Arterial oxygen saturation ($SpO_2$) monitoring for newborns requires special attention in neonatal intensive care units (NICUs). Newborns have very low photo-plethysmogram (PPG) amplitudes and their body movements are difficult to contain. Hardware design and its associated signal processing algorithms should be robust enough so that faulty measurements can be avoided. In this study, improved designs were implemented to deal with low perfusion, motion artifact, and the influence of ambient light. Dynamic range was increased by using different LED intensities and a feedback system. To minimize the effects of motion artifact and to discard other unqualified data, four additional algorithms were used, which were based on dual-trace detection, continuity of DC level, morphology of PPG, and simultaneity check of $SpO_2$. Our $SpO_2$ system was tested with newborns with normal respiration in the NICU. Our system provided fast, real-time responses and 100% artifact detection was accomplished under 84% of $SpO_2$.
Shin, Jae-Young;Ku, Boncho;Kim, Tae-Hun;Bae, Jang Han;Jun, Min-Ho;Lee, Jun-Hwan;Kim, Jaeuk U.
Journal of Pharmacopuncture
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v.19
no.3
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pp.197-206
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2016
Introduction: This study aims to investigate the effects of acupuncture stimulation on the radial artery's pressure pulse wave, along with various hemodynamic parameters, and to explore the possible underlying mechanism of pulse diagnosis in healthy participants in their twenties. Methods and analysis: This study is a prospective, single-arm, exploratory clinical study. A total of 25 healthy participants, without regard to gender, in their twenties will be recruited by physicians. Written informed consent will be obtained from all participants. The participants will receive acupuncture once at ST36 on both sides. The radial arterial pulse waves will be measured on the left arm of the subjects by using an applicable pulse tonometric device (KIOM-PAS). On the right arm (appearing twice), electrocardiogram (ECG), photoplethysmogram (PPG), respiration and cardiac output (CO) signals, will be measured using a physiological data acquisition system (Biopac module), while the velocity of blood flow, and the diameter and the depth of the blood vessel will be measured using an ultrasonogram machine on the right arm (appearing twice). All measurements will be conducted before, during, and after acupuncture. The primary outcome will be the spectral energy at high frequencies above 10 Hz ($SE_{10-30Hz}$) calculated from the KIOM-PAS device signal. Secondary outcomes will be various variables obtained from the KIOM-PAS device, ECG, PPG, impedance cardiography modules, and an ultrasonogram machine. Discussion: The results of this trial will provide information regarding the physiological and the hemodynamic mechanisms underlying acupuncture stimulation and clinical evidence for the influence of acupuncture on the pressure pulse wave in the radial artery. Ethics and dissemination: This study was approved by the Institutional Review Board (IRB) of Kyung Hee University's Oriental Medical Center, Seoul, Korea (KOMCIRB-150818-HR-030). The study findings will be published in peer-reviewed journals and presented at national and international conferences. Trial registration number: This trial was registered with the Clinical Research Information Service (CRIS) at the Korea National Institute of Health (NIH), Republic of Korea (KCT0001663), which is a registry in the World Health Organization's (WHO's) Registry Network.
Background: In patients with chronic obstructive pulmonary disease(COPD). it is well known that hypoxemia increases the frequency of VPB, which is associated with the poor prognosis such as sudden death. The aim of this study is to evaluate the effect of short and long-term low flow oxygen therapy on the development of VPBs in patients with COPD by correcting the hypoxemia. Method: In 19 patients with COPD, oxygen saturation and VPB's were monitored by pulse oxymeter and 24-hour Holter EKG, with room air and oxygen saturation and VPB's were monitored on the 1st and on the 8th day during oxygen therapy with nasal prong (2L/min). Results : The arterial oxygen saturation was significantly higher on the 1st day of oxygen therapy compared with breathing room air, and was also higher on the 8th day of oxygen therapy than on the 1st day. We found that there was significant correlation between the lowest value of the arterial oxygen saturation and the mean value of the arterial oxygen saturation. The number of VPB's per hour was significantly lower on the 1st day of oxygen therapy compared with breathing room air, and also lower on the 8th day of oxygen therapy than on the 1st day. Our results showed positive correlation between the decrease in the frequency of VPB's and the increase in the lowest arterial oxygen saturation, even though correlation was not significant(p=0.056). Conclusion: With oxygen therapy, the arterial oxygen saturation was increased and the number of VPB's was decreased. Long-term oxygen therapy more than 7days, would be helpful to decrease the number of VPB' s in patients with COPD.
