Pulse Rate Values Research Articles

Comparative evaluation of efficacy of external vibrating device and counterstimulation on child's dental anxiety and pain perception during local anesthetic administration: a clinical trial.

BackgroundThis study aimed to evaluate the efficacy of external vibrating devices and counterstimulation on a child's dental anxiety, apprehension, and pain perception during local anesthetic administration.MethodsThis was a prospective, randomized, parallel-arm, single-blinded interventional, clinical trial. One hundred children aged 4–11 years, requiring pulp therapy or extraction under local anesthesia (LA), were recruited and allocated equally into two groups (1:1) based on the interventions used: Group BD (n = 50) received vibration using a Buzzy® device {MMJ Labs, Atlanta, GE, USA} as a behavior guidance technique; Group CS (n = 50) received counterstimulation for the same technique. Anxiety levels [Venham's Clinical Anxiety Rating Scale (VCARS), Venham Picture Test (VPT), Pulse oximeter {Gibson, Fingertip Pulse Oximeter}, Beijing, China)] were assessed before, during, and after LA administration, while pain perception [Wong-Baker Faces Pain Rating Scale (WBFPS), Visual Analogue Scale (VAS)] was evaluated immediately after injection. Statistical analysis was performed using the Student's t-test to assess the mean difference between the two groups and the repeated measures ANOVA for testing the mean difference in the pulse rates. Statistical significance was set at P < 0.05.ResultsSignificant differences in mean pulse rate values were observed in both groups. In contrast, the children in the BD group had higher diminution (P < 0.05), whereas the mean VCARS and VPT scores were conspicuous (P < 0.05). Based on the mean WBFPS and VAS scores, delayed pain perception after LA injection was more prominent in the BD group than in the CS group.ConclusionExternal vibration using a Buzzy® device is comparatively better than counterstimulation in alleviating needle-associated anxiety in children requiring extraction and pulpectomy.

Does the mean 24-h pulse rate from ambulatory blood pressure monitoring reflect the mean 24-h ventricular rate from Holter electrocardiogram in atrial fibrillation patients?

Ambulatory blood pressure monitoring (ABPM) on the oscillometric method is applicable in patients with atrial fibrillation, but the mean pulse rate is or not similar to the ventricular rate from the Holter in atrial fibrillation patients remains unknown. This study included 228 persistent atrial fibrillation patients who received simultaneous 24-h ABPM and 24-h Holter. The mean 24-h pulse rate and the mean 24-h ventricular rate were calculated, and mVR-mPR was used to reflect the difference between them. The SD of 24-h pulse rate values was calculated as SD-pulse rate. Furthermore, according to the SD-pulse rate, the patients were divided into ≤5, 6-10, 11-15 and >15 bpm subgroups. For the total population, the mean 24-h pulse rate is positively correlated with the mean 24-h ventricular rate, and the Bland-Altman plot showed quite wide 95% limits. As the SD-pulse rate increased, the 24-h mVR-mPR also increased. The mean 24-h mVR-mPR was 0.5 bpm when SD-pulse rate ≤5, 3.5 bpm when SD-pulse rate of 6-10, 7.6 bpm when SD-pulse rate of 11-15, and 12.5 bpm when SD-pulse rate >15 bpm, respectively. Meanwhile, in the SD-pulse rate 0-10 subgroup, the 95% limits were only from -13.8 to 19.7 bpm, while in the >10 subgroup, these values were from -19.5 to 36.5 bpm. The mean 24-h pulse rate should not be used to represent the true ventricular rate for all atrial fibrillation patients. However, when lower the SD-pulse rate, the mVR-mPR becomes smaller.

Changes in Pulse Rate, Respiratory Rate and Rectal Temperature in Working Dogs before and after Three Different Field Trials.

Physiological changes (pulse rate, respiratory rate and rectal temperature) induced by exercise are usually studied as physical fitness indices. The aim of this study was to investigate how these physiological parameters could be modified in a group of trained working dogs during three different field trials (rubble, search on field, obedience), in order to assess which parameter would be more useful to detect the dog response to exercise. Nine dogs were included in this study. The animals were monitored at rest, immediately before and after the working session. Pulse rate values increased significantly in all the phases compared to rest status. Respiratory rate values increased significantly after the competition, while rectal temperature was significantly increased only after search on rubbles and obedience activities. Reference values for specific competitions need to be stablished in order to promptly identify poor performance or exercise intolerance.

