P. Å. Öberg

Monitoring of respiratory and heart rates using a fibre-optic sensor

A new method, which uses a fibre-optic probe to monitor respiratory and heart rates simultaneously has been developed and evaluated. The results provide evidence that it is possible to monitor respiratory and heart rates using the reflection mode of photoplethysmography (PPG). The fibre-optic probe makes it possible to monitor from different sites on the patient, and the method is convenient to use. In addition, the probe is X-ray transparent, insensitive to electromagnetic interference (e.g. during MRI investigation) and may be made very light and small. Therefore the method is suitable for the observation of both adults and neonates, in hospitals as well as in other environments.

Estimation of respiratory volumes from the photoplethysmographic signal. Part I: experimental results

To evaluate the possibility of respiratory-volume measurement using photoplethysmography (PPG), PPG signals from 16 normal volunteers are collected, and the respiratory-induced intensity variations (RIIV) are digitally extracted. The RIIV signals are studied while reepiratory volume is varied. Furthermore, respiratory rate, body posture and type of respiration are varied. A Fleisch pneumotachograph is used as the inspired volume reference. The RIIV and pneumotachography signals are compared, and a statisical analysis is performed (linear regression and t-tests). The key idea is that the amplitude of the RIIV signal is related to the respiratory volume. The conclusion from the measurements is that there exists a relationship between the amplitude of the RIIV signal and the respiratory volume (R=0.842, s=0.428, p<0.005). Absolute measurements of the respiratory volume are not possible from the RIIV signal with the present set-up. The RIIV signal also seems to be affected by respiratory rate and type. More knowledge about respiratory parameters and improved sensor and filter design are required to make absolute measurements of volumes possible.

Magnetophosphenes : A quantitative analysis of thresholds

Low-frequency and transient magnetic fields of moderate flux densities are known to generate visual phenomena, so-called magnetophosphenes. In the present study, time-variable very low frequency (10–50 Hz) electromagnetic fields of moderate flux density (0–40 mT) were used to induce magnetophosphenes. The threshold values for these phosphenes were determined as a function of the frequency of the magnetic field both in normal subjects and colour defective ones. Maximum sensitivity occurred at a frequency of approximately 20–30 Hz, and with broad-spectrum light the threshold flux density was 10–12 mT. The threshola values were found to be dependent upon the intensity and the spectral distribution of the background light. Sensitivity decreased during dark adaptation. In certain respects deutans differed from subjects with normal colour vision. Possible mechanisms for generation of magnetophosphenes are discussed. The present magnetic threshold curves show a close resemblance to corresponding curves obtained by electric stimulation at various frequencies provided the electric thresholds are divided by the a.c. frequency. These problems are under current investigation in our laboratory. This is in full agreement with the assumption that the fluctuating magnetic field affects retinal neurons by inducing currents which polarise synaptic terminals.

TRANSEPIDERMAL WATER LOSS IN NEWBORN INFANTS II. Relation to Activity and Body Temperature

Abstract. Using a method described in a previous article the transepidermal water loss (TEWL) was studied in 10 healthy newborn infants at rest and during activity. On the average TEWL was 37% higher during activity than during rest although no sweating was observed. In 9 infants placed in incubators with an ambient temperature slightly above the thermoneutral range measurements were made as the body temperature rose. TEWL was almost constant until a temperature of 37.1°C was reached whereupon the water loss suddenly increased as the infant started sweating.

Monitoring of heart and respiratory rates in newborn infants using a new photoplethysmographic technique.

Objective.A new photoplethysmographic (PPG) device for respiratoryand heart rate monitoring has been evaluated in the neonatal care units at theUniversity Childrens Hospital of Uppsala, Sweden. The purpose of thisstudy was to compare this new device with more established techniques, i.e.,transthoracic impedance plethysmography (TTI) for monitoring of respiratoryrate and ECG for heart rate monitoring. Methods.Data were acquiredcontinuously for 8-hours in each of 6 neonates. The signals were analysed forperiods of 30 seconds, in which the heart and respiratory signals from the PPGdevice were compared with the ECG and the impedance plethysmogram. Results.The ECG recordings were of high quality in 77% of the analysed periods.In these periods, excluding periods (6%) disturbed by offset-adjustement ofthe PPG signal, the PPG heart signal included 1.1% (±0.7% SD) falsenegative beats and 0.9% (±0.6%) false positive beats. In periods withan impedance signal of high quality (29% of total time), the part of the PPGsignal synchronous with respiration included 2.7% (±1.1%) falsenegative breaths and 1.5% (±0.4%) false positive breaths. Here, 2% ofthe periods were discarded because of offset-adjustment. From the periods oflow signal quality, two other conclusions were drawn: 1) The impedance signalcontains more power in the respiratory range than the corresponding PPGrespiratory signal. 2) The breaths are easier to identify in the PPGrespiratory signal than in the impedance signal (subjective measure).Conclusions.Electrode and motion artefacts seem to disturb the ECGsignals and, particularly, the impedance signals. During periods of highquality ECG and impedance signals, the new optical device produces signals ofequal quality to these traditional methods, and is in some cases even better.The new device is non-invasive and has a small optical probe. These factorsindicate further advantages of the photoplethysmographic method.