Purpose: The purpose of this study was to examine the effects of position change from supine to Fowler's on back pain and discomfort in patients who remained on bed rest after undergoing PCIs with a vascular closure device. Methods: Data was collected from 35 inpatients who were hospitalized in coronary-care unit to perform PCIs with a vascular closure device at S hospital in Seoul from December, 2006 to May, 2007. Back pain, discomfort, presence and grade of bleeding and hematoma from femoral arterial puncture site and blood pressure/pulse rate were measured prior to, 10 minutes, 1 hour and 2 hours after position change. Data was analyzed with descriptive statistics, $x^2$ tests and t-tests using SPSS/WIN 12.0 for Windows program. The level of significance (${\alpha}$) was set at 0.05 for this study. Results: We found that there was no significant difference in back pain and discomfort in 10 minutes after position change between the two groups. However, the experimental group reported significantly less back pain and discomfort than the control group in 1 hour (p<.01, respectively) and 2 hour (p<.01, respectively) after position change. There was no significant difference in the presence and grade of bleeding and hematoma at the puncture site, blood pressure, and pulse rate in 10 minutes, 1hour and 2hours after position change between the two groups. Conclusion: Fowler's position change after PCIs in, therefore, safe and effective method of reducing back pain and physical discomfort without causing additional bleeding and changes in blood pressure and pulse rate.
Functional imaging based on the susceptibility only is achieved by separation of the susceptibility effect from the mixture of flow effect by use of a tailored RF pulse in conjunction with gradient echo sequence. Using the tailored RF pulse the susceptibility enhanced functional imaging appears to be explicitly related to the deoxygenation processes, while in the conventional gradient echo technique functional contrast on $T2^{*}$ effect images appear to be mixed with a significant fraction of blood flow (in- flow) signals of both arterial as well as venous bloods due to the nature of the fast sequence employed with the gradient echo technique. In this paper, using the tailored RF pulses, one can unambiguously separate the susceptibility and flow effects in functional imaging. Since the signal obtained can be made sufficiently high and represents oxygenation process more accurately, it seems possible to study quantitative oxygen metabolisms in brain function hitherto difficult to do with other gradient echo techniques.
Early age at menarche, which is indicator of early biological maturity, has been shown to be associated with increased adult body mass index. Early menarche has also been associated with many cardiovascular disease risk factors and metabolic syndrome. To evaluate the impact of menarche to cardiovascular risk factor, we assessed by age at menarche, brachial-ankle pulse wave velocity (baPWV), which represents arterial stiffness, in women with or without metabolic syndrome. The subjects recruited for this study were three hundred one women. Relatively early menarche and relatively late menarche were classified according to less than $50^{th}$ percentile for relatively early menarche, and great than the $50^{th}$ percentile for relatively late menarche. Subject were divided four group, 1) women who had not adulthood metabolic syndrome and relatively early menarche, 2) women who had not adulthood metabolic syndrome and relatively late menarche, 3) women who had adulthood metabolic syndrome and relatively early menarche, 4) women who had adulthood metabolic syndrome and relatively late menarche. Women who had a relatively early menarche with adulthood metabolic syndrome had significantly high levels of blood pressure, triglyceride, fasting insulin and homeostatic model assessment of insulin resistance (HOMA-IR) levels than women with late menarche with adulthood metabolic syndrome, and had significantly lower HDL-cholesterol levels. And also, women who underwent a relatively early menarche with metabolic syndrome had highest level of baPWV in adult. In this study we found effect of age at menarche on adulthood metabolic risk factors for cardiovascular disease (e.g., baPWV, insulin resistance, hyperlipidemia) in Korean women.
