Pulse Oximeter Research Articles

Electronic health record data is unable to effectively characterize measurement error from pulse oximetry: a simulation study.

Large data sets from electronic health records (EHR) have been used in journal articles to demonstrate race-based imprecision in pulse oximetry (SpO2) measurements. These articles do not appear to recognize the impact of the variability of the SpO2 values with respect to time ("deviation time"). This manuscript seeks to demonstrate that due to this variability, EHR data should not be used to quantify SpO2 error.Using the MIMIC-IV Waveform dataset, SpO2 values are sampled from 198 patients admitted to an intensive care unit and used as reference samples. The error derived from the EHR data is simulated using a set of deviation times. The laboratory oxygen saturation measurements are also simulated such that the performance of three simulated pulse oximeter devices will produce an average root mean squared (ARMS) error of 2%. An analysis is then undertaken to reproduce a medical device submission to a regulatory body by quantifying the mean error, the standard deviation of the error, and the ARMS error. Bland-Altman plots were also generated with their Limits of Agreements. Each analysis was repeated to evaluate whether the measurement errors were affected by increasing the deviation time.All error values increased linearly with respect to the logarithm of the time deviation. At 10min, the ARMS error increased from a baseline of 2% to over 4%.EHR data cannot be reliably used to quantify SpO2 error. Caution should be used in interpreting prior manuscripts that rely on EHR data.

U.S. Food and Drug Administration Strategy to Evaluate Pulse Oximeters: The Same Cause Will Produce the Same Effects.

U.S. Food and Drug Administration Strategy to Evaluate Pulse Oximeters: The Same Cause Will Produce the Same Effects.

Cyber-attacks Risk Analysis of a Connected Pulse Oximeter Device: A Threat Modeling Using STRIDE and DREAD Models

The term "Internet of Things (IoT)" has gained significant traction in recent years due to its wide-ranging applications across various industries, including the healthcare sector. These medical devices, known as connected medical devices, offer immense benefits to patients with chronic diseases and others. However, despite their advantages, regulatory bodies responsible for issuing medical device sales and usage permits currently lack a standardized method for evaluating the security and cybersecurity resilience of these devices before granting approval. The proposed threat modeling approach is an engineering tool that utilizes the STRIDE model to identify and categorize potential threats to connected devices, determine the mitigation techniques employed, and generate a comprehensive report. Additionally, the DREAD model is employed to assess the severity of potential threats throughout the development life cycle of the connected medical device. This paper aims to validate the accuracy and realism of the outcomes derived from this tool and assess the ease of implementation of the proposed methodology by medical device designers and biomedical engineers who lack cybersecurity expertise. The results of applying the proposed threat modeling approach using the STRIDE and DREAD models to an open-source connected pulse oximeter revealed a low average severity score for the connected medical device against potential cyber threats. Our approach was also compared to other threat modeling methods in terms of the number of steps, implementation complexity, and result realism. The findings demonstrat that our threat modeling approach requires the fewest steps, does not necessitate cybersecurity expertise for implementation, and produces more realistic and stable results. Consequently, we propose that the FDA adopt and implement our proposed approach to expedite the approval process for the sale and use of these medical devices, enabling healthcare providers to leverage connected medical devices on a wider scale to combat diseases and epidemics, ultimately delivering higher quality and more effective healthcare.

Non-invasive blood glucose estimation method based on the phase delay between oxy- and deoxyhemoglobin using visible and near-infrared spectroscopy.

Many researchers have attempted to estimate blood glucose levels (BGLs) noninvasively using near-infrared (NIR) spectroscopy. However, the optical absorption change induced by blood glucose is weak in the NIR region and often masked by interference from other components such as water and hemoglobin. Instead of using direct optical absorption by glucose, this study proposes an index calculated from oxy- and deoxyhemoglobin signals that shows a good correlation with BGLs while using conventional visible and NIR spectroscopy. The metabolic index, which is based on tissue oxygen consumption, was derived through analytical methods and further verified and reproduced in a series of glucose challenge experiments. Blood glucose estimation units were prototyped by utilizing commercially available smart devices. Our experimental results showed that the phase delay between the oxy- and deoxyhemoglobin signals in near-infrared spectroscopy correlates with BGL measured by a conventional continuous glucose monitor. The proposed method was also confirmed to work well with visible spectroscopy systems based on smartphone cameras. The proposed method also demonstrated excellent repeatability in results from a total of 19 oral challenge tests. This study demonstrated the feasibility of non-invasive glucose monitoring using existing photoplethysmography sensors for pulse oximeters and smartwatches. Evaluating the proposed method in diabetic or unhealthy individuals may serve to further increase its practicality.

