Estimating Carotid Pulse and Breathing Rate from Near-infrared Video of the Neck

Objective: Non-contact physiological measurement is a growing research area that allows capturing vital signs such as heart rate (HR) and breathing rate (BR) comfortably and unobtrusively with remote devices. However, most of the approaches work only in bright environments in which subtle photoplethysmographic and ballistocardiographic signals can be easily analyzed and/or require expensive and custom hardware to perform the measurements. Approach: This work introduces a low-cost method to measure subtle motions associated with the carotid pulse and breathing movement from the neck using near-infrared (NIR) video imaging. A skin reflection model of the neck was established to provide a theoretical foundation for the method. In particular, the method relies on template matching for neck detection, Principal Component Analysis for feature extraction, and Hidden Markov Models for data smoothing. Main Results: We compared the estimated HR and BR measures with ones provided by an FDA-cleared device in a 12-participant laboratory study: the estimates achieved a mean absolute error of 0.36 beats per minute and 0.24 breaths per minute under both bright and dark lighting. Significance: This work advances the possibilities of non-contact physiological measurement in real-life conditions in which environmental illumination is limited and in which the face of the person is not readily available or needs to be protected. Due to the increasing availability of NIR imaging devices, the described methods are readily scalable.Comment: 21 pages, 15 figure

Blood pressure wave propagation : a multisensor setup for cerebral autoregulation studies

Objective. Cerebral autoregulation is critically important to maintain proper brain perfusion and supply the brain with oxygenated blood. Non-invasive measures of blood pressure (BP) are critical in assessing cerebral autoregulation. Wave propagation velocity may be a useful technique to estimate BP but the effect of the location of the sensors on the readings has not been thoroughly examined. In this paper, we were interested in studying whether the propagation velocity of a pressure wave in the direction from the heart to the brain may differ compared with propagation from the heart to the periphery, as well as across different physiological tasks and/or health conditions. Using non-invasive sensors simultaneously placed at different locations of the human body allows for the study of how the propagation velocity of the pressure wave, based on pulse transit time (PTT), varies across different directions. Approach. We present a multi-sensor BP wave propagation measurement setup intended for cerebral autoregulation studies. The presented sensor setup consists of three sensors, one placed on each of the neck, chest and finger, allowing simultaneous measurement of changes in BP propagation velocity towards the brain and to the periphery. We show how commonly tested physiological tasks affect the relative changes of PTT and correlations with BP. Main results. We observed that during maximal blow, valsalva and breath hold breathing tasks, the relative changes of PTT were higher when PTT was measured in the direction from the heart to the brain than from the heart to the peripherals. In contrast, during a deep breathing task, the relative change in PTT from the heart to the brain was lower. In addition, we present a short literature review of the PTT methods used in brain research. Significance. These preliminary data suggest that the physiological task and direction of PTT measurement may affect relative PTT changes. The presented three-sensor setup provides an easy and neuroimaging compatible method for cerebral autoregulation studies by allowing measurement of BP wave propagation velocity towards the brain versus towards the periphery

Wearable in-ear pulse oximetry: theory and applications

Wearable health technology, most commonly in the form of the smart watch, is employed by millions of users worldwide. These devices generally exploit photoplethysmography (PPG), the non-invasive use of light to measure blood volume, in order to track physiological metrics such as pulse and respiration. Moreover, PPG is commonly used in hospitals in the form of pulse oximetry, which measures light absorbance by the blood at different wavelengths of light to estimate blood oxygen levels (SpO2). This thesis aims to demonstrate that despite its widespread usage over many decades, this sensor still possesses a wealth of untapped value. Through a combination of advanced signal processing and harnessing the ear as a location for wearable sensing, this thesis introduces several novel high impact applications of in-ear pulse oximetry and photoplethysmography. The aims of this thesis are accomplished through a three pronged approach: rapid detection of hypoxia, tracking of cognitive workload and fatigue, and detection of respiratory disease. By means of the simultaneous recording of in-ear and finger pulse oximetry at rest and during breath hold tests, it was found that in-ear SpO2 responds on average 12.4 seconds faster than the finger SpO2. This is likely due in part to the ear being in close proximity to the brain, making it a priority for oxygenation and thus making wearable in-ear SpO2 a good proxy for core blood oxygen. Next, the low latency of in-ear SpO2 was further exploited in the novel application of classifying cognitive workload. It was found that in-ear pulse oximetry was able to robustly detect tiny decreases in blood oxygen during increased cognitive workload, likely caused by increased brain metabolism. This thesis demonstrates that in-ear SpO2 can be used to accurately distinguish between different levels of an N-back memory task, representing different levels of mental effort. This concept was further validated through its application to gaming and then extended to the detection of driver related fatigue. It was found that features derived from SpO2 and PPG were predictive of absolute steering wheel angle, which acts as a proxy for fatigue. The strength of in-ear PPG for the monitoring of respiration was investigated with respect to the finger, with the conclusion that in-ear PPG exhibits far stronger respiration induced intensity variations and pulse amplitude variations than the finger. All three respiratory modes were harnessed through multivariate empirical mode decomposition (MEMD) to produce spirometry-like respiratory waveforms from PPG. It was discovered that these PPG derived respiratory waveforms can be used to detect obstruction to breathing, both through a novel apparatus for the simulation of breathing disorders and through the classification of chronic obstructive pulmonary disease (COPD) in the real world. This thesis establishes in-ear pulse oximetry as a wearable technology with the potential for immense societal impact, with applications from the classification of cognitive workload and the prediction of driver fatigue, through to the detection of chronic obstructive pulmonary disease. The experiments and analysis in this thesis conclusively demonstrate that widely used pulse oximetry and photoplethysmography possess a wealth of untapped value, in essence teaching the old PPG sensor new tricks.Open Acces

