Clinical screening for congenital heart disease in newborns at a tertiary care hospital of a developing country

Objective: To screen all newborns admitted to a tertiary care hospital to rule out congenital heart disease before discharge and to find out the utility of pulse oximetry to detect congenital heart disease. Methodology: This prospective study was done at Aga Khan University Hospital from January 2014 to December 2014 in 1,650 newborns over a period of 12 months. Pulse oximetry and clinical examination were done. Persistent oxygen saturation less than 95% was considered as positive pulse oximetry. Newborns who had positive pulse oximetry or abnormal clinical examinations findings were subjected to echocardiography. Result: Pulse oximetry was performed on 1,650 newborns, out of which 25 (1.5%) had congenital heart disease. Positive pulse oximetry cases were 16 (0.97%), out of which 10 had only positive pulse oximetry (negative clinical examination). Positive clinical examination cases were 45 (2.7%), out of which 39 cases had only positive clinical examinations (negative pulse oximetry). Six newborns had both positive pulse oximetry and positive clinical examination. Out of the 25 diagnosed cases of congenital heart disease, ventricular septal defect (VSD) was the most common congenital heart disease, followed by patent ductus arteriosus (PDA). The sensitivity, specificity, positive predictive value, and negative predictive value of pulse oximetry were 32%, 99.5%, 50%, and 98.9% respectively. Conclusion: The community setting of a developing country, a combination of pulse oximetry screening and clinical examination are better at detecting congenital heart defects than either test alon

Direct pulse oximetry within the esophagus, on the surface of abdominal viscera, and on free flaps

Pulse oximetry is a noninvasive photometric technique that provides information about arterial blood oxygen saturation (SpO2) and heart rate and has widespread clinical applications. This is accomplished via peripheral pulse oximetry probes mainly attached to the finger, toe, or earlobe. The direct application of pulse oximetry to an organ, such as the esophagus, liver, bowel, stomach or free flap, might provide an indication of how well perfused an organ or a free flap is. Also, the placement of a pulse oximetry probe at a more central site, such as the esophagus, might be more reliable at a time when conventional peripheral pulse oximetry fails

PULSE OXIMETRY UTILIZATION AND OXYGEN WEANING DECISION TO CHILDREN PATIENT WITH ACUTE ASTHMA ATTACK AT EMERGENCY UNIT

Introduction: Emergency nurses’s somehow actually have lack of knowledge performing pulse oximetry utilization and decision made when an oxygen weaning is done especially for those patient’s who are suffered from acute asthma attack. Method: The used method was by collecting and analyzing related textbook and articles with pulse oximetry and decision of oxygen weaning at children with acute asthma attack. The literatures were obtained from textbook and electronic articles such as ScienceDirect, World Health Organization, Google Scholar, PubMed and ClinicalKey with textbook and article criteria that were published from 2000 to 2015. Results: Pulse oximetry utilization based on asthma attack level to children. The attack level is divided into 3, mild, moderate, and severe. The asthma attack level can be classified based on the symptoms that can be seen by GINA guidance (2015) or by using PRAM (Pediatric Respiratory Assessment Measure) score. Mild asthma patients without oxygen administered will be examine by pulse oximetry every four hours, however, for those with oxygen administered will be set up pulse oximetry every two to four hours. For moderate attack, the pulse oxymetry examination had done in each two to four hours within stable condition, if it didn’t stable the pulse oximetry should be installed continuously. While the severe asthma attack level, the pulse oximetry should be installed continuously for monitoring SpO2 and breathing status. The oxygen weaning decision is done at SpO2 > 91%. At SpO2 91% level then O2 is still installed and SpO2 reexamination in 60 minutes. If SpO2 91% and rechecked in next 15-60 minutes. Discussion: Pulse oximetry provide information to SpO2, further it can be used as evidence based in giving appropriate oxygen during stable condition as a guidance in the oxygen weaning. Keywords: pulse oximetry, asthma, emergenc

Pulse oximetry and photoplethysmographic waveform analysis of the esophagus and bowel

Purpose of review This article reviews the development of novel reflectance pulse oximetry sensors for the esophagus and bowel, and presents some of the techniques used to analyze the waveforms acquired with such devices. Recent findings There has been much research in recent years to expand the utility of pulse oximetry beyond the simple measurement of arterial oxygen saturation from the finger or earlobe. Experimental sensors based on reflectance pulse oximetry have been developed for use in internal sites such as the esophagus and bowel. Analysis of the photoplethysmographic waveforms produced by these sensors is beginning to shed light on some of the potentially useful information hidden in these signals. Summary The use of novel reflectance pulse oximetry sensors has been successfully demonstrated. Such sensors, combined with the application of more advanced signal processing, will hopefully open new avenues of research leading to the development of new types of pulse oximetry-based monitoring techniques

Racial Discrepancies in Pulse Oximetry Reading and Their Effects on Self-monitoring Devices Usage and Clinical Decision-Making

INTRODUCTION: As technology use rises and the use of pulse oximetry data increases, the demand for accurate oxygen saturation (SpO2) readings is paramount to ensure health equity among all populations. Pulse oximetry is a non-invasive tool used to monitor SpO2. Self-monitoring devices, such as SMART devices, allow for portable and cost-effective utilization; therefore, self-monitoring device usage and pulse oximetry data are quickly becoming more available to patients and their providers. Pulse oximetry is a critical component used when evaluating the severity of arterial deoxygenation. Providers often use data from pulse oximetry to determine treatment options. Recent studies have found discrepancies in pulse oximeter reading among Black patients, posing a problem for both patients and their providers. We hypothesize that self-monitoring devices can affect mortality rates among Black patients if these disparities are not addressed. OBJECTIVES: The aim of this study is to investigate how racial discrepancies in pulse oximetry reading among self-monitoring devices can affect mortality rates among Black patients in the United States. METHODS: The design of this study is a systematic review and data extraction of relevant articles that discuss the use of self-monitoring devices to determine oxygen saturation and relevant racial disparities associated with health outcomes. RESULTS: Searches identified 123 citations with relative pulse oximetry data in relation to race. Some of the data extraction provided significant evidence that there are disparities present among reading provided by self-monitoring, pulse oximetry devices and Black patients. CONCLUSION This is a research proposal that is still ongoing. Current independent reviews of individual articles are still being analyzed

Pulse Oximetry

As part of the mini-symposium entitled Bench to Bedside: Engineering Technology Translation, Dr. Mendelson describes pulse oximetry technology and how that technology idea successfully developed into a real world medical product

Investigating optical path in reflectance pulse oximetry using a multilayer monte carlo model

Despite the wide clinical uses of pulse-oximetry, the precise nature of the light-tissue interaction underneath the technique is not clearly understood. A heterogeneous opto-anatomical model is presented to describe the optical path in pulse oximetry