Methodological Recommendations for the Creation of Sensor Measurement Systems for Respiratory Rate Monitoring Based on Photoplethysmographic Signal Processing

To assess the accuracy of novel algorithms using an oximeter-based finger plethysmographic signal in combination with a nasal cannula for the detection and differentiation of central and obstructive apneas. The validity of single pulse oximetry to detect respiratory disturbance events was also studied. Patients recruited from four sleep laboratories underwent an ambulatory overnight cardiorespiratory polygraphy recording. The nasal flow and photoplethysmographic signals of the recording were analyzed by automated algorithms. The apnea hypopnea index (AHI(auto)) was calculated using both signals, and a respiratory disturbance index (RDI(auto)) was calculated from photoplethysmography alone. Apnea events were classified into obstructive and central types using the oximeter derived pulse wave signal and compared with manual scoring. Sixty-six subjects (42 males, age 54 ± 14 yrs, body mass index 28.5 ± 5.9 kg/m(2)) were included in the analysis. AHI(manual) (19.4 ± 18.5 events/h) correlated highly significantly with AHI(auto) (19.9 ± 16.5 events/h) and RDI(auto) (20.4 ± 17.2 events/h); the correlation coefficients were r = 0.94 and 0.95, respectively (p < 0.001) with a mean difference of -0.5 ± 6.6 and -1.0 ± 6.1 events/h. The automatic analysis of AHI(auto) and RDI(auto) detected sleep apnea (cutoff AHI(manual) ≥ 15 events/h) with a sensitivity/specificity of 0.90/0.97 and 0.86/0.94, respectively. The automated obstructive/central apnea indices correlated closely with manually scoring (r = 0.87 and 0.95, p < 0.001) with mean difference of -4.3 ± 7.9 and 0.3 ± 1.5 events/h, respectively. Automatic analysis based on routine pulse oximetry alone may be used to detect sleep disordered breathing with accuracy. In addition, the combination of photoplethysmographic signals with a nasal flow signal provides an accurate distinction between obstructive and central apneic events during sleep.

An efficient model for extracting respiratory and blood oxygen saturation data from photoplethysmogram signals by removing motion artifacts using heuristic-aided ensemble learning model

The photoplethysmographic (PPG) signal measures the local variations of blood volume in tissues, reflecting the peripheral pulse modulated by cardiac activity, respiration, and other physiological effects. Therefore, PPG can be used to extract the vital cardiorespiratory signals like heart rate (HR), and respiratory rate (RR) and this will reduce the number of sensors connected to the patient's body for recording these vital signs. In this paper, we propose an algorithm based on ensemble empirical mode decomposition with principal component analysis (EEMD-PCA) as a novel approach to estimate HR and RR simultaneously from PPG signal. To examine the performance of the proposed algorithm, we used 310 (from 35 subjects) and 632 (from 42 subjects) epochs of simultaneously recorded electrocardiogram, PPG, and respiratory signal extracted from MIMIC (Physionet ATM data bank) and Capnobase database, respectively. Results of EEMD-PCA-based extraction of HR and RR from PPG signal showed that the median RMS error (1st and 3rd quartiles) obtained in MIMIC data set for RR was 0.89 (0, 1.78) breaths/min, for HR was 0.57 (0.30, 0.71) beats/min and in Capnobase data set it was 2.77 (0.50, 5.9) breaths/min and 0.69 (0.54, 1.10) beats/min for RR and HR, respectively. These results illustrated that the proposed EEMD-PCA approach is more accurate in estimating HR and RR than other existing methods. Efficient and reliable extraction of HR and RR from the pulse oximeter's PPG signal will help patients for monitoring HR and RR with low cost and less discomfort.

Clinical investigation of some sleep disorders requires simultaneous monitoring of heart and respiratory rates. There have been several efforts on ECG-Derived Respiration (EDR). The photoplethysmographic (PPG) signal includes both heart and respiratory components. In situations such as ambulatory monitoring, stress tests and sleep disorder investigations, where the respiration is not monitored by specialized equipment, it would be advantageous to derive a surrogate respiratory signal directly from the PPG. This paper presents an efficient technique, for the estimation of heart and respiratory rates from the PPG signals based on modified covariance auto regressive model. Test results reveal that the order reduced-modified covariance AR model (OR-MCAR) has efficiently estimated heart and respiratory rates. Accuracy rate, a quantitative evaluation measure, establishes the efficacy of the proposed algorithm.

The respiratory rate is a vital parameter that can provide valuable information about the health condition of a patient. The extraction of respiratory information from photoplethysmographic signal (PPG) was actually encouraged by the reported results, our main goal being to obtain accurate respiratory rate estimation from the PPG signal. We developed a fusion algorithm that identifies the best derived respiratory signals, from which is possible to extract the respiratory rate; based on these, a global respiratory rate is computed using the proposed fusion algorithm. The algorithm is qualitatively tested on real PPG signals recorded by an acquisition system we implemented, using a reflection pulse oximeter sensor. Its performance is also statistically evaluated using benchmark dataset publically available from CapnoBase.Org.