Widefield Computational Biophotonic Imaging for Spatiotemporal Cardiovascular Hemodynamic Monitoring

Cardiovascular disease is the leading cause of mortality, resulting in 17.3 million deaths per year globally. Although cardiovascular disease accounts for approximately 30% of deaths in the United States, many deleterious events can be mitigated or prevented if detected and treated early. Indeed, early intervention and healthier behaviour adoption can reduce the relative risk of first heart attacks by up to 80% compared to those who do not adopt new healthy behaviours. Cardiovascular monitoring is a vital component of disease detection, mitigation, and treatment. The cardiovascular system is an incredibly dynamic system that constantly adapts to internal and external stimuli. Monitoring cardiovascular function and response is vital for disease detection and monitoring. Biophotonic technologies provide unique solutions for cardiovascular assessment and monitoring in naturalistic and clinical settings. These technologies leverage the properties of light as it enters and interacts with the tissue, providing safe and rapid sensing that can be performed in many different environments. Light entering into human tissue undergoes a complex series of absorption and scattering events according to both the illumination and tissue properties. The field of quantitative biomedical optics seeks to quantify physiological processes by analysing the remitted light characteristics relative to the controlled illumination source. Drawing inspiration from contact-based biophotonic sensing technologies such as pulse oximetry and near infrared spectroscopy, we explored the feasibility of widefield hemodynamic assessment using computational biophotonic imaging. Specifically, we investigated the hypothesis that computational biophotonic imaging can assess spatial and temporal properties of pulsatile blood flow across large tissue regions. This thesis presents the design, development, and evaluation of a novel photoplethysmographic imaging system for assessing spatial and temporal hemodynamics in major pulsatile vasculature through the sensing and processing of subtle light intensity fluctuations arising from local changes in blood volume. This system co-integrates methods from biomedical optics, electronic control, and biomedical image and signal processing to enable non-contact widefield hemodynamic assessment over large tissue regions. A biophotonic optical model was developed to quantitatively assess transient blood volume changes in a manner that does not require a priori information about the tissue's absorption and scattering characteristics. A novel automatic blood pulse waveform extraction method was developed to encourage passive monitoring. This spectral-spatial pixel fusion method uses physiological hemodynamic priors to guide a probabilistic framework for learning pixel weights across the scene. Pixels are combined according to their signal weight, resulting in a single waveform. Widefield hemodynamic imaging was assessed in three biomedical applications using the aforementioned developed system. First, spatial vascular distribution was investigated across a sample with highly varying demographics for assessing common pulsatile vascular pathways. Second, non-contact biophotonic assessment of the jugular venous pulse waveform was assessed, demonstrating clinically important information about cardiac contractility function in a manner which is currently assessed through invasive catheterization. Lastly, non-contact biophotonic assessment of cardiac arrhythmia was demonstrated, leveraging the system's ability to extract strong hemodynamic signals for assessing subtle fluctuations in the waveform. This research demonstrates that this novel approach for computational biophotonic hemodynamic imaging offers new cardiovascular monitoring and assessment techniques, which can enable new scientific discoveries and clinical detection related to cardiovascular function

