Oxygen Saturation Data Research Articles

Cardiorespiratory Stability in Critically Ill Preterm Infants following Dexmedetomidine Initiation.

This study aimed to evaluate cardiorespiratory status in preterm infants receiving dexmedetomidine using high-resolution physiologic data. We analyzed preterm infants with continuous heart rate (HR) and oxygen saturation (SpO2) data for 24 hours preceding and 48 hours following dexmedetomidine initiation. Invasive arterial blood pressure (ABP), when available, was analyzed. In 100 infants with a mean gestational age of 28 weeks and high baseline illness severity, mean HR decreased from 152 to 141 beats per minute while mean SpO2 increased from 91 to 93% in the 48 hours after dexmedetomidine initiation (p < 0.01). In 57 infants with continuous ABP monitoring, mean ABP increased from 40 to 42 mm Hg (p = 0.01). Vasoactive-inotropic support increased before and after initiation. We observed cardiorespiratory changes in critically ill preterm infants following dexmedetomidine initiation; mean HR decreased and mean SpO2 increased in the 48 hours after initiation. In a subset, mean ABP increased along with vasoactive-inotropic support. · Limited evidence exists on the acute cardiorespiratory effects of dexmedetomidine in preterm infants.. · Evaluation of continuous HR, blood pressure, and oxygenation from two centers provides useful data.. · Dexmedetomidine consistently decreased the HR of preterm infants.. · Dexmedetomidine initiation during critical illness complicated the interpretation of physiologic effects.. · Oxygenation stabilized after initiation during invasive mechanical ventilation..

Impact of Pharmacologic Patent Ductus Arteriosus Treatment on Acute Respiratory and Oxygenation Metrics in Very Low Birth Weight Infants.

Hypoxemia and respiratory compromise occur in very low birth weight (VLBW, <1,500 g) infants and may be associated with shunting across patent ductus arteriosus (PDA). The impact of pharmacologic PDA treatment on acute hypoxemia and respiratory metrics is unclear. This study aimed to determine whether pharmacologic PDA treatment is associated with acute improvement in hypoxemia and respiratory metrics in VLBW infants. At a single center (2012-2022), all VLBW infants with echocardiographic evidence of PDA and without exclusions were classified as having received or not received pharmacologic PDA treatment (PDA-T and PDA-NT). Mean daily fraction of inspired oxygen (FIO2) and Respiratory Acuity Score (RAS, PMID 30374050) were compared at baseline (day 0) and 3 days after the start of treatment. For PDA-T infants with archived 0.5 Hz (every 2-second) oxygen saturation (SpO2) data, mean daily SpO2 and the percentage of time with severe hypoxemia (SpO2 <80%) were compared before and after treatment. Severe hypoxemia was further analyzed after stratification by clinical variables (sex, medication, gestational age, and postnatal age). We analyzed 125 VLBW infants with PDA, of whom 66 received pharmacologic PDA treatment. We analyzed a subgroup of 43 PDA-T infants with every 2-second SpO2 data available. PDA-T infants had higher baseline FiO2 and RAS and lower SpO2 than PDA-NT infants (p < 0.05). Compared to baseline, RAS decreased from a median of 258 (interquartile range [IQR]: 171, 348) to 254 (IQR: 174, 419), 3 days after the start of treatment (p = 0.012), but median FiO2 increased from 37% (IQR: 28, 46) to 40% (IQR: 29, 52; p = 0.008). SpO2 and the percent time with severe hypoxemia were unchanged. In this 10-year, retrospective, single-center analysis, pharmacologic PDA treatment in VLBW infants was not associated with a major improvement in acute measures of oxygenation or level of respiratory support. · Infants with pharmacologically treated PDA had worse baseline respiratory and oxygenation metrics.. · RAS decreased but FiO2 increased 3 days after pharmacologic PDA treatment.. · Pharmacologic PDA treatment did not acutely improve SpO2 or severe hypoxemia..

Utilizing IoMT-Based Smart Gloves for Continuous Vital Sign Monitoring to Safeguard Athlete Health and Optimize Training Protocols.