Patterns in continuous pulse oximetry data prior to pulseless electrical activity arrest in the general care setting.

The study objective was to understand if features derived from continuous pulse oximetry data can provide advanced warning of pulseless electrical activity arrest in the general care inpatient setting. Retrospective analysis of SpO2 and pulse rate data derived from continuous pulse oximetry was performed for pulseless electrical activity (n = 38) and control (n = 42) patient cohorts. Measures of central tendency and variation over time intervals ranging from 1min to 1h were used for inter- and intra-group comparisons. Logistic regression was applied to understand ability of features to predict pulseless electrical activity in future time intervals. Overall, the pulseless electrical activity arrest group tended to have lower mean SpO2 and higher mean pulse rate values than the control group. SpO2 and pulse rate variability was higher in the pulseless electrical activity arrest cohort. Changes in variability were observed beginning several hours prior to the rescue event. Up to 20min before rescue events, pulse rate features were significantly different from feature values for the preceding 30-min interval (> 10% difference in mean, > 46% difference in range). Similar results were found for SpO2 features 10min before the event (> 4% difference in mean, > 60% difference in range). There is a significant difference in SpO2 and pulse rate features derived from continuous pulse oximetry between pulseless electrical activity and control groups. Integration of automated feature calculation and clinician notification into clinical monitoring and information systems may increase patient safety by supporting early detection of such events.

Efficacy and safety of a combination antihypertensive drug (olmesartan plus azelnidipine): “Issues with hypertension studies in real-world practice”

ABSTRACTBackground: This study investigated whether a combination drug containing an angiotensin II receptor blocker (ARB) and a calcium channel blocker (CCB) could provide effective antihypertensive therapy.Methods: A multicenter, prospective, open-label study was conducted at the clinics of Clinical Research Network. The subjects had uncontrolled blood pressure (BP) despite ARB or CCB monotherapy. The effect on both office and home BP was examined after patients switched to a combination drug (REZ: containing 20 mg of olmesartan [OL] and 16 mg of azelnidipine [AZ]).Results: A total of 78 patients were enrolled. After switching to REZ, a significant and sustained reduction of office BP was observed. The proportion of patients who achieved the target for both office and home BP was an increase from 0% to 55%. Switching from amlodipine to REZ resulted in a significant and sustained decrease of office and home BP. There was also a significant decrease of home pulse rate (PR), but office PR was unchanged. To determine the accuracy of the BP and PR values reported by patients, the frequency of each number as the first digit was determined. The frequency of “0” was extremely high for both office and home BP values, and the same was noted for home PR values.Conclusion: The results of this study suggested that switching from a single drug to combination therapy with REZ could achieve a stronger antihypertensive effect. However, concern was raised regarding the methods of BP and PR measurement and recording in this clinical trial involving general practitioners.

3D Convolutional Neural Networks for Remote Pulse Rate Measurement and Mapping from Facial Video

Remote pulse rate measurement from facial video has gained particular attention over the last few years. Research exhibits significant advancements and demonstrates that common video cameras correspond to reliable devices that can be employed to measure a large set of biomedical parameters without any contact with the subject. A new framework for measuring and mapping pulse rate from video is presented in this pilot study. The method, which relies on convolutional 3D networks, is fully automatic and does not require any special image preprocessing. In addition, the network ensures concurrent mapping by producing a prediction for each local group of pixels. A particular training procedure that employs only synthetic data is proposed. Preliminary results demonstrate that this convolutional 3D network can effectively extract pulse rate from video without the need for any processing of frames. The trained model was compared with other state-of-the-art methods on public data. Results exhibit significant agreement between estimated and ground-truth measurements: the root mean square error computed from pulse rate values assessed with the convolutional 3D network is equal to 8.64 bpm, which is superior to 10 bpm for the other state-of-the-art methods. The robustness of the method to natural motion and increases in performance correspond to the two main avenues that will be considered in future works.

Home-based isometric handgrip training on RBP in hypertensive adults-Partial preliminary findings from RCT.

