-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2009] [Accepted: 07/30/2010] [Indexed: 10/19/2022]
Abstract
This paper answers the question of whether it is possible to detect changes below the surface in epithelium layered structures using a Stochastic Decomposition Method (SDM) that models the scattered light reflected from the layered structure over an area (2-D scan) illuminated by an optical sensor (fibre) emitting light at either one wavelength or with white light. Our technique correlates the differential changes in the reflected tissue texture with the morphological and physical changes that occur in the tissue occurring inside the structure. This work has great potential for detecting changes in mucosal structures and may lead to enhanced endoscopy when the disease is developing to the outside of the mucosal structure and hence becoming hidden during colonoscopy or endoscopic examination. Tests are performed on layered tissue phantoms, and the results obtained show great effectiveness of the model and method in picking up changes in the morphology of the layered tissue phantoms occurring below the surface. We also establish the robustness of the model to changes in viewing depth by testing it on phantoms viewed at different depths. We show that the model is robust to within a 4-mm-deep viewing range.
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