Abstract

Pulse oximetry is a ubiquitous optical technology, widely used for diagnosis and treatment guidance. Current pulse oximeters provide indications of arterial oxygen saturation. We present here a new quantitative methodology that extends the capability of pulse oximetry and provides real-time molar concentrations of oxy- and deoxy-hemoglobin at rates of up to 27 Hz by using advanced digital hardware, real-time firmware processing, and ultra-fast optical property calculations with a deep neural network (DNN). The technique utilizes a high-speed frequency domain spectroscopy system with five frequency-multiplexed wavelengths. High-speed demultiplexing and data reduction were performed in firmware. The DNN inversion algorithm was benchmarked as five orders of magnitude faster than conventional iterative methods for optical property extractions. The DNN provided unbiased optical property extractions, with an average error of 0 ± 5.6% in absorption and 0 ± 1.4% in reduced scattering. Together, these improvements enabled the measurement, calculation, and real-time continuous display of hemoglobin concentrations. A proof-of-concept cuff occlusion measurement was performed to demonstrate the ability of the device to track oxy- and deoxy-hemoglobin, and measure quantitative photoplethysmographic changes during the cardiac cycle. This technique substantially extends the capability of pulse oximetry and provides unprecedented real-time non-invasive functional information with broad applicability for cardiopulmonary applications.

Highlights

  • Pulse oximetry is a ubiquitous optical technology used for the measurement of arterial oxygen saturation and pulse rate in hospital and out-patient settings

  • Arterial oxygen saturation measured by pulse oximetry has been proposed as the “fifth vital sign”, with some suggesting that it be viewed with the same level of importance as blood pressure and pulse rate [7,8]

  • The measurement of the time-varying optical changes that occur during the cardiac cycle allows pulse oximetry to isolate the arterial vascular compartment, which, unlike the venous compartment, undergoes volume changes with each beat of the heart [9]

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Summary

Introduction

Pulse oximetry is a ubiquitous optical technology used for the measurement of arterial oxygen saturation and pulse rate in hospital and out-patient settings. First utilized as early as the 1940s [1], pulse oximetry is a critical tool for monitoring oxygen transport in the body. This information is essential for patient care in a variety of clinical situations, including anesthesia monitoring [2], post-operative evaluation [3], triage [4], and for monitoring patients with reduced lung function due to asthma [5] or chronic obstructive pulmonary disorder [6]. Ratiometric measurements are typically calibrated using a precomputed correction factor (determined using invasive co-oximetry), and reported as an absolute value of oxygen saturation [10]

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