Aerospace Medicine and Biology: A continuing bibliography with indexes, supplement 158, September 1976

This bibliography lists 191 reports, articles, and other documents introduced into the NASA scientific and technical information system in August 1976

Central venous pressure estimation from ultrasound assessment of the jugular venous pulse

OBJECTIVES: Acquiring central venous pressure (CVP), an important clinical parameter, requires an invasive procedure, which poses risk to patients. The aim of the study was to develop a non-invasive methodology for determining mean-CVP from ultrasound assessment of the jugular venous pulse. METHODS: In thirty-four adult patients (age = 60 ± 12 years; 10 males), CVP was measured using a central venous catheter, with internal jugular vein (IJV) cross-sectional area (CSA) variation along the cardiac beat acquired using ultrasound. The resultant CVP and IJV-CSA signals were synchronized with electrocardiogram (ECG) signals acquired from the patients. Autocorrelation signals were derived from the IJV-CSA signals using algorithms in R (open-source statistical software). The correlation r-values for successive lag intervals were extracted and used to build a linear regression model in which mean-CVP was the response variable and the lagging autocorrelation r-values and mean IJV-CSA, were the predictor variables. The optimum model was identified using the minimum AIC value and validated using 10-fold cross-validation. RESULTS: While the CVP and IJV-CSA signals were poorly correlated (mean r = -0.018, SD = 0.357) due to the IJV-CSA signal lagging behind the CVP signal, their autocorrelation counterparts were highly positively correlated (mean r = 0.725, SD = 0.215). Using the lagging autocorrelation r-values as predictors, mean-CVP was predicted with reasonable accuracy (r2 = 0.612), with a mean-absolute-error of 1.455 cmH2O, which rose to 2.436 cmH2O when cross-validation was performed. CONCLUSIONS: Mean-CVP can be estimated non-invasively by using the lagged autocorrelation r-values of the IJV-CSA signal. This new methodology may have considerable potential as a clinical monitoring and diagnostic tool

Characterization and processing of novel neck photoplethysmography signals for cardiorespiratory monitoring

Epilepsy is a neurological disorder causing serious brain seizures that severely affect the patients' quality of life. Sudden unexpected death in epilepsy (SUDEP), for which no evident decease reason is found after post-mortem examination, is a common cause of mortality. The mechanisms leading to SUDEP are uncertain, but, centrally mediated apneic respiratory dysfunction, inducing dangerous hypoxemia, plays a key role. Continuous physiological monitoring appears as the only reliable solution for SUDEP prevention. However, current seizure-detection systems do not show enough sensitivity and present a high number of intolerable false alarms. A wearable system capable of measuring several physiological signals from the same body location, could efficiently overcome these limitations. In this framework, a neck wearable apnea detection device (WADD), sensing airflow through tracheal sounds, was designed. Despite the promising performance, it is still necessary to integrate an oximeter sensor into the system, to measure oxygen saturation in blood (SpO2) from neck photoplethysmography (PPG) signals, and hence, support the apnea detection decision. The neck is a novel PPG measurement site that has not yet been thoroughly explored, due to numerous challenges. This research work aims to characterize neck PPG signals, in order to fully exploit this alternative pulse oximetry location, for precise cardiorespiratory biomarkers monitoring. In this thesis, neck PPG signals were recorded, for the first time in literature, in a series of experiments under different artifacts and respiratory conditions. Morphological and spectral characteristics were analyzed in order to identify potential singularities of the signals. The most common neck PPG artifacts critically corrupting the signal quality, and other breathing states of interest, were thoroughly characterized in terms of the most discriminative features. An algorithm was further developed to differentiate artifacts from clean PPG signals. Both, the proposed characterization and classification model can be useful tools for researchers to denoise neck PPG signals and exploit them in a variety of clinical contexts. In addition to that, it was demonstrated that the neck also offered the possibility, unlike other body parts, to extract the Jugular Venous Pulse (JVP) non-invasively. Overall, the thesis showed how the neck could be an optimum location for multi-modal monitoring in the context of diseases affecting respiration, since it not only allows the sensing of airflow related signals, but also, the breathing frequency component of the PPG appeared more prominent than in the standard finger location. In this context, this property enabled the extraction of relevant features to develop a promising algorithm for apnea detection in near-real time. These findings could be of great importance for SUDEP prevention, facilitating the investigation of the mechanisms and risk factors associated to it, and ultimately reduce epilepsy mortality.Open Acces