Drowsiness of driver while driving is one major factor of traffic accident. Therefore, there are many researches to prevent and detect drowsy driving. Recent researches have focused on motion detection using cameras to determine drowsy driving. However, we have focused on non-invasive and inexpensive drowsiness detection system. In our previous research, we suggested a system based on the driver's head movement using infrared sensors. In this paper, we suggest another non-invasive and inexpensive system based on the driver's pulse wave by photoplethysmography (PPG) signal processing. Firstly, the system collects a pulse wave from a PPG sensor on a steering wheel and then it processes the signal to analyze driver's state. In order to evaluate the effectiveness of a human pulse wave for drowsiness detection, we integrated two systems. The experimental result using new integration system showed 83 percent drowsy driving detection rate in the state of real driving.

The mathematical models’ analysis for indoor microclimate parameters’ monitoring characterize of their negative impact on animals and humans degree in terms of their effect on thermal stress is presented. The heat and humidity index features’ mathematical dependencies, based on temperature and relative air humidity’s assessment; the environment’s thermal index loading, that also takes account into the air flows speed in the room and thermal radiation on the body are considered. A cows thermal stress index based on animals’ clinical-and-physiological indicators, cows’ respiratory rate and pulse is proposed. During the studies there in the climate chamber microclimate’s conditions were simulated in the ranges from 15°C till 35 °C of air temperature and from 50% till 80% for relative humidity, the air flow velocity was lesser than 0,2 m/s. The animals’ respiratory and pulse rate and body temperature were recorded. As a result of the research, an animals’ respiratory and pulse rate increasing was found. Based on the obtained data, a mathematical model quantitatively characterizes the thermal stress degree in depending on the respiratory and pulse rate values is proposed. The cows’ heat, humidity and thermal stress indexes’ values proposed by the authors are compared. These study results’ analysis suggests that cows respiratory and pulse rate monitoring allows to take into account the animals’ individual characteristics under thermal stress. A variant of the cows heat humidity and thermal stress indexes integrated application is proposed.

Respiratory rate (RR) changes in the elderly can indicate serious diseases. Thus, accurate estimation of RRs for cardiopulmonary function is essential for home health monitoring systems. However, machine learning (ML) algorithm errors embedded in health monitoring systems can be problematic in medical decision-making because some data have much larger sample sizes in the training set than others. This difference in sample size implies biosignal data imbalance. Therefore, we propose a novel methodology that combines bootstrap-based imbalanced continuous power spectral generation (IPSG) with ML approaches to estimate RRs and uncertainty to address data imbalance. The sample differences between normal breathing (12-20 breaths per minute (brpm)), dyspnea (≥20 brpm), and hypopnea (<8 brpm) show significant data imbalance, which can affect the learning of ML algorithms. Hence, the normal breathing part with a large amount of data is well-trained. In contrast, the dyspnea and hypopnea parts with relatively fewer data are not well-trained, and this data imbalance makes it difficult to estimate the reference variables of the actual dyspnea and hypopnea data parts, thus generating significant errors. Hence, we apply ML models by mixing artificial feature curves generated using a bootstrap model with the original feature curves to estimate RRs and solve this problem. As a result, the nonparametric bootstrap approach significantly increases the number of artificial feature curves. The generated artificial feature curves are selectively utilized in the highly imbalanced parts. Therefore, we confirm that IPSG is efficiently trained to predict the complex nonlinear relationship between the feature vectors obtained from the photoplethysmography signal and the reference RR. The proposed methodology shows more accurate prediction performance and uncertainty. Combining the proposed Gaussian process regression (GPR) with IPSG based on the Beth Israel Deaconess Medical Center dataset, the mean absolute error of the RR is 0.79 and 1.47 brpm. Our approach achieves high stability and accuracy by randomly mixing original and artificial feature curves. The proposed GPR-IPSG model can improve the performance of clinical home-based monitoring systems and design a reliable framework.

Fast and accurate respiratory rate (RR) estimation from photoplethysmography (PPG) signal is still a challenging problem. In this paper, we propose a real-time algorithm for RR estimation from PPG signal using sparse signal reconstruction (SSR) based on orthogonal matching pursuit (OMP). This algorithm greatly reduces the computational complexity of the original sparse signal reconstruction and respiratory rate tracking (S2R3T) algorithm. While the proposed algorithm and a state-of-the-art real-time algorithm based on smart fusion of RR estimates from three respiratory modulations have similar estimation accuracy, the proposed algorithm outperforms the smart fusion algorithm in number of RR estimates.

Respiratory rate (RR) is an important measurement for ambulatory care and there is high interest in its detection using unobtrusive mobile devices. For this study, we investigated the estimation of RR from a photoplethysmography (PPG) signal that originated from a pulse oximeter sensor and had a sub-optimal sampling rate. We explored the possibility of estimating RR by extracting respiratory sinus arrhythmia (RSA) from the PPG-derived heart rate variability (HRV) measurement using real-time algorithms. Data from 29 children and 13 adults undergoing general anesthesia were analyzed. We compared the RSA power derived from electrocardiography (ECG) with PPG at the reference RR derived from capnography. The power of the PPG was significantly higher than that of the ECG (182.42 ± 36.75 dB vs. 162.30 ± 43.66 dB). Further, the mean RR error for PPG was lower than ECG. Both PPG and ECG RR estimation techniques were more powerful and reliable in cases of spontaneous ventilation than when pressure controlled ventilation was used. The analysis of cases containing artifacts in the PPG revealed a significant increase in RR error, a trend that was less pronounced for controlled ventilation. These results indicate that the estimation of RR from the sub-optimally sampled PPG signal is possible and more reliable than from the ECG.