The aim of this study is to confirm whether 8 weeks of home-based isometric handgrip (IHG) training would reduce resting blood pressure (RBP) in an adult Indian population. Hypertensive patients (Stage 1 [previously prehypertension] and Stage 2 [previously Stage 1 hypertension]) aged 30-45 years, male and female, were included. Two groups were included (active control group and IHG training group at 30% of maximal voluntary isometric contraction). Outcomes of this study were resting pulse rate (PR) and RBP, which were taken at baseline and after 8 weeks. Stratified randomization was done by sex and hypertension grade. The study was a double-blind intervention (both participants and the assessor were blinded to intervention allotment). Forty hypertensive individuals were randomly assigned to a control (N = 20) and an 8-week home-based IHG training (N = 20) using a stratified random sampling technique. Each training session consisted of 4 × 2 min bouts with a 4-min rest between bouts for 8 weeks. Resting PR and RBP were taken at baseline and after 8 weeks. After 8 weeks, there was a significant reduction in blood pressure and PR values in the IHG group as compared with those in the control group: systolic blood pressure (mean difference, MD -8.75 mmHg; 95% CI [-6.51, -10.39]); diastolic blood pressure (MD -8.35 mmHg; 95% CI [-6.25, -10.45]); mean arterial pressure (MD -8.13 mmHg; 95% CI [-6.21, -10.05]); and PR (MD -8.90 mmHg; 95% CI [-5.08, -12.72]. On the basis of study findings, home-based IHG training can be used as an adjunct to control BP in the initial stage of hypertension in an Indian population.

Child Security Enhancement System using Raspberry Pi and Amazon Elasticsearch Service

According to recent surveys child missing, child kidnapping cases are rapidly increasing in India [1]. Child’s safety in school buses and outside school premises is one of main concern for the parents today. The proposed system tries to provide security features to the children using new methodologies that are added to the existing safety system for better protection. The proposed system consists of portable unit, cloud system and android application. The portable unit consists of raspberry pi 2 model B, GPS receiver with antenna and pulse rate sensor. This unit will track the position of the child in the form of latitude longitude and altitude using GPS receiver and sense the pulse rate values using heart beat sensor. These data are sending to raspberry pi module which is then injected into elasticsearch with the help of internet connectivity. In cloud system elastic search which is served by amazon cloud service provides a URL which extracts the indexed values from the data injected by raspberry pi device. The android application in a user interface that shows the location of the child in map, path in which the child travelled and the speed in which child moves. The pulse rate of the child is also monitored in application real-time. The URL produced by the elasticsearch is used to retrieve values to the application.

Wrist-Sensor Pulse Oximeter Enables Prolonged Patient Monitoring in Chronic Lung Diseases.

Pulse oximetry is an important diagnostic tool in monitoring and treating both in-patients and ambulatory patients. Modern pulse oximeters exploit different body sites (eg fingertip, forehead or earlobe). All those are bulky and uncomfortable, resulting in low patient compliance. Therefore, we evaluated the accuracy and precision of a wrist-sensor pulse oximeter (Oxitone-1000, Oxitone Medical) vs. the traditional fingertip device. Fifteen healthy volunteers and 23 patients were recruited. The patient group included chronic obstructive pulmonary disease (COPD) (N = 8), asthma (N = 6), sarcoidosis (N = 5) and others. Basic demographic data, skin tone type, smoking status and medical history were recorded. Blood oxygen level (SpO2) and pulse-rate values were determined by a non-invasive pulse oximeter (Reference, a conventional FDA-cleared fingertip pulse oximeter) and by Oxitone-1000. All tests were performed in singleton and in a blinded fashion. The measurements were done in sitting and standing positions, as well as after a 6-min walk test. The mean age was 60.4 ± 9.83years, 55% were male. No significant differences were observed between the wrist-sensor and the traditional fingertip pulse oximeters in all tested parameters. Mean SpO2 was 96.45% vs. 97.18% and the mean pulse was 74.64 vs. 74.6bpm (Oxitone-1000 vs. Reference, respectively, p < 0.0001). Precision rate was 2.28472% and the accuracy was met (Arms -Root mean-square-error < 3%). The Oxitone-1000 is both accurate and precise for SpO2 and pulse measurements during daily activities of pulmonary patients, and is not inferior to standard devices for spot checking or short period examinations. Its wrist-sensor design is comfortable and provides the advantage of extended use.