This paper presents the development of a vital sign monitoring system designed specifically for professional athletes, with a focus on runners. The system aims to enhance athletic performance and mitigate health risks associated with intense training regimens. It comprises a wearable glove that monitors key physiological parameters such as heart rate, blood oxygen saturation (SpO2), body temperature, and gyroscope data used to calculate linear speed, among other relevant metrics. Additionally, environmental variables, including ambient temperature, are tracked. To ensure accuracy, the system incorporates an onboard filtering algorithm to minimize false positives, allowing for timely intervention during instances of physiological abnormalities. The study demonstrates the system's potential to optimize performance and protect athlete well-being by facilitating real-time adjustments to training intensity and duration. The experimental results show that the system adheres to the classical "220-age" formula for calculating maximum heart rate, responds promptly to predefined thresholds, and outperforms a moving average filter in noise reduction, with the Gaussian filter delivering superior performance.

Clinical correlates of a high cardiorespiratory risk score for very low birth weight infants

Abstract Background A pulse oximetry warning system (POWS) to analyze heart rate and oxygen saturation data and predict risk of sepsis was developed for very low birth weight (VLBW) infants. Methods We determined the clinical correlates and positive predictive value (PPV) of a high POWS score in VLBW infants. In a two-NICU retrospective study, we identified times when POWS increased above 6 (POWS spike). We selected an equal number of control times, matched for gestational and chronologic age. We reviewed records for infection and non-infection events around POWS spikes and control times. We calculated the frequencies and PPV of a POWS spike for infection or another significant event. Results We reviewed 111 POWS spike times and 111 control times. Days near POWS spikes were more likely to have clinical events than control days (77% vs 50%). A POWS spike had 52% PPV for suspected or confirmed infection and 77% for any clinically significant event. Respiratory deterioration occurred near more POWS spike times than control times (34% vs 18%). Conclusions In a retrospective cohort, infection and respiratory deterioration were common clinical correlations of a POWS spike. POWS had a high PPV for significant clinical events with or without infection. Impact There are significant gaps in understanding the best approach to implementing continuous sepsis prediction models so that clinicians can best respond to early signals of deterioration. Infection and respiratory deterioration were common clinical events identified at the time of a high predictive model score. Understanding the clinical correlates of a high-risk early warning score will inform future implementation efforts.

OSA Symptom Subtypes and Hypoxic Burden Independently Predict Distinct Cardiovascular Outcomes

Study ObjectivesStudies on obstructive sleep apnea (OSA) have identified clinically relevant symptom-based subtypes and novel OSA-specific nocturnal hypoxic measures. Both traits are individually associated with cardiovascular outcomes, but evidence about their independent or shared effects is unknown. This study investigated the simultaneous contributions of OSA symptom subtypes and hypoxic burden (HB) on incident cardiovascular outcomes.MethodsSleep Heart Health Study participants with high-quality oxygen saturation, apnea-hypopnea index (AHI), and symptom data were included. Participants with OSA (AHI≥5 events/hour) were grouped into symptom subtypes. HB was calculated from respiratory event-related hypoxia. Cox proportional hazards models assessed whether symptom subtypes and/or HB were independently associated with cardiovascular mortality and major adverse cardiovascular events (MACE).Results4396 participants free of cardiovascular disease were analyzed, with median follow-up &gt;11 years. Higher HB was associated with worse cardiovascular mortality (HR [95% CI]: 1.63 [1.13,2.35]; p=0.009) independently of symptom subtypes. Compared to those without OSA, the excessively sleepy OSA subtype had higher risk of incident MACE (1.62 [1.23,2.15]; p&lt;0.001), independently of HB. Among participants with moderate-severe OSA (AHI ≥15 events/hour), excessively sleepy participants had higher risk of cardiovascular endpoints compared to other subtypes, but HB was not associated with cardiovascular mortality or MACE risk.ConclusionOSA symptom subtypes and HB are independently associated with MACE and cardiovascular mortality, respectively. Thus, both are important for understanding OSA-related cardiovascular risk. Future studies using clinical samples including OSA therapy information that incorporate symptom subtypes and novel biomarkers, such as HB, could improve predictive models for cardiovascular disease risk.