Contactless Blood Oxygen Saturation Estimation from Facial Videos Using Deep Learning.

Blood oxygen saturation (SpO2) is an essential physiological parameter for evaluating a person's health. While conventional SpO2 measurement devices like pulse oximeters require skin contact, advanced computer vision technology can enable remote SpO2 monitoring through a regular camera without skin contact. In this paper, we propose novel deep learning models to measure SpO2 remotely from facial videos and evaluate them using a public benchmark database, VIPL-HR. We utilize a spatial-temporal representation to encode SpO2 information recorded by conventional RGB cameras and directly pass it into selected convolutional neural networks to predict SpO2. The best deep learning model achieves 1.274% in mean absolute error and 1.71% in root mean squared error, which exceed the international standard of 4% for an approved pulse oximeter. Our results significantly outperform the conventional analytical Ratio of Ratios model for contactless SpO2 measurement. Results of sensitivity analyses of the influence of spatial-temporal representation color spaces, subject scenarios, acquisition devices, and SpO2 ranges on the model performance are reported with explainability analyses to provide more insights for this emerging research field.

Comparison of oxygen saturation values between term and pre-term neonates.

Objective: To determine mean oxygen saturation (SpO2) values in normal newborns and compare mean Spo2 values between term and preterm infants. Study Design: Descriptive Case Series. Setting: Hameed Latif Teaching Hospital Lahore. Period: March 2023 to November 2023. Material & Methods: The study involved 100 neonates from operation theatre and labor room. Informed consent was obtained from parents. Immediately after birth, pulse oximeter was applied and serial monitoring of oxygen saturation was carried out starting at 1 minute and recording values after every 1 minute till 10 minutes of life. Results: There were 50% male and 50% female neonates. The average SpO2 values were 76.13±10.41 at first minute, 89.68±6.62 at 5 minutes & 95.84±3.65 at 10 minutes of life. Mean SpO2 was significantly high in term babies as compared to preterm babies at one minute and 5 minutes. However there was no significant difference in mean SpO2 at 10 minutes in term and preterm babies. Conclusion: The process of transition to normal postnatal oxygen saturation requires more than 5 minutes in healthy newborns. In healthy term newborn, oxygen saturation rises slowly. SpO2 monitoring may help identifying the infants requiring resuscitation to avoid overexposure to high supplemental oxygen after birth. Many newborns have SpO2 <90% during the first 5 minutes of life. This should be considered when choosing SpO2 targets for infants treated with supplemental oxygen in the delivery room.

Cardiovascular response to body positioning following sub-maximal exercise test among long-COVID individuals

Abstract This study aimed to observe the effect of cardiovascular response to body positioning after cardiopulmonary exercise testing in post covid individuals. Ninety post covid participants (age group 18-45) were assigned into four groups: standing, sitting, supine, and prone position. All participants were assessed cardiovascular response, VO2max baseline, post exercise in standing, sitting, supine and prone by using pulse oximeter, digital sphygmomanometer, polar heart rate and Borg scale. In SpO2, rate of perceived exertion (RPE), diastolic blood pressure, and heart rate, there was no significant difference between the groups at pre-exercise. However, a significant difference was observed at 1 min post-exercise and at 3 min post-exercise. As for systolic blood pressure, there was no significant difference between the groups at pre-exercise and at 1 min post-exercise, but a significant difference was noted at 3 min post-exercise. The findings of this study suggest that, when comparing standing, sitting, supine, and prone positions, the prone position exhibited faster recovery in terms of oxygen saturation and rate of perceived exertion, while the supine position showed quicker recovery in both systolic and diastolic blood pressure. Additionally, individuals with long-COVID symptoms were observed to have a lower VO2max.

Effect of lower body negative pressure on cardiac and cerebral function in postural orthostatic tachycardia syndrome: A pilot MRI assessment.