The Purpose Of This Paper Is To Use A Tactile Sensor To Compensate The Error Rate. Most Automated Sphygmomanometers Use The Oscillometric Method And Characteristic Ratio To Estimate Systolic And Diastolic Blood Pressure. However, Based On The Fact That Maximum Amplitude Of The Oscillometric Waveform And Characteristic Ratio Are Affected By Compliance Of The Aorta And Large Arteries, A Method To Measure The Artery Stiffness By Using A Tactile Sensor Was Chosen In Order To Integrate It With The Sphygmomanometer In The Future Instead Of Using Photoplethysmography. Since Tactile Sensors Have Very Weak Movements, Efforts Were Made To Maintain The Subject's Arm In A Fixed Position, And A 40hz Low Pass Filter Was Used To Eliminate Noise From The Power Source As Well As High Frequency Noise. An Analyzing Program Was Made To Get Time Delay Between The First And Second Peak Of The Averaged Digital Volume Pulse(${\Delta}t_{dvp}$), And The Subject's Height Was Divided By ${\Delta}t_{dvp}$ To Calculate The Stiffness Index Of The Arteries($Si_{dvp}$). Regression Equations Of Systolic And Diastolic Pressure Using $Si_{dvp}$ And Mean Arterial Pressure(Map) Were Computed From The Test Group (60 Subjects) Among A Total Of 121 Subjects(Age: $44.9{\pm}16.5$, Male: Female=40:81) And Were Tested In 61 Subjects To Compensate The Error Rate. Error Rates Considering All Subjects Were Systolic $4.62{\pm}9.39mmhg$, And Diastolic $14.40{\pm}9.62mmhg$, And Those In The Test Set Were $3.48{\pm}9.32mmhg,\;And\;14.34{\pm}9.67mmhg$ Each. Consequently, Error Rates Were Compensated Especially In Diastolic Pressure Using $Si_{dvp}$, Various Slopes From Digital Volume Pulse And Map To Systolic-$1.91{\pm}7.57mmhg$ And Diastolic $0.05{\pm}7.49mmhg$.
Dalhae, Kim;Won-Gyun, Son;Donghwi, Shin;Jiyoung, Kim;Inhyung, Lee
Journal of Veterinary Science
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v.23
no.6
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pp.68.1-68.8
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2022
Background: Studies on anesthetized dogs regarding pulse pressure variation (PPV) are increasing. The influence of respiratory rate (RR) on PPV, in mechanically ventilated dogs, has not been clearly identified. Objectives: This study evaluated the influence of RR on PPV in mechanically ventilated healthy dogs after hemorrhage. Methods: Five healthy adult Beagle dogs were premedicated with intravenous (IV) acepromazine (0.01 mg/kg). Anesthesia was induced with alfaxalone (3 mg/kg IV) and maintained with isoflurane in 100% oxygen. The right dorsal pedal artery was cannulated with a 22-gauge catheter for blood removal, and the left dorsal pedal artery was cannulated and connected to a transducer system for arterial blood pressure monitoring. The PPV was automatically calculated using a multi-parameter monitor and recorded. Hemorrhage was induced by withdrawing 30% of blood (24 mL/kg) over 30 min. Mechanical ventilation was provided with a tidal volume of 10 mL/kg and a 1:2 inspiration-to-expiration ratio at an initial RR of 15 breaths/min (baseline). Thereafter, RR was changed to 20, 30, and 40 breaths/min according to the casting lots, and the PPV was recorded at each RR. After data collection, the blood was transfused at a rate of 10 mL/kg/h, and the PPV was recorded at the baseline ventilator setting. Results: The data of PPV were analyzed using the Friedman test followed by the Wilcoxon signed-rank test (p < 0.05). Hemorrhage significantly increased PPV from 11% to 25% at 15 breaths/min. An increase in RR significantly decreased PPV from 25 (baseline) to 17%, 10%, and 10% at 20, 30, and 40 breaths/min, respectively (all p < 0.05). Conclusions: The PPV is a dynamic parameter that can predict a dog's hemorrhagic condition, but PPV can be decreased in dogs under high RR. Therefore, careful interpretation may be required when using the PPV parameter particularly in the dogs with hyperventilation.