Oxygen saturation and work of breathing indices in preterm infants with bronchopulmonary dysplasia compared to healthy preterm infants at discharge.

Thoracoabdominal asynchrony (TAA) is commonly seen in preterm infants. Respiratory inductive plethysmography (RIP) is a noninvasive way to objectively assess work of breathing (WOB) indices. The impact of bronchopulmonary dysplasia (BPD) on TAA at discharge has not been established. The aim of this study is to compare WOB indices in premature infants with a diagnosis of BPD to premature infants without a diagnosis of BPD at discharge. A prospective, observational study of premature infants (<32 weeks gestation) at discharge during quiet breathing in the supine position. RIP noninvasively measured WOB indices. A high-resolution pulse oximeter collected oxygen saturation and heart rate data. This study included thirty-one infants with BPD and thirty-four infants without BPD. Infants diagnosed with BPD had increased phase angle [BPD Φ=73.90 (8.2) vs NoBPD Φ=52.6 (8.2), p = 0.039]. Infants diagnosed with BPD had decreased saturations [BPD SpO2 = 96% (0.4) vs NoBPD Sp02 98% (0.3), p=<0.001], increased time with saturations less than 85% [BPD % =2.74 (0.7) vs NoBPD % =0.91 (0.4), p = .018], and increased time with saturations less than 80% [BPD % =1.57 (0.5) vs NoBPD % =0.52 (0.3), p = 0.045]. There was no difference in heart rate or breaths per minute for infants with BPD versus controls. Premature infants with BPD demonstrated increased TAA and had lower saturations compared to infants without BPD at discharge despite being chronologically older and being discharged at an older corrected gestational age. The impact of BPD on breathing patterns persists at discharge and suggests these patients may have residual lung and/or respiratory muscle dysfunction.

A Rehabilitation and Monitoring System for Upper Limb Stroke Based on The Combination of Mirror and Stationary Bicycle

The weakening of motor functions in individuals due to a stroke can impact daily life productivity, necessitating therapy or rehabilitation. One method for restoring the function of body parts, especially the upper limb affected by a stroke, is through mirror therapy on a bicycle. Mirror therapy provides visual stimulation to the brain, influencing the improvement of motor functions. To monitor the effectiveness and safety during therapy, a monitoring system is required to track progress and evaluate vital signs to prevent health issues arising from the exercise process. This research aims to design an integrated upper limb motor exercise system using a mirror therapy bicycle with a website to monitor the therapy process and evaluate the results. Observed parameters include heart rate, oxygen saturation, pedal rotations, and therapy duration. This is because the longer the duration and the more rotations of the static bicycle pedaled by post-stroke patients, the greater the likelihood of improving motor skills. Software reliability was tested for the website and data communication. The study involved 20 healthy subjects, analyzed statistically through descriptive statistics and normality tests using the Kolmogorov-Smirnov type. Then, data similarity was tested against a comparator using the Independent Sample T-Test. Heart rate (bpm) and oxygen saturation (SpO2%) data from the sensor were normally distributed with a p-value ≥ 0.05. MQTT demonstrated optimal performance at QoS 0 with a throughput value of 604.8 bits/s, delay of 3.4 ms, jitter of 2.152 ms, and no packet loss.