Postural orthostatic tachycardia syndrome (POTS) is characterized by an excessive heart rate (HR) response upon standing and symptoms indicative of inadequate cerebral perfusion. We tested the hypothesis that during lower body negative pressure (LBNP), individuals with POTS would have larger decreases in cardiac and cerebrovascular function measured using magnetic resonance (MR) imaging. Eleven patients with POTS and 10 healthy controls were studied at rest and during 20 min of -25 mmHg LBNP. Biventricular volumes, stroke volume (SV), cardiac output (Qc), and HR were determined by cardiac MR. Cerebral oxygen uptake (VO2 ) in the superior sagittal sinus was calculated from cerebral blood flow (CBF; MR phase contrast), venous O2 saturation (SvO2 ; susceptometry-based oximetry), and arterial O2 saturation (pulse oximeter). Regional cerebral perfusion was determined using arterial spin labelling. HR increased in response to LBNP (p < 0.001) with no group differences (HC: +9 ± 8 bpm; POTS: +13 ± 11 bpm; p = 0.35). Biventricular volumes, SV, and Qc decreased during LBNP (p < 0.001). CBF and SvO2 decreased with LBNP (p = 0.01 and 0.03, respectively) but not cerebral VO2 (effect of LBNP: p = 0.28; HC: -0.2 ± 3.7 mL/min; POTS: +1.1 ± 2.0 mL/min; p = 0.33 between groups). Regional cerebral perfusion decreased during LBNP (p < 0.001) but was not different between groups. These data suggest patients with POTS have preserved cardiac and cerebrovascular function.

The impact of room shape on affective states, heartrate, and creative output

The architectural design of space can deeply impact an individuals' mood, physiology, and mental health. While previous research has predominantly focused on elements like nature and lighting within architectural spaces, there is a growing literature base that also investigates the psychological and neurophysiological impacts of geometrical properties of architectural spaces. Employing virtual reality technology, the study sought to investigate the effects of curved and rectangular architectural spaces on affective states, heart rate, and creativity.A total of 35 participants were exposed to two distinct virtual environments: a curved room and a rectangular room. Participants' self-reported mood was assessed using the Positive and Negative Affect Schedule (PANAS-Long Form). Heart rate was monitored using a pulse oximeter, and creative output was evaluated using the Guilford Alternative Uses Task (GAUT).Statistical comparisons between the two room types indicated that participants experienced higher positive affect and lower negative affect in the curved room condition compared to the rectangular room condition. Furthermore, heart rate measurements revealed lower physiological arousal in the curved room. Additionally, participants exhibited higher creative output in the curved room as opposed to the rectangular room.These findings align with previous literature on the influence of geometric factors on affective responses. The implications of this study are significant as they pertain to individuals' daily environments and their impact on health and well-being. The positive influence of curved room geometry on mood, arousal, and creativity emphasises the importance of considering room layout and design in various settings, such as workplaces and educational environments. Architects and designers can utilise these findings to inform their decisions and promote neuroarchitecture that enhances positive emotional experiences and productivity.

Development of a wearable monitor to identify stress levels using internet of things

Modern life's ubiquitous component of stress has a significant impact on many facets of human existence. This article presents the development of a wearable device integrated with internet of things (IoT) technology, aiming to identify and quantify stress levels in real-time. This technology provides a possible means of improving stress assessment, enabling prompt treatments and individualized stress management techniques. ESP32-PICO computation platform was used as part of wearable stress monitor. The developed wearable monitor also includes a high-sensitivity pulse oximeter and heart-rate sensor (MAX30102) and galvanic skin response (GSR) sensors to acquire physiological signals associated with stress status. The wearable monitor device delivers data to the firebase platform via Wi-Fi. The benefits and prospective uses of the IoT-enabled wearable device are also covered in the article. It demonstrates the mobile wearable monitor adaptability in a variety of scenarios, such as offices, classrooms, and healthcare facilities, where stress management is vita and required for activity optimization. Continuous monitoring capabilities allow users to learn about their stress levels and take proactive self-care measures. During the validation experiments, the accuracy of measurement capabilities of the developed wearable monitor were evaluated reduced errors of heart rate and respiratory rate being observed.

