PHOTOPLETHYSMOGRAPHIC WAVEFORM ANALYSIS DURING LOWER BODY NEGATIVE PRESSURE SIMULATED HYPOVOLEMIA AS A TOOL TO DISTINGUISH REGIONAL DIFFERENCES IN MICROVASCULAR BLOOD FLOW REGULATION.

The purpose of this investigation was to explore modulation of the photoplethsymographic (PPG) waveform in the setting of simulated hypovolemia as a tool to distinguish regional differences in regulation of the microvasculature. The primary goal was to glean useful physiological and clinical information as it pertains to these regional differences in regulation of microvascular blood flow. This entailed examining the cardiovascular, autonomic nervous, and respiratory systems interplay in the functional hemodynamics of regulation of microvascular blood flow to both central (ear, forehead) and peripheral (finger) sites. We monitored ten healthy volunteers (both men and women age 24-37 ) non-invasively with central and peripheral photoplethysmographs and laser Doppler flowmeters during Lower Body Negative Pressure (LBNP). Waveform amplitude, width, and oscillatory changes were characterized using waveform analysis software (Chart, ADInstruments). Data were analyzed with the Wilcoxon Signed Ranks Test, paired t-tests, and linear regression. Finger PPG amplitude decreased by 34.6 ± 17.6% (p = 0.009) between baseline and the highest tolerated LBNP. In contrast, forehead amplitude changed by only 2.4 ± 16.0% (p=NS). Forehead and finger PPG width decreased by 48.4% and 32.7%, respectively. Linear regression analysis of the forehead and finger PPG waveform widths as functions of time generated slopes of -1.113 (R = -0.727) and -0.591 (R = -0.666), respectively. A 150% increase in amplitude density of the ear PPG waveform was noted within the range encompassing the respiratory frequency (0.19-0.3Hz) (p=0.021) attributable to changes in stroke volume. We also noted autonomic modulation of the ear PPG signal in a different frequency band (0.12 0.18 Hz). The data indicate that during a hypovolemic challenge, healthy volunteers had a relative sparing of central cutaneous blood flow when compared to a peripheral site as indicated by observable and quantifiable changes in the PPG waveform. These results are the first documentation of a local vasodilatation at the level of the terminal arterioles of the forehead that may be attributable to recently documented cholinergic mechanisms on the microvasculature

Using Respiratory Variations Of Plethysmographic Waveforms To Track Changes In Intravascular Volume During Hemodialysis

Whereas dynamic indices have been shown to accurately predict volume status in mechanically ventilated patients, we still lack a reliable noninvasive means of intravascular volume status assessment in spontaneously breathing patients. The present study was undertaken to determine the impact of incentive spirometry (IS) on plethysmographic (PPG) waveforms in spontaneously breathing end stage renal disease (ESRD) patients. Furthermore, the impact of ultrafiltration on plethysmographic waveform variability in spontaneously breathing patients with and without incentive spirometry was analyzed. With IRB approval, data were collected and analyzed for 44 hemodialysis cases. PPG waveforms were recorded at 100 Hz with a data acquisition system (S5 Collect) with patients first spontaneously breathing (SB) and then performing IS breathing. The waveforms were analyzed (spectrum, 4K, Hamming, Amplitude density) using Chart software (ADInstruments). Data were presented as mean ± SD. The results were compared using the 2-tailed t-test, and P \u3c 0.05 was considered statistically significant. There was significant increase in the PPG DC with the use of IS, p value = 0.0000002. The average PPG DC at baseline was 1.06 ± 0.82 with SB while average PPG DC with IS was 3.54 ± 1.58, with percent change of 234% increase from baseline. Similarly, at the end of dialysis, a comparison between SB and IS showed a 203% change in the PPG DC value (1.92±1.03 with SB versus 5.819±2.84 with IS, p=0.000023). Whereas IS was consistently associated with a significant increase in PPG DC at the end of dialysis, SB was not associated with a significant increase in PPG DC at the end of dialysis when the ultrafiltrate rate exceeded 1000cc/hr. Dynamic noninvasive hemodynamic evaluation has been shown to be more accurate than conventional hemodynamic static pressures; among the noninvasive methods is the PPG. This study showed a significant increase in PPG DC amplitude density during IS, and a significant increase in PPG DC during IS at the end of dialysis as compared to the beginning. This suggests that IS can be used as a tool to track changes in PPG DC variability in spontaneously breathing ESRD patients undergoing dialysis

Respiratory Physiology and the Impact of Different Modes of Ventilation on the Photoplethysmographic Waveform