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

Patients with surgical, pulmonary, and cardiac problems, continual monitoring of Oxygen Saturation of a Person (SpO2) and Respiratory Rate (RR) is essential. Similarly, the persons with cardiopulmonary health issues, RR estimation is crucial. The performance of the ventilator assistance and lung medicines are evaluated using SpO2 and RR. For the persons, those who are living alone with respiratory illnesses need a compulsory estimation of RR. In case of serious illness, the RR might face abrupt changes. The immobility of the disturbance and RR makes the RR evaluation from the PhotoPlethysmoGraphic (PPG) signals is a difficult challenge. So, an efficient RR and SpO2 estimation framework from the PPG signal using the deep learning method is developed in this paper. At first, the PPG signal is collected from standard data sources. The collected PPG signals undergo signal pre-processing. The pre-processing procedures include Motion Artifacts (MA) removal and filtering techniques. The pre-processed signals are split into distinct windows. From the split windows of the signals, the spectral features, RR, and Respiratory Peak Variance (RPV) features are extracted. The retrieved features are selected optimally with the help of Advanced Golden Tortoise Beetle Optimizer (AGTBO). The weights are chosen optimally with the same AGTBO. The optimally selected features are fused with the optimal features to get the weighted optimal features. These weighted optimal features are fed into the Ensemble Learning-based RR and SpO2 Estimation Network (ELRR-SpO2EN). The ensemble learning model is developed by combining Multilayer Perceptron (MLP), AdaBoost, and Attention-based Long Short Term Memory (A-LSTM). The performance of the developed RR and SpO2 estimation model is compared with other existing techniques. The experimental analysis results revealed that the proposed AGTBO-ELRR-SpO2EN model attained 96 % accuracy for the second dataset, which is higher than the conventional models such as MLP (90 %), Adaboost (92 %), A-LSTM (92 %), and MLP-ADA-ALSTM (94 %). Thus, it has been confirmed that the designed RR and SpO2 estimation framework from PPG signals is more efficient than the other conventional models.

Early Prediction of Hemodynamically Significant Patent Ductus Arteriosus in Preterm Infants using Non-invasive Electrical Cardiometry

Abstract Background Prematurity is a term for the broad category of neonates born at less than 37 weeks' gestation following onset of the last menstrual period. Different degrees of prematurity are defined by gestational age (GA) or birth weight (BW). Prematurity is associated with approximately one- third of all infant deaths. Complications of prematurity are the underlying cause of the higher rate of infant mortality and morbidity in preterm infants compared to full term infants. Objective To identify hemodynamic changes during the first 48hrs in life using non-invasive cardiometry and how these changes can predict which infants would develop clinical and echocardiographic criteria for PDA treatment. Patients and Methods This Prospective cohort study was conducted at tertiary care hospital at the neonatal intensive care units of Ain Shams University, Children’s Hospital from October 2021 till April 2022 and performed on preterm neonates who are less than 35 weeks gestational age and admitted to the NICU of pediatric hospital. Results Hemodynamically-significant PDA group had significantly lower systolic, diastolic blood pressure and mean arterial blood pressure than hemodynamically not significant PDA group at each time of follow up and significantly higher heart rate at (12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 45, 48) hours in patients with hemodynamically-significant PDA. There was statistically significant difference between the two studied groups as regards vital data of Oxygen saturation (SpO2) and UOP which were significantly lower in hemodynamically-significant PDA. Conclusion in our prospective cohort study increased heart rate, decreased mean arterial blood pressure predict a clinically significant PDA requiring treatment. Furthermore, vital data seem to be a good non invasive tools to monitor hemodynamic changes in preterms with hemodynamically significant PDA. However, further studies with a higher number of patients are necessary to ground the outcomes of these preliminary considerations.

The effect of Qur’an recitation and kangaroo mother care on vital signs among low birth weight infants

Background: Infants with low birth weight require intensive care to prevent potential hypothermia, which increases the risk of pain and death. Kangaroo mother care, involving skin-to-skin contact, can reduce the risk of hypothermia and strengthen the bond with their mothers. Purpose: To observe the effect of the simultaneous application of Qur'an recitation and kangaroo mother care on the vital signs of low birth weight infants. Method: The study involved 17 stable low birth weight infants chosen through non-probability accidental sampling. The intervention consisted of playing recorded Qur'an recitation and administering kangaroo mother care for 45 minutes daily over a period of 3 days. The recitation was played at a volume of 40-50dB, maintaining at least 30 cm distance from the infants' ears. Results: The Shapiro-Wilk normality test showed that the data for oxygen saturation, heart rate, and temperature were normally distributed, with values exceeding α (0.05). According to the Wilcoxon test, the oxygen saturation data had a p-value of 0.001, with pre-test and post-test means of 94.29% and 98.53%, respectively. The heart rate data had a p-value of 0.011, with a pre-test mean of 139.8 beats per minute and a post-test mean of 132.4 beats per minute. The body temperature data had a p-value of 0.140, with pre-test and post-test means of 36.8°C and 36.7°C, respectively. Conclusion: Combining kangaroo care with playing recorded Qur'an recitation in the treatment and care of low birth weight infants significantly enhances physiological parameters, including oxygen saturation and heart rate.

