Pulse Oximeter

History
Before pulse oximeter, the oxygen saturation was measured by a painful arterial blood gas and it typically took a minimum of 20-30 minutes to obtain the result. This delay is not acceptable as severe brain damage can occur within 5 minutes of low oxygenation. Early scientists Lambert, Beer, Bunson, and Kirchoff were the ones who studied the monitoring of patients' blood level in 1860 and research about the blood oxygen saturation of people. Soon, other scientists continued their research in 1932. 1876- Karl von Vierordt, a German physician who developed techniques and tools for the monitoring of blood circulation, used a light source to distinguish fully saturated blood from that which is not.

 1935 -The first device developed by Carl Matthes to noninvasively measure oxygen saturation in human blood by transilluminating it with coloured light,which employed an ear probe. It used a 2-wavelength light source with red and green filters, which was later changed to red and infrared filters. 1939- K.Matthews and F. Gross used photometry in examination of the ear auricle. Two-wavelength spectrophotometry was used to avoid the absorption of light by surrounding tissues.

 It was in 1940 when Millikan, Wood and Shaw developed the principles of pulse oximetry. Used a dual light source to create the first practical aviation ear oxygen meter. During Second World War, many pilots were saved from under pressurized cabins by using oximetry testing. 1941 "Oximetry testing" is first used to mesure oxygen saturation level with a pulse oximeter. 1942 E. Goldie used compression of earlobe to obtain "bloodless" reference. 1942 G. Millikan and H. Sarre used local heating to arterialize capillary blood. 1942 Light reflection oximetry was developed.

 1972 Takuo Aoyagi, a Japanese bioengineer at Nihon Kohden, developed a pulse oximeter based on the ratio of red to infrared light absorption in blood. He obtained a Japanese patent. Another Japanese research, Minolta, obtained an US patent based on the same concept. Oximetry became clinically feasible. 1978- William New- invented the prototype for Modern pulse oximeter. Oximeters became smaller in size, easier to apply, and less expensive. 1981- Biox introduced the first commercial pulse oximeter. Initially it was focused on respiratory care and later expanded into operating rooms. Since then, other manufacturers have entered the market and the pulse oximeter technology has improved significantly.

 1987- Pulse Oximetry becomes part of a standard procedure in administrating general anesthetic in US. The use of oximetry quickly spread to other hospital units, such as emergency rooms, recovery rooms, neonatal units, and intensive care units. 1995- Fingertip pulse oximeters first appeared on the market. Fingertip oximeters, which are small enough to put a finger in, first appeared on the market.

What is Pulse Oximeter?

is a photoelectric instrument for measuring oxygen saturation of blood. a non-invasive monitoring system that provides continuous information about arterial oxygen saturation without subjecting the patient to a painful arterial stick. Using light to measure arterial oxygen saturation (SaO2), the pulse oximeter tracks the patients SaO2 level non-invasively and continuously monitors pulse rate and amplitude too. provides estimates of arterial oxyhemoglobin saturation (SaO2) by utilizing selected wavelengths of light to noninvasively determine the saturation of oxyhemoglobin (SpO2). The oximeters most commonly used today are called pulse oximeters because they respond only to pulsations, such as those in pulsating capillaries of the area tested.

A Pulse Oximeter is a device used to perform the diagnostic procedure for determining the: Percentage of hemoglobin (Hb) that is saturated with oxygen The oxygen saturation (SpO2) is a measure of how much oxygen the blood is carrying as a percentage of the maximum it could carry and is sometimes referred to colloquially as the "sats reading The heart rate The heart rate refers to the number of times that the heart contracts in a period of one minute

What is Oximetry?
a procedure for measuring the concentration of oxygen in the blood. The test is used in the evaluation of various medical conditions that affect the function of the heart and lungs.

Purpose
measures the amount of oxygen present in blood by registering pulsations within an arteriolar bed (an area between arteries and capillaries). A sensor is placed usually on a fingertip or earlobe--or on the foot of an infant--and it measures the oxygenation levels by passing infrared wavelengths back and forth, and then noting the absorbency changes from each wavelength. measure the oxygen saturation of the hemoglobin in blood without a blood sample. Hemoglobin is a protein in the blood that carries oxygen. When oxygen is bound, it is referred to as oxy-hemoglobin; when oxygen is not bound, it is referred to as deoxy-hemoglobin. The pulse oximeter quantifies how much hemoglobin is in the oxy-hemoglobin form. minimizing unestablished episodes of Hypoxaemia cogitate with growing malpractice stands.

Two basic physical principles

1. The light absorbance of oxygenated hemoglobin is different from that of reduced hemoglobin, at the oximeter's two wavelengths, which include red and near infrared light. The presence of a pulsatile signal generated by arterial blood, which is relatively independent of non-pulsatile arterial blood, venous and capillary blood, and other tissues; and

2. The absorbance of both wavelengths has a pulsatile component, which is due to the fluctuations in the volume of arterial blood between the source and the detector. The fact that oxyhemoglobin (O2Hb) and reduced hemoglobin (Hb) have different absorption spectra.

Principle of pulse oximetry. Light passing through tissue containing blood is absorbed by tissue as well as arterial, capillary, and venous blood. Usually only the arterial blood is pulsatile, however. Light absorption may therefore be split into a pulsatile component (AC) and a constant or nonpulsatile component (DC). Hb-o2 saturation may be obtained by application of equation

Currently available oximeters use two light-emitting diodes (LEDs) that emit light at the 660 nm (red) and the 940 nm (infrared) wavelengths. These two wavelengths are used because O2Hb and Hb have different absorption spectra at these particular wavelengths. In the red region,O2Hb absorbs less light than Hb, while the reverse occurs in the infrared region. The ratio of absorbencies at these two wavelengths is calibrated empirically against direct measurements of arterial blood oxygensaturation (SaO2) in volunteers, and there sulting calibration algorithm is stored in a digital microprocessor within the pulse oximeter.

Principles
Spectrophotometry [light absorbance of oxyhb is different from deohb] Plrthysmography [measurement of the fluctuations in the volume of arterial blood between source and the detector] Beers law: states that intensity of transmitted light decreases exponentially as the concentration of the substance increases. Lamberts law: states that intensity of transmitted light decreases exponentially as the distance travelled through the substance increases.

o The light absorbed by non-pulsatile tissues is constant (DC). The non-constant absorption (AC) is the result of pulsatile blood pulsations. The photo detector generates a voltage proportional to the transmitted light. The AC component of the wave accounts for between 1-5% of the total signal. The high frequency of the diodes allows the absorption to be calculated many times per second. This reduces movement effects on the signal. o The microprocessor analyses both the DC and AC components at 660 nm and 940 nm. The absorption of oxyhaemoglobin and deoxyhaemoglobin at these two wavelengths is very different. Hence, these two wavelengths provide good sensitivity.

Advantages
Non-invasive Continuous real time information No calibration Rapid response time (5-7sec) Minimal saturation error (1-2%) over range of 6090% Unaffected by skin pigmentation. Painless and simple to use Continuous evaluation of oxygenation without drawing blood