The photoplethysmographic waveform sits at the core of the most used, and arguably the most important, clinical monitor, the pulse oximeter. Interestingly, the pulse oximeter was discovered while examining an artifact during the development of a noninvasive cardiac output monitor. This article will explore the response of the pulse oximeter waveform to various modes of ventilation. Modern digital signal processing is allowing for a re-examination of this ubiquitous signal. The effect of ventilation on the photoplethysmographic waveform has long been thought of as a source of artifact. The primary goal of this article is to improve the understanding of the underlying physiology responsible for the observed phenomena, thereby encouraging the utilization of this understanding to develop new methods of patient monitoring. The reader will be presented with a review of respiratory physiology followed by numerous examples of the impact of ventilation on the photoplethysmographic waveform

A Comparative Evaluation of Heart Rate Estimation Methods using Face Videos

This paper presents a comparative evaluation of methods for remote heart rate estimation using face videos, i.e., given a video sequence of the face as input, methods to process it to obtain a robust estimation of the subjects heart rate at each moment. Four alternatives from the literature are tested, three based in hand crafted approaches and one based on deep learning. The methods are compared using RGB videos from the COHFACE database. Experiments show that the learning-based method achieves much better accuracy than the hand crafted ones. The low error rate achieved by the learning based model makes possible its application in real scenarios, e.g. in medical or sports environments.Comment: Accepted in "IEEE International Workshop on Medical Computing (MediComp) 2020

Low-cost photoplethysmograph solutions using the Raspberry Pi

Photoplethysmography is a prevalent, non-invasive heart monitoring method. In this paper an implementation of photoplethysmography on the Raspberry Pi is presented. Two modulation techniques are discussed, which make possible to measure these signals by the Raspberry Pi, using an external sound card as A/D converter. Furthermore, it is shown, how can digital signal processing improve signal quality. The presented methods can be used in low-cost cardiac function monitoring, in telemedicine applications and in education as well, since cheap and current hardware are used. Full documentation and open-source software for the measurement available: http://www.noise.inf.u-szeged.hu/Instruments/raspberryplet/Comment: 14th IEEE International Symposium on Computational Intelligence and Informatics (CINTI 2013), November 19-21, 2013, Budapest, Hungar

Aerospace medicine and biology: A continuing bibliography with indexes, supplement 184

This bibliography lists 139 reports, articles, and other documents introduced into the NASA scientific and technical information system in August 1978

Development of limb volume measuring system

The mechanisms underlying the reductions in orthostatic tolerance associated with weightlessness are not well established. Contradictory results from measurements of leg volume changes suggest that altered venomotor tone and reduced blood flow may not be the only contributors to orthostatic intolerance. It is felt that a more accurate limb volume system which is insensitive to environmental factors will aid in better quantification of the hemodynamics of the leg. Of the varous limb volume techniques presently available, the ultrasonic limb volume system has proven to be the best choice. The system as described herein is free from environmental effects, safe, simple to operate and causes negligible radio frequency interference problems. The segmental ultrasonic ultrasonic plethysmograph is expected to provide a better measurement of limb volume change since it is based on cross-sectional area measurements

Noncontact imaging photoplethysmography to effectively access pulse rate variability

Noncontact imaging photoplethysmography (PPG) can provide physiological assessment at various anatomical locations with no discomfort to the patient. However, most previous imaging PPG (iPPG) systems have been limited by a low sample frequency, which restricts their use clinically, for instance, in the assessment of pulse rate variability (PRV). In the present study, plethysmographic signals are remotely captured via an iPPG system at a rate of 200 fps. The physiological parameters (i.e., heart and respiration rate and PRV) derived from the iPPG datasets yield statistically comparable results to those acquired using a contact PPG sensor, the gold standard. More importantly, we present evidence that the negative influence of initial low sample frequency could be compensated via interpolation to improve the time domain resolution. We thereby provide further strong support for the low-cost webcam-based iPPG technique and, importantly, open up a new avenue for effective noncontact assessment of multiple physiological parameters, with potential applications in the evaluation of cardiac autonomic activity and remote sensing of vital physiological signs

Cardiovascular assessment by imaging photoplethysmography – a review

AbstractOver the last few years, the contactless acquisition of cardiovascular parameters using cameras has gained immense attention. The technique provides an optical means to acquire cardiovascular information in a very convenient way. This review provides an overview on the technique’s background and current realizations. Besides giving detailed information on the most widespread application of the technique, namely the contactless acquisition of heart rate, we outline further concepts and we critically discuss the current state.</jats:p