An Analytics of Sleep Apnea Classification using Caswideresnet Algorithm

Sleep apnea is a common yet serious sleep disorder that affects millions of individuals worldwide. Timely and accurate detection of sleep apnea can significantly improve patient outcomes and quality of life. In this study, we propose an advanced approach for sleep apnea classification and prediction using the CasWideResNet algorithm. Our methodology includes preprocessing steps such as Z-score normalization to standardize the data and improve algorithm performance. Additionally, we employ an improved Pan-Tompkins algorithm for feature selection, which helps in identifying relevant features from physiological signals such as electrocardiogram (ECG) and oxygen saturation (SpO2) data. The CasWideResNet algorithm, known for its deep learning capabilities, is utilized for the classification and prediction tasks. This algorithm leverages the power of deep convolutional neural networks (CNNs) to automatically learn discriminative features from the input data and make accurate predictions. By integrating Z-score normalization, improved feature selection, and the CasWideResNet algorithm, our proposed system aims to achieve high accuracy in detecting and predicting sleep apnea episodes. We evaluate the performance of our approach using a comprehensive dataset containing a diverse range of sleep apnea cases. Our results demonstrate the effectiveness of Z-score normalization in improving data quality and the role of the improved Pan-Tompkins algorithm in selecting informative features.

A gated recurrent unit model based on ultrasound images of dynamic tongue movement for determining the severity of obstructive sleep apnea

Obstructive sleep apnea (OSA) presents as a respiratory disorder characterized by recurrent upper pharyngeal airway collapse during sleep. Dynamic tongue movement (DTM) analysis emerges as a promising avenue for elucidating the pathophysiological underpinnings of OSA, thereby facilitating its diagnosis. Recent endeavors have utilized artificial intelligence techniques to categorize OSA severity leveraging electrocardiography and blood oxygen saturation data. Nonetheless, the integration of ultrasound (US) imaging of the tongue remains largely untapped in the development of machine learning models aimed at determining the severity of OSA. This study endeavors to bridge this gap by capturing US images of DTM dynamics during wakefulness, encompassing transitions from normal breathing (NB) to the performance of the Müller maneuver (MM) in a cohort of 53 patients. Leveraging the modified optical flow method (MOFM), the trajectories of patients’ DTM were tracked, facililtating the extraction of 27 parameters vital for model training. These parameters encompassed nine-point lateral movement, nine-point axial movement, and nine-point total displacement of the tongue, resulting in a dataset of 186,030 samples. The gated recurrent unit (GRU) method, renowned for its efficacy in motion tracking, was employed for model development in this study. Validation of the developed model was conducted via stratified k-fold cross-validation (SCV). The systems’ overall performance in classifying OSA severity, as quantified by mean accuracy (MA), yielded a value of 43.49%. This pilot investigation marks an exploratory endeavor into the utilization of artificial intelligence for the classification of OSA severity based on US images and dynamic movement patterns. This novel model holds potential to assist clinicians in categorizing OSA severity and guiding the selection of pertinent treatment modalities tailored to the individual needs of patients afflicted with OSA.

Calculating Load and Intensity Using Muscle Oxygen Saturation Data.