Maximum Phonation Time of School-Aged Children in Pakistan: A Normative Study

Maximum phonation time (MPT) evaluates maximum vocal capabilities and can be used to assess the effectiveness of behavioral and medical therapy interventions. There is a literature gap regarding MPT normalcy data for Pakistani children. Objective: To determine the Maximum Phonation Time of School Aged Children in Pakistan and its association with participant variables and impact of the 6-minute walk test on participant vitals. Methods: This cross-sectional survey was conducted in Rawalpindi and Islamabad on typical healthy school-aged children from August 2021 to January 2022. The sample included both genders, aged 6-13 years having normal language. Tools used included a basic demographic sheet, token test, stopwatch, growth chart, sphygmomanometer, pulse oximeter, and 6-minute walk test. Blood Pressure, oxygen saturation, heart rate, and MPT were calculated before and after the six-minute walk test (6-MWT). Data were analyzed by using SPSS version 21.0. Results: Results show MPT of 13.11 ± 3.93 seconds. Scores were significantly (p= 0.000) higher for higher age groups. 6-MWT revealed a significantly (p=0.000) higher post walk SPO2 (99.16 ± 0.89 Vs.97.82 ± 1.45), HR (105.94 ± 14.53 vs 92.94 ± 14.79). systolic (112.46±13.40 vs. 107.25 ± 13.66) and diastolic blood pressure (79.07 ± 8.17 Vs.73.84 ± 8.50) compared to pre walk. A significantly (p&lt;0.001) strong positive correlation was noted for age(r=.515), weight (r=.460), height (r=.491) and distance (r=.281). Conclusions: MPT of Pakistani 6-13 years children is 13.11 ± 3.93 seconds with significantly higher MPT for higher age groups. MPT has a strong positive correlation with age, weight, height and distance and increases after walking. MPT values for boys were slightly higher than for girls.

A pulse oximeter for measuring the blood oxygenation level considering the carboxyhemoglobin concentration: principles of development, computer model and accuracy assessment

The main method for estimating the level of arterial blood oxygenation is pulse oximetry, which has the advantages of being fast, simple, reliable, and non-invasive. However, in well-known pulse oximeters, oxygen saturation is determined only by hemoglobin functional fractions, which reduces the device accuracy and is unacceptable in certain clinical cases. The known pulse oximeter improvement that considers the dysfunctional fraction concentration, especially carboxyhemoglobin, when measuring the level of blood oxygenation is an actual scientific and technical task. The research subjects. Mathematical, algorithmic, and technical support of a pulse oximeter that measures blood oxygenation levels considering the carboxyhemoglobin concentration. Objective. To expand the pulse oximeter functionality to consider the concentration of carboxyhemoglobin in arterial blood. Methods. Methods of computer simulation for developing a model and estimating the pulse oximeter accuracy that measures the blood oxygenation level considering the carboxyhemoglobin concentration. Results. The theoretical statements of measuring the level of blood oxygenation considering the carboxyhemoglobin concentration and the simplest pulse oximeter structural diagram for measuring are developed. An additional LED used in the pulse oximeter is proposed, and the wavelength choice is justified on the condition of maximizing the carboxyhemoglobin contribution to the optical density of the biological object. Computer models of a traditional pulse oximeter and a pulse oximeter with an additional LED were developed, simulation research was conducted using the developed models, and the device accuracy for measuring the level of blood oxygenation was estimated considering the carboxyhemoglobin concentration. Conclusions. Simulation studies based on the developed models show that the proposed pulse oximeter, compared with the known one, allows determining and estimating a decrease in blood oxygenation caused by the carboxyhemoglobin concentration increasing in the patient’s blood. Considering that light is also absorbed by the third derivative of hemoglobin, carboxyhemoglobin, increases the accuracy of the proposed pulse oximeter in measuring functional saturation.

Comparison between Portable Pulse Oximeter and Conventional ICU Pulse Oximeter measurements in healthy adults: A Cross Sectional Study