A methodology that combines information from several nonstationary biological signals is presented. This methodology is based on time-frequency coherence, that quantifies the similarity of two signals in the time-frequency domain. A cross time-frequency analysis method, based on quadratic time-frequency distribution, has been used for combining information of several nonstationary biomedical signals. In order to evaluate this methodology, the respiratory rate from the photoplethysmographic (PPG) signal is estimated. The respiration provokes simultaneous changes in the pulse interval, amplitude, and width of the PPG signal. This suggests that the combination of information from these sources will improve the accuracy of the estimation of the respiratory rate. Another target of this paper is to implement an algorithm which provides a robust estimation. Therefore, respiratory rate was estimated only in those intervals where the features extracted from the PPG signals are linearly coupled. In 38 spontaneous breathing subjects, among which 7 were characterized by a respiratory rate lower than 0.15 Hz, this methodology provided accurate estimates, with the median error {0.00; 0.98} mHz ({0.00; 0.31}%) and the interquartile range error {4.88; 6.59} mHz ({1.60; 1.92}%). The estimation error of the presented methodology was largely lower than the estimation error obtained without combining different PPG features related to respiration.

Estimation of respiratory rate (RR) from photoplethysmography (PPG) signals has important applications in the healthcare sector, from assisting doctors onwards to monitoring patients in their own homes. The problem is still very challenging, particularly during the motion for large segments of data, where results from different methods often do not agree. The authors aim to propose a new technique which performs motion reduction from PPG signals with the help of simultaneous acceleration signals where the PPG and accelerometer sensors need to be embedded in the same sensor unit. This method also reconstructs motion corrupted PPG signals in the Hilbert domain. An auto-regressive (AR) based technique has been used to estimate the RR from reconstructed PPGs. The proposed method has provided promising results for the estimation of RRs and their variations from PPG signals corrupted with motion artefact. The proposed platform is able to contribute to continuous in-hospital and home-based monitoring of patients using PPG signals under various conditions such as rest and motion states.

The photoplethysmogram (PPG) obtained from pulse oximetry measures local variations of blood volume in tissues, reflecting the peripheral pulse modulated by heart activity, respiration and other physiological effects. We propose an algorithm based on the correntropy spectral density (CSD) as a novel way to estimate respiratory rate (RR) and heart rate (HR) from the PPG. Time-varying CSD, a technique particularly well-suited for modulated signal patterns, is applied to the PPG. The respiratory and cardiac frequency peaks detected at extended respiratory (8 to 60 breaths/min) and cardiac (30 to 180 beats/min) frequency bands provide RR and HR estimations. The CSD-based algorithm was tested against the Capnobase benchmark dataset, a dataset from 42 subjects containing PPG and capnometric signals and expert labeled reference RR and HR. The RR and HR estimation accuracy was assessed using the unnormalized root mean square (RMS) error. We investigated two window sizes (60 and 120 s) on the Capnobase calibration dataset to explore the time resolution of the CSD-based algorithm. A longer window decreases the RR error, for 120-s windows, the median RMS error (quartiles) obtained for RR was 0.95 (0.27, 6.20) breaths/min and for HR was 0.76 (0.34, 1.45) beats/min. Our experiments show that in addition to a high degree of accuracy and robustness, the CSD facilitates simultaneous and efficient estimation of RR and HR. Providing RR every minute, expands the functionality of pulse oximeters and provides additional diagnostic power to this non-invasive monitoring tool.

Changes in tidal volume, frequency, and ventilation induced by their measurement.

This paper proposes a framework combining the complementary ensemble empirical mode decomposition with both the independent component analysis and the non-negative matrix factorization for estimating both the heart rate and the respiratory rate from the photoplethysmography (PPG) signal. After performing the complementary ensemble empirical mode decomposition on the PPG signal, a finite number of intrinsic mode functions are obtained. Then, these intrinsic mode functions are divided into two groups to perform the further analysis via both the independent component analysis and the non-negative matrix factorization. The surrogate cardiac signal related to the heart activity and another surrogate respiratory signal related to the respiratory activity are reconstructed to estimate the heart rate and the respiratory rate, respectively. Finally, different records of signals acquired from the Medical Information Mart for Intensive Care database downloaded from the Physionet Automated Teller Machine (ATM) data bank are employed for demonstrating the outperformance of our proposed method. The results show that our proposed method outperforms both the digital filtering approach and the conventional empirical mode decomposition based methods in terms of reconstructing both the surrogate cardiac signal and the respiratory signal from the PPG signal as well as both achieving the higher accuracy and the higher reliability for estimating both the heart rate and the respiratory rate.