The study aimed to calculate training intensity and load using muscle oxygen saturation (SmO2) during two differentiated physical tasks. 29 university athletes participated in a 40-m Maximal Shuttle Run Test (MST, 10 × 40-m with 30 s recovery between sprints) and a 3000-m time trial run. Distance and time were used to calculate external load (EL). Internal load indicators were calculated based on percentage of maximum heart rate (%HRMAX) and SmO2 variables: muscle oxygen extraction (∇%SmO2) and the cardio-muscle oxygen index (CMOI) was also provided by relating ∇%SmO2 ÷ %HRMAX, and the training load were calculated as the product of speed (m/min × IL) and the efficiency index [Effindex (m/min ÷ IL)]. A student t test was applied based on Bayesian factor analysis. As expected, EL differed in the 40-m MST (331 ± 22.8) vs. 3000-m trials (222 ± 56.8) [BF10 = 6.25e+6; p = <0.001]. Likewise, IL showed higher values in 40-m MST (39.20 ± 15.44) vs. 3000-m (30.51 ± 8.67) in CMOI: [BF10 = 1.70; p = 0.039]. Training load was greater in 40-m MST (85.77 ± 27.40) vs. 3000-m (15.55 ± 6.77) [(m/min × ∇%SmO2): BF10 = 12.5; p = 0.003] and 40-m MST (129.27 ± 49.44) vs. 3000-m (70.63 ± 32.98) [(m/min × CMOI): BF10 = 169.6; p = <0.001]. Also, the Effindex was higher in 40-m MST (10.19 ± 4.17) vs. 3000-m (6.06 ± 2.21) [(m/min × ∇%SmO2): BF10 = 137.03; p = <0.001] and 40-m MST (9.69 ± 4.11) vs. 3000-m (7.55 ± 1.87) [(m/min × CMOI): BF10 = 1.86; p = 0.035]. This study demonstrates calculations of training intensity and load based on SmO2 as an internal load indicator along with speed as an external load indicator during two differentiated exercises.

Application of Near-infrared reflectance spectroscopy in the diagnosis of varicocele in children and adolescents

Varicocele is a venous anomaly characterized by the enlargement of the plexus of veins in the testicle. In pediatric cases, indications for surgical intervention in varicocele include palpable dilatation of the enlargement of the plexus veins, intermittent pain in the ipsilateral testicle, and a 20% reduction in size of the ipsilateral testicle compared to the contralateral healthy one. The limitations of evaluating these criteria and the need to assess semen parameters prompt clinicians to explore new diagnostic methods for timely surgical interventions in adolescents. One such promising study involves Near-infrared reflectance spectroscopy (NIRS) in the Near-infrared range. The aim of the research is to evaluate the diagnostic capabilities of NIRS in children with varicocele to determine the indications for surgical intervention. The study included 65 boys aged 11 to 17 years with left-sided grade III varicocele (main group) and 29 healthy boys as a control group. Monitoring of regional oxygen saturation (rSO2) of testicular tissues was conducted using optical spectroscopy. NIRS examination of testicular tissues in both study and control groups showed statistically homogeneous data for regional oxygen saturation in the healthy (right) testicle. However, the NIRS study revealed significantly lower oxygen saturation (rSO2) in the testicular tissue of the left testicle in patients with varicocele compared to the control group. The diagnostic significance of the difference in bilateral NIRS monitoring Δ rSO2 &gt;13% reliably characterized the presence of testicular hypotrophy by more than 20% compared to the healthy contralateral side (AUC=0.64, 95% CI (0.505-0.775), sensitivity – 79%, specificity – 50%, p=0.042). Δ rSO2 &gt;11% values indicated disturbances in spermogram related to oxidative stress (AUC=0.702, 95% DI (0.51-0.88), sensitivity – 82%, specificity – 61%, p=0.031). Therefore, NIRS study data have potential valuable information for the diagnosis and selection of treatment for varicocele in children. The research utilizing Near-infrared Reflectance Spectroscopy revealed a significant potential of this method for diagnosing and assessing the impact of varicocele on the microcirculation of testicular tissue in children. The diagnostic significance of the difference in bilateral monitoring using this non-invasive technique in determining the state of testicles and the possibility of addressing the question of the necessity of surgical intervention is established.

Predicting Extubation Readiness in Preterm Infants Utilizing Machine Learning: A Diagnostic Utility Study