Effectiveness of Virtual Reality Eyeglasses as a Distraction Aid to Reduce Anxiety among 6-10-year-old Children Undergoing Dental Extraction Procedure.

ABSTRACTIntroductionDistraction is commonly used nonpharmacologic pain management technique by pedodontists to manage pain and anxiety. There are some new techniques which uses audiovideo stimulation and distract the patient by exposing him or her to three-dimensional videos. These techniques are referred to as virtual reality audiovisual systems. The aim is to evaluate the effectiveness of virtual reality eyeglasses as a distraction aid to reduce anxiety of children undergoing extraction procedure.ObjectiveThe aim of this study is to evaluate the effectiveness of virtual reality eyeglasses as a distraction aid to reduce anxiety of children undergoing dental extraction procedure.Materials and methodsThirty children of age 6–10 years (n = 60) with bilateral carious primary molars indicated for extraction were randomly selected and divided into two groups of 30 each. The first one was group I (VR group) (n = 30) and group II (control group) (n = 30). Anxiety was measured by using Venham's picture test, pulse rate and oxygen saturation. Anxiety level between group I and group II was assessed using paired “t” test.ResultsThe mean pulse rate values after extraction procedure in group I were 107.833 ± 1.356 and group II were 108.4 ± 0.927 respectively. The pulse rate values in intergroup comparison were found statistically significant p = 0.03.ConclusionThe virtual reality used as a distraction technique improves the physiologic parameters of children aged 6–10 years but does not reduce the patient's self-reported anxiety according to Venham's picture test used.How to cite this articleKoticha P, Katge F, et al. Effectiveness of Virtual Reality Eyeglasses as a Distraction Aid to Reduce Anxiety among 6–10-year-old Children Undergoing Dental Extraction Procedure. Int J Clin Pediatr Dent 2019;12(4):297–302.

Integrated Pulmonary Index (IPI) monitorization under sedation in cataract surgery with phacoemulsification technique.

We aimed to investigate that change of IPI values after sedation of patients undergoing cataract surgery under sedation. We included 50 patients (ASA I-III) undergoing cataract surgery under sedation by phacoemulsification method in this prospective observational study. IPI, SpO2, ETCO2, respiratory rate (RR), peripheral pulse rate (PR), hemodynamic data and BIS values and perioperative complications were recorded. Compared to baseline values, RR value at 5th min, RR, PR, IPI values at 10th min and RR, PR values at 15th min were significantly low and heart rate value at 15th min and arterial pressure, bispectral index (BIS) values at 5th min, 10th min, 15th min, 20th min, 25th min and 30th min were lower than baseline values. IPI monitoring will provide guidance during sedation of patients with comorbid diseases undergoing cataract surgery by phacoemulsification method.

Working Dogs Drinking a Nutrient-Enriched Water Maintain Cooler Body Temperature and Improved Pulse Rate Recovery After Exercise.

Exercise-related physiological changes were evaluated in hydrated, exercise-conditioned working dogs with free access to tap water (TW) with or without a nutrient-enriched water supplement (NW). Physiological samples and measures were collected before and after work-related field tasks in a warm and moderately humid ambient environment. In a cross-over design study, 12 dogs (age range 8–23 months) were evaluated on 3 separate occasions within each period with exercise bouts up to 30 min, on days −4, 3, and 11. Dogs were offered either ad libitum TW or portion-controlled NW daily plus ad libitum TW. Prior to and serially after exercise, pulse rate (PR), core (BTcore) and ear (BTear) temperature were recorded. Urine was collected first thing in the morning, whereas blood samples collected and body weight (BW) recorded pre- and immediately post exercise. Ambient temperature was above 21.7°C (71°F) and relative humidity ranged from 36 to 76%. Activity parameters, AM urine measures, post-exercise percent change of BW, resting PR and resting BTcore did not differ between treatment groups on any exercise day. At the completion of exercise, mean BTcore for all dogs ranged from 104.8 to 105.6°F. Immediate post-exercise BTear was always lower compared to BTcore and means ranged from 103.3 to 104.0°F. The effect of time was highly significant (P < 0.001) for both BT measures with both BTcore and BTear recovering to resting levels by 60 min post exercise. PR and several blood values showed a significant main effect of time. Over the recovery period, dogs in the NW group had lower mean BTear and PR by 0.6°F and 3.4 bpm, respectively. Daily ingestion of a NW in combination with free access to TW can reduce the post-exercise-related BTcore and BTear hyperthermia, and improve pulse rate recovery following exercise in this population of working dogs undergoing 30 min bout of exercise.