Transepidermal water loss in newborn infants. V. Evaporation from the skin and heat exchange during the first hours of life.

Abstract. Hammarlund, K., Nilsson, G. E., öberg, P. Å. and Sedin, G. (Department of Paediatrics, University Hospital, Uppsala, and Department of Biomedical Engineering, Linköping University, Linköping, Sweden). Transepidermal water loss in newborn infants. V. Evaporation from the skin and heat exchange during the first hours of life. Acta Paediatr Scand, 69:385, 1980.—The amount of water evaporated from the skin was studied in 10 healthy newborn infants from their first minute of life, while being taken care of in the delivery room, and in 11 infants treated in incubators from their 30th min of life. The heat lost by evaporation, radiation and convection was calculated. Evaporation from the skin was very high during the first minutes after birth and was the main cause of heat loss during the first 15–30 min of life. Thereafter the amount of heat lost depended on the conditions under which the infant was nursed. Higher convective and radiative heat losses were found in delivery rooms than in incubators.

Estimation of respiratory volumes from the photoplethysmographic signal. Part 2 : a model study

A Windkessel model has been constructed with the aim of investigating the respiratory-volume dependence of the photoplethysmographic (PPG) signal. Experimental studies show a correlation between respiratory volume and the peak-to-peak value of the respiratory-induced intensity variations (RIIV) in the PPG signal. The model compartments are organised in two closed chambers, representing the thorax and the abdomen, and in a peripheral part not directly influenced by respiration. Cardiac pulse and respiration are created by continuous adjustment of the pressures in the affected compartments. Together with the criteria for heart and venous valves, the model is based on a set of 17 differential equations. These equations are solved for varying thoracic and abdominal pressures corresponding to different respiratory volumes. Furthermore, a sensitivity analysis is performed to evaluate the properties of the model. The PPG signals are created as a combination of peripheral blood flow and pressure. From these signals, the respiratory synchronous parts are extracted and analysed. To study some important limitations of the model, respiratory type and rate are varied. From the simulations, it is possible to verify our earlier experimental results concerning the relationship between respiratory volume and the peak-to-peak value of the RIIV signal. An expected decrease in the amplitude of the respiratory signal with increased respiratory rate is also found, which is due to the lowpass characteristics of the vessel system. Variations in the relationship between thoracic and abdominal respiration also affect the RIIV signal. The simulations explain and verify what has been found previously in experimental studies.

Magneto- and electrophosphenes: A comparative study

The purpose of this study was to compare the threshold values for magnetophosphenes and electrophosphenes under identical experimental conditions. Such comparisons between the phosphene types would increase our knowledge of the mechanism of the interaction between magnetic fields and electric current, respectively, and excitable tissue.The phosphenes were generated in the frequency range 10–45 Hz at moderate magnetic flux densities [up to 40 mT (400 G)] and electric currents up to 0.3 mA, respectively.The first part of the study was devoted to the problem of how electrode location and consequent current directions influence the threshold values of electrophosphenes. In the second part a comparison was made of the threshold values for electrophosphenes and magnetophosphenes under identical experimental conditions apart from the stimulation method.With electric-current stimulation in different directions no great differences were obtained with regard to the mean value for the threshold values within the frequency range 10–30 Hz. However, from 30 Hz upwards a significant difference developed between the threshold values for some of the curves.When generating electrophosphenes and magnetophosphenes we found significant differences in the threshold values between approximately 25 and 45 Hz. Both types of phosphenes had a concurring sensitivity maximum at 20 Hz.The deviations between the curves may be due, among other factors, to the generation of different current paths in electrical and magnetic stimulation, respectively.

Experimental evaluation of two new sensors for respiratory rate monitoring

Visual observation was chosen as the reference method for measuring the respiratory rate in ten healthy volunteers. The new fibre-optic and acoustic sensors were simultaneously compared with capnography and transthoracic impedance plethysmography during normoventilation in the respiratory rate range of 6-24 breaths per minute and at a fixed respiratory rate of 13 breaths per minute. In addition a simulation of central apnoea was performed. All the measurements were recorded on an analogue tape recorder and a strip-chart recorder and analysed off line. The analyses of the recordings were performed by a person who was unable to see the monitoring systems. There was no discrepancy in the results of these methods. Each of the methods responded rapidly to an apnoeic event. The new fibre-optic and acoustic sensors correlate well with more traditional methods such as capnography and transthoracic impedance plethysmography for respiratory rate monitoring.

INFLUENCE ON VISION OF EXTREMELY LOW FREQUENCY ELECTROMAGNETIC FIELDS

The strong electric currents used for heating purposes in welding and steel industries set up related magnetic fields (generally 0.1–10 mT and 50 Hz).