ABSTRACT: Objective: To assess the agreement between oxygen saturation reading between portable pulse oximeter and conventional ICU monitor pulse oximeter. Methods: This cross-sectional study was conducted at Department of Medicine, Fatima Hospital Baqai Medical University, Karachi, from 1st March 2023 to 31st March 2023. Participants in the study in- cluded healthy health care workers and medical students who were over the age of 18 and did not have any known co-morbid conditions like hypertension or diabetes that may affect peripheral perfu- sion. None of the participants had hypotension, clinical evidence of anemia, fingernail paint or poor peripheral perfusion as these are the factors that may influence pulse oximetry readings. Both the portable pulse oximeter and the traditional intensive care unit (ICU) monitors were utilized to take and record the oxygen saturation levels of each of the ten fingers in a sequential manner while the patient was seated. Data was analyzed using SPSS version 22. Readings of both instruments were com- pared employing Regression analysis. Bland-Altman analysis was applied to measure the level of agreement between readings of portable pulse oximeter and conventional ICU monitors. Results: Total 200 participants were enrolled for this study and most of them were from younger age group. (Mean age of participants = 33.05 ± 10.31). There was no significant difference between oxy- gen saturation readings of respective finger from portable pulse oximeter and conventional ICU moni- tors on regression analysis (p &gt; 0.05). Highest mean oxygen saturation was recorded in right middle finger using portable pulse oximeter (98.71 ± 1.21). On the ICU monitor pulse oximeter, it was 2nd highest in right middle finger (98.33 ± 2.49). Therefore, Bold-Altman analysis applied between oxygen saturation reading for two devices in right middle finger and was found to be comparable. (Mean dif- ference (bias) = 0.375 with 95% confidence interval). Conclusion: Modern portable pulse oximeters can reliably be used to rule out hypoxemia.

Medical Sensors and their Integration in Wireless Body area Networking for Pervasive Healthcare Delivery

Wireless Body Area Networks (WBANs) integrate diverse sensors like heart rate monitors, electrocardiograms, pulse oximeters, respiration rate sensors, gyroscopes, and skin conductance sensors into a network for pervasive healthcare delivery. This interconnected system enables real-time monitoring and data fusion, ensuring accurate and comprehensive health assessments. Efficient communication protocols, cloud integration, and power management enhance the reliability and longevity of wearable devices. Security measures and user-friendly interfaces prioritize the protection of sensitive health data and ease of access. Machine learning algorithms contribute to predictive analytics for early detection of health issues. WBANs offer a holistic approach to personalized healthcare, allowing for continuous and remote monitoring of physiological parameters. The seamless integration of these sensors establishes a foundation for timely intervention and improved patient outcomes.

Impact of high-speed handpiece noise-induced dental anxiety on heart rate: analyzing experienced and non-experienced patients - a comparative study

BackgroundDental anxiety is very much common among the patients and could be due to different factors like the behavior of the dentist, past experiences, Needle phobia, or word of mouth from other patients. According to recent studies, a strong association between sound and anxiety has been found, so this observational study has been conducted to find out the link between the activation of anxiety with the sound of a handpiece between experienced patients, who have already gone through the dental treatments and non-experienced patients.MethodsTotal of 297 participants were part of this study. These participants were divided into 2 groups according to the experienced and non-experienced dental patients. The researcher first filled out the CORAH Dental Anxiety Scale (DAS) form to mark the anxiety level of the patients, and then noted the readings of the heart rate in 3 intervals which were before during, and after the treatment with the pulse oximeter. Later the data was analysed using the SPSS independent t-test.ResultsResults show that patients in group 1 who have gone through the dental treatment before were less anxious and had a lesser effect on their heart rate than the patient who were having the treatment for the first time who were in group 2. Another interesting factor was noticed that in both the groups female were found to be more anxious than male participants. Participants with younger age were found to be more anxious than older age patient in both groupsConclusionsThe sound of the handpiece can provoke anxiety in the patient, affecting the heart and increasing the heart rate. Participants who were experienced were found to be less anxious than the participants who were inexperienced.

Plethysmography variation index versus pulse pressure variation as an indicator of fluid responsiveness in colorectal surgeries during immediate postoperative period

ABSTRACT Background During major abdominal surgery, goal-directed fluid therapy may lessen postoperative morbidity. It has been demonstrated that the Plethysmography Variability Index (PVI), which is generated from the pulse oximeter waveform, can predict fluid responsiveness in a variety of surgical settings. Pulse pressure variation (PPV), one of the indicators of fluid responsiveness, has received the most research attention and clinical application of all the indicators. Through arterial cannulation, primarily the radial artery, pulse pressure fluctuation is recorded. The cyclic variations in intrathoracic pressure have less of an immediate impact on pulse pressure than they do on systolic pressure. In this study, sedated, intubated, mechanically ventilated patients admitted for postoperative resuscitation in our surgical ICU following colorectal surgeries had their fluid responsiveness assessed using the Plethysmography Variation Index (PVI) and the Pulse Pressure Variation (PPV) to compare their effectiveness and reliability.