Effects of Geiji-Bokryung-Hwan on common carotid artery elasticity and erythrocyte deformability in healthy male subjects – A pilot randomized controlled crossover study

IntroductionArterial elasticity is the significant indicator of atherosclerosis. Recently, the treatment of subclinical atherosclerosis is important for preventing cardiovascular diseases. The purpose of this study was to identify the effect of the Korean herbal medicine, Geiji-Bokryung-Hwan (GBH), on carotid arterial elasticity in healthy male subjects. MethodsThis study was conducted with a pilot randomized controlled, cross-over design. Subjects were enrolled in Kyung Hee Medical Center visitors, with meeting criteria, and allocated to the two groups; One group received GBH with water, and the other group received only water at the first phase. The measurements were repeated three times at 2 hourly intervals. After one week of wash-out period, the two groups were repeated using the same procedure. Common carotid strain, erythrocyte deformability, carotid intima-media thickness, blood pressure and pulse rate values of each subjects were measured before administration and 2, 4 h after administration. ResultsFifteen subjects were enrolled into this study. Common carotid arterial circumference strain after GBH administration showed a significantly different interaction effect as compared to water administration (p < 0.05). There was no statistically difference between the two groups in terms of erythrocyte deformability, carotid intima-media thickness, pulse pressure or pulse rate. ConclusionsThis preliminary study suggests that GBH could improve vascular endothelial wall function by increasing the common carotid artery elasticity in healthy male subjects.

Perfusion index and pleth variability index in the first hour of life according to mode of delivery

Yiğit Ş, Takcı Ş, Bozkaya D, Yurdakök M. Perfusion index and pleth variability index in the first hour of life according to mode of delivery. Turk J Pediatr 2018; 60: 421-425. Perfusion index (PI) is a relative assessment of the pulse strength at the monitoring site. The plethysmographic variability index (PVI, pleth variability index) is a noninvasive and continuous measure of the dynamic change in PI that occurs during respiratory cycles. In this study PI and PVI changes were compared in babies born with cesarean section (C/S) or spontaneous vaginal delivery (SVD); 125 healthy term infants were monitored with pulse oxymeter after first ten minutes of life. Data were recorded from this monitor on a personal computer and analyzed by generalized estimating equations (GEE) method. Pulse rate was lower in babies born via SVD. Perfusion index were higher in C/S group. Pleth variability index were higher in C/S group. Higher pulse rate, PI and PVI values in babies born via C/S may be indicative of more significant hemodynamic changes in these infants during early transitional period after birth.

Use of interventional radiology as initial hemorrhage control to improve outcomes for potentially lethal multiple blunt injuries

IntroductionRecently, trauma management has been markedly improved with interventional radiology (IVR) and damage-control strategies. However, the indications for its use in hemodynamically unstable patients with severe trauma remains unclear. In some cases, IVR may be more effective than surgery for damage-control hemostasis; however, performing IVR in life-threatening trauma settings is challenging. To address this, we practiced and evaluated a trauma-management system with emergency physicians who trained for both severe trauma management, and techniques of surgery and IVR. Materials and methodsAmong the 1822 patients with severe trauma admitted between October 2014 and December 2016, 201 underwent emergency surgery or IVR. Among these, 16 patients whose systolic blood pressure was ≤90 mmHg, without improvement following primary resuscitation, and whose first intervention was IVR, were analyzed. We retrospectively evaluated the admission characteristics, IVR-related characteristics, and prognoses, and compared several parameters before and after IVR. ResultsThis study included 10 men and 6 women (median age: 46 years). IVR was performed for 10 pelvic fractures; five liver-, one splenic-, and one renal injury; and one transection each of the external carotid-, vertebral-, axillosubclavian-, intercostal-, and lumbar arteries. The mean times from the patient arrival, and diagnosis to the start of IVR were 56.3 ± 26.6 and 15.1 ± 3.8 min, respectively. The mean time spent in the angiography suite was 50 min. The systolic blood pressure, pulse rate, base excess/deficit, serum-lactate levels, and D-dimer values were significantly improved after IVR. Although two patients needed additional treatment for morbidities following IVR intervention, all achieved complete recovery. The mortality rate was 25.0%, and no preventable deaths were noted. Eight patients showed unexpected survival. ConclusionsIn some cases, IVR may be the best first measure for resuscitative hemostasis in potentially lethal multiple injuries, given efficient diagnoses/actions and the ability to deal with complications.

