Investigation of oesophageal photoplethysmographic signals and blood oxygen saturation measurements in cardiothoracic surgery patients

Kyriacou, P. A., Powell, S., Langford, R. M. & Jones, D. P. (2002). Investigation of oesophageal photoplethysmographic signals and blood oxygen saturation measurements in cardiothoracic surgery patients. Physiological Measurement, 23(3), pp. 533-546. doi: 10.1088/0967-3334/23/3/305

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Abstract

Pulse oximeter probes attached to the finger may fail to estimate blood oxygen saturation (SpO2) in patients with compromised peripheral perfusion (e.g. hypothermic cardiopulmonary bypass surgery). The measurement of SpO2 from a central organ such as the oesophagus is suggested as an alternative to overcome this problem. A reflectance oesophageal pulse oximeter probe and a processing system implemented in LabVIEW were developed. The system was evaluated in clinical measurements on 50 cardiothoracic surgery patients. Oesophageal photoplethysmographic (PPG) signals with large amplitudes and high signal-to-noise ratios were measured from various depths within the oesophagus from all the cardiothoracic patients. The oesophageal PPG amplitudes from these patients were in good agreement with previous oesophageal PPG amplitude measurements from healthy anaesthetized patients. The oesophageal pulse oximeter SpO2 results agreed well with the estimated arterial oxygen saturation (SaO2) values inferred from the oxygen tension obtained by blood gas analysis. The mean (+/- SD) of the differences between the oesophageal pulse oximeter SpO2 readings and those from blood gas analysis was 0.02 +/- 0.88%. Also, the oesophageal pulse oximeter was found to be reliable and accurate in five cases of poor peripheral perfusion when a commercial finger pulse oximeter probe failed to estimate oxygen saturation values for at least 10 min. These results suggest that the arterial blood circulation to the oesophagus is less subject to vasoconstriction and decreased PPG amplitudes than are the peripheral sites used for pulse oximetry such as the finger. It is concluded that oesophageal SPO2 monitoring may be of clinical value.

Item Type: Article
Additional Information: This is an author-created, un-copyedited version of an article accepted for publication in 'Physiological Measurement'. The publisher is not responsible for any errors or omissions in this version of the manuscript or any version derived from it. The Version of Record is available online at http://dx.doi.org/10.1088/0967-3334/23/3/305.
Uncontrolled Keywords: photoplethysmography (PPG); oesophagus; blood oxygen saturation; cardiac surgery
Subjects: Q Science > QM Human anatomy
R Medicine > RD Surgery
T Technology > TA Engineering (General). Civil engineering (General)
Divisions: School of Engineering & Mathematical Sciences > Engineering
URI: http://openaccess.city.ac.uk/id/eprint/14684

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