ObjectiveTo predict extubation readiness in preterm infants using machine learning analysis of bedside pulse oximeter and ventilator data. Study designThis is an observational study with prospective recordings of oxygen saturation (SpO2) and ventilator data from infants < 30 weeks’ gestation age (GA). Research pulse oximeters collected SpO2 (1 Hz sampling rate) to quantify intermittent hypoxemia (IH). Continuous ventilator metrics were collected (4-5 min sampling) from bedside ventilators. Data modeling was completed using unbiased machine learning algorithms. Three model sets were created using the following data source combinations: [1] IH and ventilator (IH + SIMV), [2] IH, and [3] ventilator (SIMV). Infants were also analyzed separated by postnatal age (infants < 2 or ≥ 2 weeks of age). Models were compared by area under the ROC curve (AUC). ResultsA total of 110 extubation events from 110 preterm infants were analyzed. Infants had a median GA and birth weight of 26 weeks and 825 grams, respectively. Of the three models presented, the IH + SIMV model achieved the highest AUC of 0.77 for all infants. Separating infants by postnatal age increased accuracy further achieving AUC of 0.94 for < 2 weeks of age group and AUC of 0.83 for ≥ 2 weeks group. ConclusionsMachine learning analysis has the potential to enhance prediction accuracy of extubation readiness in preterm infants while utilizing readily available data streams from bedside pulse oximeters and ventilators.

Identification of recreational cycling training dose as an effective physical therapy to elicit changes into active lifestyle

This study aims to determine the relationship of living habits during the new normal period with (1) body composition and (2) blood oxygen levels after cycling while wearing a mask. This research is a multicenter study between Indonesia and Malaysia, with the data presented here being specifically from the DI Yogyakarta region in Indonesia, involving an analytical observational study using a cross-sectional approach. The study included 71 research subjects. The instruments used to collect data were fitness behavior during the pandemic (exercise frequency and duration), anthropometric and oxygen saturation measurement after cycling during pandemic. Body composition was determined using the BMI formula, involving height and weight. Oxygen saturation during cycling was measured using the Pulse Oximeter FOX-1(N) by Elitech Technovision. The largest percentage of cycling is twice a week (42.25%), followed by three, one, fifth and fourth times a week. The majority of participants cycled for 120 minutes (35.21%), followed by durations of 180 minutes, 60 minutes, 30 minutes, and so on. Oxygen saturation data shows that most subjects have oxygen saturation of 98% (47.8% of respondents), none of them have 100%, but 97% saturation, 96% occupying the second and third distributions. From the primary data obtained in Indonesia, only oxygen saturation and cycling duration showed a highly significant relationship (p = 0.009), while other variables, such as BMI and cycling frequency, did not exhibit a significant correlation. It can be concluded that a significant relationship exists between exercise duration, specifically cycling, and oxygen saturation in Indonesian subjects.

Association between Intermittent Hypoxemia and NICU Length of Stay in Preterm Infants

Introduction: Length of hospitalization varies widely in preterm infants and can be affected by multiple maternal and neonatal factors including respiratory instability. Therefore, we aimed to determine the association between postnatal intermittent hypoxemia (IH) and prolonged hospitalization. Methods: This prospective single-center cohort study followed infants born at <31 weeks of gestational age through 2 years corrected age with detailed oxygen saturation data captured from days 7 to 30 of age. Results: 51/164 (31%) of infants were discharged after 400/7 weeks of corrected gestational age (CGA). A greater average daily number of IH events (OR per 10 events/day 1.33 [95% CI 1.03–1.72]), duration of events (OR per minute 1.14 [1.07–1.21]), and percent time with oxygen saturation <80% (OR per percent 1.88 [1.25–2.85]) on days 7–30 of age were all significantly associated with prolonged hospitalization past 400/7 weeks CGA. In survival analyses, infants with a greater average daily number of IH events (HR per 10 events/day 0.89 [0.81–0.98]), percent time with oxygen saturation <80% (HR per percent 0.79 [0.67–0.94]), and duration of events (HR per minute 0.93 [0.91–0.95]) on days 7–30 of age all had significantly lower probability of earlier discharge. In addition, there was a significant interaction with gestational age; the association between IH and prolonged hospitalization was stronger in more mature infants (p = 0.024). Conclusions: Physiological instability on days 7–30 of age, as manifested by IH, is significantly associated with prolonged hospitalization. IH likely represents both a marker of initial severity of illness and the beginning of biological cascades, leading to prematurity-associated morbidities.

Near-infrared spectroscopy data for foot skin oxygen saturation in healthy subjects.

