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Wearable Wireless Pulse Oximetry for Physiological
MonitoringYitzhak Mendelson, Ph.D.
Deptartment of Biomedical EngineeringWorcester Polytechnic Institute
PPL Workshop (Aug. 4th, 2008)
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• Motivation• Goal• Background• Development of a Wearable Pulse Oximeter• Measurement Validations• Future Development
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Presentation Outline
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Telemedicine using wearable sensors can provide useful information for emergency first responders and facilitate life saving rescues of:
• Soldiers• Firefighters• Mountain climbers
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Operating in harsh and hazardous environmentsOperating over large geographical terrains
Motivation
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• Data derived from sensors can provide input information in models developed to assess and predict the health status of wounded soldiers.
• The reliability of the wearable sensors usedand the data extracted is essential for the successful implementation of these predictive models.
Motivation
PredictiveModels
Wearable Sensors Health Status
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Personnel monitoring (physiological monitoring of firefighters) capability — In particular, integrated body-worn sensor suite to provide real-time health analysis and issue alarms to both wearer and command staff.
DHS Leads: Federal Emergency Management Agency and Office of Emergency Communications
Representative Technology Needs for Improved Incident Management:
Motivation
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• Firefighters experience tremendous CV demands with high-levels of short-term strenuous physical workloads and overexertion.
• Increased HR and core body temperature leads to increased physiological stress.
• Risks related to exhaustion, overheating and inhalation of combustion products can lead to work injuries and fatalities.
Motivation
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What are the Needs
Physiological Monitoring
?Wearable
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Development of aRobust Wearable Pulse Oximeter
for Field Applications
Our Goal
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OR (Anesthesia)ERICUAmbulances
Pulse oximeters are commonly employed in nearly all hospital areas where patients
are at an increased risk of developing hypoxemia
…
Background
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• Appeared in the early 1980’s.• Gained overnight popularity.• By 1987, the standard of care for the
administration of a general anesthetic in the USA included pulse oximetry.
• Transformed monitoring hypoxemia from a crude and imprecise visual color assessment into a reliable, quick, noninvasive and objective measurement.
• Now a mature technology in hospitals.
Background
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• Life depends on uninterrupted O2 supply. • Different organs and tissues can survive lack of O2 for
different lengths of time: The brain is the most rapidly and irrevocably damaged organ.
• Because the brain regulates breathing and circulation, supplying O2 to the whole body, deprivation of O2 supply to the brain can be fatal.
• Mild cases of hypoxia can cause poor judgment and uncoordinated movement. Severe cases death is inevitable.
• After ~5 min, cutting off blood supply to the brain causes cells to die.
• Timing is everything!
Background
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PULSE OXIMETERS RELY ON SPECTROPHOTOMETRIC
PRINCIPLES TO DERIVE SpO2 AND HR FROM A
PULSATING VASCULAR TISSUE BED
Blood depleted of O2appears purple
Background
Blood rich in O2appears bright red
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Background
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Reflectance ModeTransmittance Mode
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Does not impede hand movements.
Easy sensor attachment.
More motion tolerant location (skull provides
mechanical support).
Provides strong and clean PPG signals.
Why the Forehead ?
Advantage of Reflectance Mode
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COTS Pulse OximetersDesigned for Clinical Settings(Patient movement relatively constrained)
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Commercial Sensors
LEDs
PD
Adhesive
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• Several prominent features can be extracted from the Photoplethysmogram(PPG).
• Monitoring multiple variables using a single sensor has distinct advantages.
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Principle
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Principle (SpO2)
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IR PPG
Principle (HR)
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IR PPG
Principle (RR)
INSPIRATION INSPIRATION
EXPIRATION EXPIRATION
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• Must operate reliably under adverseenvironmental conditions.
• Can not limit normal activities.
Use of Commercial Pulse Oximetersas a Wearable Device in the Field is
Challenging
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Multiple physiological variablesLow power consumptionCost effectiveSmall sizeLight weightEasy sensor attachmentTransparent to user (“wear-and-forget”)Adequate computation powerWireless communicationImproved immunity to motion artifacts
Design Criteria
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Battery Module
USB-Based Receiver
Wearable Pulse Oximeter
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User Interface
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Increase in HR During
Hyperventilation
Measurement Validation (rest)
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Response to Voluntary Hypoxia
Measurement Validation (rest)
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0
5
10
15
20
25
15 65 115 165 215 265 315 365
T ime (s )
Breathing Rate (b/m
)
C apnograph
WP I
Measurement Validation (rest)
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Limitations of Pulse Oximetry• Highly reliable when used on motionless
subjects.• Motion artifacts can obscure the true PPG
signal with noise, leading to inaccurate readings, false alarms, dropouts, and missed true alarms.
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HR
(BP
M)
SpO
2(%
)
Masimo (Finger)With ANCWithout ANC
Time (s)
2 mph RestingResting 2 mph 4 mph
Adaptive Noise Cancellation in Pulse Oximetry
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• Firefighters can experience inhalation of CO (e.g. malfunctioning furnaces) and Cyanide (e.g. burning plastic products).
• Acute CO and HCN poisoning renders the blood unable to carry sufficient amount of O2.
• Symptoms of acute exposure include general weakness, headache, confusion, anxiety, nausea and vomiting.
• If exposure is severe, unconsciousness and death.
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Future Developments
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• Traditional testing of HbCO and MetHb involves blood sampling and waiting for lab results.
• Conventional pulse oximeters use only two wavelengths of light.
They cannot distinguish between HbO2, HbCOand MetHb.Provide false readings when CO and MetHblevels are elevated.
• Multi-wavelengths to measure SpO2, HR, HbCOand MetHb, simultaneously.
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Future Developments
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ACKNOWLEDGEMENTSDevelopment Supported by:
WPI/BEIUSAMRMC/TATRCAdvanced Body SensingPSI/QinetiQ
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Thank You!Yitzhak Mendelson, Ph.D.
Tel: (508) 831-5103Email: [email protected]
http://www.wpi.edu/Academics/Depts/BME/People/yxm.htmlhttp://www.absensing.com/