Beyond temperature coupling: Effects of temperature on ectotherm signaling and mate choice and the implications forcommunication in multispecies assemblages.

Many organisms share communication channels, generating complex signaling environments that increase the risk of signal interference. Variation in abiotic conditions, such as temperature, may further exacerbate signal interference, particularly in ectotherms. We tested the effects of temperature on the pulse rate of male signals in a community of Oecanthus tree crickets, and for one focal species we also assessed its effect on female pulse rate preferences and motivation to seek mates. We confirm prior findings of temperature‐dependent signals that result in increasing signal similarity at lower temperatures. Temperature also affected several aspects of female preferences: The preferred pulse rate value was temperature dependent, and nearly perfectly coupled with signal pulse rate; the range of pulse rate values that females found attractive also increased with temperature. By contrast, the motivation of females to perform phonotaxis was unaffected by temperature. Thus, at lower temperatures the signals of closely related species were more similar and females more discriminating. However, because signal similarity increased more strongly than female discrimination, signal interference and the likelihood of mismating may increase as temperatures drop. We suggest that a community approach will be useful for understanding the role of environmental variability in the evolution of communication systems.

Usefulness of FGSI and UFGSI scoring systems for predicting mortality in patients with Fournier's gangrene: A multicenter study.

This study aimed to evaluate the usefulness of Fournier's gangrene scoring index (FGSI) and Uludag FGSI (UFGSI) for predicting mortality in patients with FG. Patients who underwent treatment and follow-up in the A division department of general surgery at two education and research hospitals between January 2012 and December 2015 were evaluated for mortality-related factors. The sensitivities of FGSI and UFGSI scoring systems for predicting mortality-related factors and disease prognosis were evaluated. Patients were grouped as survivors (Group I) or non-survivors (Group II). In total, 29 patients were included in the study. The mean age (±SD) was 51.52±13.36 years. The mortality rate was 20.6% (six patients). Bacterial growth was observed in wound cultures of 17 patients (58.6%). Of the patients with bacterial growth, 11 (47.8%) were in Group I and six (100%) were in Group II. The presence of bacterial growth was significantly associated with mortality (p=0.028). Fourteen patients (48.3%) had comorbid conditions. The number of comorbid conditions was related (p=0.049). FGSI and UFGSI scores were significantly higher in Group II than in Group I (p=0.002 and p=0.001, respectively). Among UFGSI parameters, extent of disease, body temperature, pulse rate, and HCO3 values were significantly higher in Group II than in Group I (p<0.05). The FGSI and UFGSI scoring systems had 100% sensitivity and 78.2% and 73.9% specificity, respectively, for predicting mortality. The FGSI and UFGSI scoring systems are valuable for predicting mortality in patients with FG. The extent of the disease was an important prognostic parameter in this study. Whichever scoring system is used, we suggest the use of the extent of disease score in UFGSI.