Our objective was to evaluate normative data for near-infrared spectroscopy (NIRS) in 110 healthy volunteers by Fitzpatrick skin type (FST) and region of the foot. We obtained measurements of the dorsum and plantar foot using a commercially available device (SnapshotNIR, Kent Imaging, Calgary Canada). On the dorsum of the foot, people with FST6 had significantly lower oxygen saturation compared to FST1-5 (p < 0.001), lower oxyhaemoglobin compared to FST2-5 (p = 0.001), but there was no difference in deoxyhaemoglobin. No differences were found on the plantar foot. When comparing dorsal and plantar foot, there was higher oxyhaemoglobin (0.40 ± 0.09 vs. 0.51 ± 0.12, p < 0.001) and deoxyhaemoglobin (0.16 ± 0.05 vs. 0.21 ± 0.05, p < 0.001) on the plantar foot, but no differences in oxygen saturation (dorsal 70.7 ± 10.8, plantar 70.0 ± 9.5, p = 0.414). In 6.4% of feet, there were black areas, for which no NIRS measurements could be generated. All areas with no data were on the dorsal foot and only found in FST 5-6. People with FST6 had significantly larger areas with no data compared to FST 5 (22.2 cm2 ± 20.4 vs. 1.9 cm2 ± 0.90, p = 0.007). These findings should be considered when using NIRS technology. Skin pigmentation should be evaluated in future NIRS studies.

Feasibility of Leveraging Consumer Wearable Devices with Data Platform Integration for Patient Vital Monitoring in Low-Resource Settings.

Manual monitoring of vital signs, which often fails to capture the onset of deterioration, is the main monitoring modality in most Ghanaian hospitals due to the high cost and inadequate supply of patient bedside monitors. Consumer wearable devices (CWDs) are emerging, relatively low-cost technologies for continuous monitoring of physiological status; however, their validity has not been established in low-resource clinical settings. We aimed to (1) investigate the validity of the heart rate (HR) and oxygen saturation (SpO2) data from two widely used CWDs, the Fitbit Versa 2 and Xiaomi Mi Smart Band 6, against gold standard bedside monitors in one Ghanaian hospital and (2) develop a web application to capture and display CWD data in a clinician-friendly way. A healthy volunteer simultaneously wore both CWDs and blood pressure cuffs to measure HR and SpO2. To test for concordance, we conducted the Bland-Altman and mean absolute percentage error analyses. We also developed a web application that retrieves and displays CWD data in near real time as text and graphical trends. Compared to gold standards (patient monitor and manual), the Fitbit Versa 2 had 96.87% and 96.67% measurement accuracies for HR, and the Xiaomi Mi Smart Band 6 had 94.24% and 93.21% measurement accuracies for HR. The Xiaomi Mi Smart Band 6 had 98.79% measurement accuracy for SpO2. The strong concordance between CWD and gold standards supports the potential implementation of these devices as a novel method of vital sign monitoring to replace manual monitoring, thus saving costs and improving patient outcomes. Further studies are needed for confirmation.

The effects of massage and white noise on physiological parameters of preterm infants: A randomized controlled research

PurposeThe present research was conducted to find out the effects of massage and white noise on physiological parameters in preterm infants. Material-methodWhile each preterm infant in the massage group was given massage by the researcher in the morning and evening for three days, the infants in the white noise group listened to white noise in the morning and evening for three days. Standard nursing care was provided for three days in the control group. Physiological parameters of the preterm infants in all of the groups on the first, second and third days were recorded by the researcher before the procedure. Following the interventions to preterm infants by the researcher, peak heart rate, respiratory rate and oxygen saturation data were recorded. ResultsSignificant difference was found between the first, second and third day peak heart rate, respiratory rate and oxygen saturation values of the preterm infants in the massage and white noise group when compared with the control group. No significant difference was found between the white noise and massage group. In the temporal analysis of the massage and white noise group, a decrease was found in peak heart rate and respiratory rate, while an increase was found in oxygen saturation values. ConclusionMassage and white noise were found to be effective on physiological parameters of preterm infants. It was found that in the neonatal intensive care unit, nurses can prefer massage or white noise methods in healing physiological parameters of preterm infants.