Evaluation of accuracy of novel pulse oximeter probe compared to commercial multiparameter monitor in horses

Evaluation of accuracy of novel pulse oximeter probe compared to commercial multiparameter monitor in horses

The efficacy of iatrosedation and music listening techniques in attenuating dental anxiety in patients undergoing dental crown preparation: A randomized clinical trial.

Dental anxiety is a common problem encountered in dental clinics that affects both patients and dentists. Adequate management of dental anxiety is critical for optimal treatment outcomes for the patient. This study aims to assess the efficacy of two anxiety-reduction techniques (iatrosedation and music listening) for dental crown preparation in adult patients. In this clinical trial, 60 patients were randomly assigned to three groups: Group 1, iatrosedation; Group 2, music listening; and Group 3, control. Patients in all three groups underwent dental crown preparation. To measure the anxiety levels of the patients, heart rate was calculated using a pulse oximeter, and verbal rating scale scores were assessed. One-way analysis of variance, post hoc analysis, and Spearman's correlation were used to compare the mean values of the three groups. Significant differences were observed in the heart rate and verbal rating scale scores among individuals in the study groups. A more substantial reduction in anxiety levels was found in patients exposed to iatrosedation (Group 1), which was followed by music listening (Group 2). Recorded heart rate and verbal rating scores were the highest in the control group patients. The iatrosedation technique significantly reduced dental anxiety for patients undergoing dental crown treatment; however, music listening was less effective than iatrosedation. Educating patients regarding the dental care they are about to receive is vital for reducing their anxiety.

The effect of the simulated intrauterine sound on behavioral and physiological indices of pain during capillary blood sampling for screening preterm infants: a randomized clinical trial study

IntroductionDue to medical procedures, preterm infants are at high risk for side effects of pain. In this regard, heel lancing for capillary blood sampling is a common painful procedure. The present study was conducted to assess the effectiveness of a simulated intrauterine sound on behavioral and physiological indices of pain due to heel-prick blood sampling in preterm infants.MethodsA double‑blind randomized clinical trial (RCT) was conducted. The data were collected from September 23 to December 22, 2019. We measured the effect of a simulated intrauterine sound on changes in the behavioral and physiological parameters of pain (heart rate, SPO2) caused by heel lance that was measured 5 min before the intervention, during the sampling, and 5 min after the procedure. We measured behavioral pain by video recording the infants’ faces and then the scoring neonatal infant pain scale (NIPS). Heart rate and SPO2 were measured using a pulse oximeter device. The data were analyzed using analysis of variance (ANOVA) and independent t‑test in SPSS software version 20.0.ResultsEighty infants were randomized (40 in each group). Mean scores NIPS during and after intervention were in the intervention group (3.55 ± 0.84, 95% CI: 3.30–3.80(, and (1.15 ± 0.84, 95%: 0.95–1.35) and in the control group (5.57 ± 0.95, 95% CI:5.30–5.85) and (3.00 ± 0.98) respectively. There were significant differences in scores of NIPS between the two study groups during (p < 0.001) and five min after heel lancing (p < 0.001). Mean scores of heart rate in the three phases of before, during, and five min after the intervention were respectively in the intervention group (127.57 ± 4.45, 95% CI:126.27-128.99), (131.07 ± 6.54, 95% CI:129.20-133.22), (128.45 ± 5.15, 95% CI:127.02-130.07) and in the control group (128.67 ± 4.57, 95% CI:127.32-130.07), (136.07 ± 7.24, 95% CI:133.90-138.37), and (132.42 ± 6.47, 95% CI:130.37-134.49). There were significant differences in heart rate between the intervention and the control group during (p = 0.002) and five min after the heel lance (p = 0.003). Mean scores of SPO2 in the three phases of baseline, during, and five min after the intervention were respectively in the intervention group (96.72 ± 0.93, 95% CI:96.42-97.00), (91.47 ± 1.46, 95% CI:91.05–91.92), (94.17 ± 1.03, 95% CI:93.22-94.00) and in the control group (96.6 ± 0.84, 95% CI:96.35–96.85), (91.5 ± 1.24, 95% CI:91.12–91.87), and (93.60 ± 1.27, 95% CI:93.85–94.50).ConclusionThis study showed that the simulated intrauterine sound reduces the behavioral pain and heart rate in the intervention group during and after heel lance. These results suggest using the method during the painful heel lancing to reduce pain parameters in preterm infants.

COVID-19 and the pulse oximeter's beep.

COVID-19 and the pulse oximeter's beep.