How to estimate heart rate from pulse rate reported by oscillometric method in atrial fibrillation: The value of pulse rate variation

ObjectivesTo evaluate whether the mean pulse rate (PR) from three oscillometric blood pressure (BP) measurements provides an accurate estimation of electrocardiogram ventricular rate (HR) in patients with permanent atrial fibrillation (AF). MethodsBP and PR were measured with an oscillometric BP device for three times with one-minute interval. Simultaneously, one-minute electrocardiogram was also recorded for three times. The first PR and HR values were recorded as PR1 and HR1, and the averages of three PR and HR values as mean PR (mPR) and mean HR (mHR). Meanwhile, the differences between the highest and lowest values among the three PR and HR were calculated as ΔPR and ΔHR. Furthermore, the patients were stratified on ΔPR into the 0–15 and >15 subgroups. ResultsA moderate positive correlation existed between PR1 and HR1 or mPR and mHR, and Bland–Altman plot also showed quite wide 95% limits between them. Meanwhile, ΔPR was significantly higher than ΔHR (12.1±8.6 vs 3.6±2.5bpm, P<0.001). However, in the 0–15 subgroup, the correlation between mPR and mHR was high (R2=0.800), and the 95% limits were only from −11.3 to 14.2bpm with a difference of 1.4bpm. The coincidence (mPR–mHR<10bpm) rate was 93.9% when PR≤80bpm, 96.3% when PR 81–100bpm, and 88.9% when PR over 100bpm. ConclusionThe average of three PR values reported by an oscillometric BP device could provide a clinically accepted estimation of mean HR of 3min in AF patients with ΔPR 0–15bpm and mean PR ≤100bpm.

Detection of Pulpal Blood Flow In Vivo with Pulse Oximetry in Dogs

The aim of the present study was to investigate the ability of pulse oximetry to detect blood flow within the canine tooth of dogs. Dogs aged 18-138 months presenting for oral treatment and meeting the inclusion criteria underwent pulse oximetry evaluation of at least one canine tooth. Oxygen saturation (SpO2) and pulse rate values were acquired from vital canine teeth of 38 clinical patients (representing 40 total teeth) with a handheld pulse oximeter and compared to a control area. SpO2 values from the tooth and control area were recorded every 5 s for three 60-s intervals. The sensors were repositioned after each 60-s interval. The vital teeth consistently recorded SpO2 values significantly lower than the control area. The mean vital tooth SpO2 was 85.9% (median = 87%; SD = 8.6), and the mean control area SpO2 was 97.7% (median = 98%; SD = 1.8). An age-related significant difference was noted in vital tooth SpO2 values. In conclusion, the present data support the possible use of pulse oximetry to detect blood flow in canine teeth. However, there was no significant correlation between SpO2 values in the vital tooth and in the control areas. Additionally, the results were not definitive, and validation of the modality with additional studies of non-vital canine teeth is needed before clinical use can be recommended.

Assessment of continuous acoustic respiratory rate monitoring as an addition to a pulse oximetry-based patient surveillance system.

Technology advances make it possible to consider continuous acoustic respiratory rate monitoring as an integral component of physiologic surveillance systems. This study explores technical and logistical aspects of augmenting pulse oximetry-based patient surveillance systems with continuous respiratory rate monitoring and offers some insight into the impact on patient deterioration detection that may result. Acoustic respiratory rate sensors were introduced to a general care pulse oximetry-based surveillance system with respiratory rate alarms deactivated. Simulation was used after 4324 patient days to determine appropriate alarm thresholds for respiratory rate, which were then activated. Data were collected for an additional 4382 patient days. Physiologic parameters, alarm data, sensor utilization and patient/staff feedback were collected throughout the study and analyzed. No notable technical or workflow issues were observed. Sensor utilization was 57%, with patient refusal leading reasons for nonuse (22.7%). With respiratory rate alarm thresholds set to 6 and 40breaths/min., the majority of nurse pager clinical notifications were triggered by low oxygen saturation values (43%), followed by low respiratory rate values (21%) and low pulse rate values (13%). Mean respiratory rate collected was 16.6±3.8breaths/min. The vast majority (82%) of low oxygen saturation states coincided with normal respiration rates of 12-20breaths/min. Continuous respiratory rate monitoring can be successfully added to a pulse oximetry-based surveillance system without significant technical, logistical or workflow issues and is moderately well-tolerated by patients. Respiratory rate sensor alarms did not significantly impact overall system alarm burden. Respiratory rate and oxygen saturation distributions suggest adding continuous respiratory rate monitoring to a pulse oximetry-based surveillance system may not significantly improve patient deterioration detection.