The purpose of the present study was to examine the hemodynamic responses, especially in arterial and skin blood flows, in conjunction with the changes of plasma catecholamine levels as an indirect marker of adrenergic tone during the early stage of head-down tilt (HDT), and to evaluate the early physiological regulatory mechanism in simulated weightlessness. Ten mongrel dogs, weighing8\;{\sim}\;14\;kg, were intravenously anesthetized with nembutal, and postural changes were performed by using the tilting table. The postural changes were performed in the following order: supine, prone, HDT $(-6^{\circ}C)$ and lastly recovery prone position. The duration of each position was 30 minutes. The measurements were made before, during and after each postural change. The arterial blood flow $({\.{Q}})$ at the left common carotid and right brachial arteries was measured by the electromagnetic flowmeter. Blood pressure (BP) was directly measured by pressure transducer in the left brachial artery. To evaluate the peripheral blood flow, skin blood flow $({\.{Q}})$ was calculated by the percent changes of photoelectric pulse amplitude on the forepaw, and skin temperature was recorded. The peripheral vascular resistance (PR) was calculated by dividing respective mean BP values by ${\.{Q}}$ of both sides of common carotid and brachial arteries. Heart rate (HR), respiratory rate (f) and PH, $Po_{2},\;Pco_{2}$ and hematocrit of arterial and venous blood were also measured. The concentration of plasma epinephrine and norepinephrine was measured by radioenzymatic method. The results are summarized as follows: Tilting to head-down position from prone position, HR was initially increased (p<0.05) and BP was not significantly changed. While ${\.{Q}}$ of the common carotid artery was decreased (p<0.05) and PR through the head was increased, ${\.{Q}}$ of the brachial artery was increased (p<0.05) and PR through forelimbs was decreased. ${\.{Q}}$ of the forepaw was initially increased (p<0.05) and then slightly decreased, on the whole revealing an increasing trend. Plasma norepinephrine was slightly decreased and the epinephrine was slightly increased. f was increased and arterial pH was increased (p<0.05). In conclusion, the central blood pooling during HDT shows an increased HR via Bainbridge reflex and an increased ${\.{Q}}$ of the forepaw and brachial ${\.{Q}}$, due to decreased PR which may be originated from the depressor reflex of cardiopulmonary baroreceptors. It is suggested that the blood flow to the brain was adequately regulated throughout HDT $(-6^{\circ}C)$ in spite of central blood pooling. And it is apparent that the changes of plasma norepinephrine level are inversely proportional to those of ${\.{Q}}$ of the forepaw, and the changes of epinephrine level are paralleled with those of the brachial ${\.{Q}}$.
[Purpose] The purpose of this study was to assess changes in blood glucose level, blood pressure, and arterial stiffness after a 75 g oral glucose tolerance test (OGTT) in elderly women aged over 65 years with hypertension and either normal glycemic control, impaired fasting glucose tolerance, or diabetes mellitus. We also wished to investigate the relationship between stages of diabetes and physical fitness. [Methods] A total of 24 elderly women with hypertension were assigned to a control group (CON; n=7), impaired fasting glucose group (IFG; n=9), and diabetes mellitus group (DM; n=8). In each group, blood glucose level, brachial ankle pulse wave velocity (PWV), and blood pressure were measured at baseline as well as 60 and 120 minutes after a 75 g OGTT. Physical fitness factors such as hand grip strength, balance test, 4 m gait speed test, chair stand test, short physical performance battery, and 6-minute walking test were subsequently assessed. [Results] In all three groups, blood glucose levels were significantly increased at 60 and 120 minutes after a 75 g OGTT. In the DM group, blood glucose levels were significantly higher before and after a 75 g OGTT than in the CON group. In the CON group, PWV was significantly increased at 60 minutes after a 75 g OGTT; however, there were no changes in other groups after glucose ingestion. In the CON group, systolic and diastolic blood pressures were significantly decreased at 60 and 120 minutes after a 75 g OGTT compared to baseline. However, there was no change in blood pressure after ingestion in the DM group. The IFG group had greater grip strength than the CON group; however, there were no differences in other variables between the groups. [Conclusion] After a 75 g OGTT, elderly women with hypertension and diabetes maintain higher blood glucose levels compared to those with hypertension alone. Unlike elderly women with hypertension alone, those with hypertension and diabetes did not show changes in arterial stiffness and blood pressure after a 75 g OGTT. Therefore, elderly women with hypertension and diabetes may not be able to control their blood vessels following a 75 g OGTT due to impaired vascular endothelial function. Moreover, there was no association between diabetes stage and physical fitness in elderly women with hypertension.
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