FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4383554518> ?p ?o ?g. }

• W4383554518 endingPage "26" @default.
• W4383554518 startingPage "24" @default.
• W4383554518 abstract "Invented in 1974 by Takuo Aoyagi, the finger pulse oximeter has become an essential tool for health care providers.1Miyasaka K. Shelley K. Takahashi S. et al.Tribute to Dr. Takuo Aoyagi, inventor of pulse oximetry.J Anesth. 2021; 35: 671-709Crossref Scopus (12) Google Scholar The device emits a range of red (660 nm) and near-infrared (940 nm) light through a patient’s finger to a detector that measures the transmittance of each wavelength. The estimation of blood oxygen saturation (Spo2) depends on the differential absorbance of these wavelengths by hemoglobin (Hb) and oxyhemoglobin (OHb). Oxygenated blood absorbs more near-infrared light, and deoxygenated blood absorbs more steeply in the red wavelength, making it appear darker.2Chan E.D. Chan M.M. Chan M.M. Pulse oximetry: understanding its basic principles facilitates appreciation of its limitations.Respir Med. 2013; 107: 789-799Abstract Full Text Full Text PDF PubMed Scopus (327) Google Scholar Spo2 measurements are often used to monitor patients’ oxygen needs and are so important they have even been termed the “fifth vital sign.”2Chan E.D. Chan M.M. Chan M.M. Pulse oximetry: understanding its basic principles facilitates appreciation of its limitations.Respir Med. 2013; 107: 789-799Abstract Full Text Full Text PDF PubMed Scopus (327) Google Scholar,3T.A. Neff, Routine oximetry: a fifth vital sign?, Chest. 1988;94(2):227.Google Scholar However, the widespread use of pulse oximeters has revealed several technical limitations that can affect their accuracy and reliability. A study in the United Kingdom found that up to 30.5% of pulse oximeters were faulty because of circuitry issues or incorrect emission spectra.4Milner Q.J. Mathews G.R. An assessment of the accuracy of pulse oximeters.Anaesthesia. 2012; 67: 396-401Crossref Scopus (48) Google Scholar None of the 29 hospitals investigated in the study regularly calibrated their devices.4Milner Q.J. Mathews G.R. An assessment of the accuracy of pulse oximeters.Anaesthesia. 2012; 67: 396-401Crossref Scopus (48) Google Scholar This highlights the importance of regular maintenance and calibration of pulse oximeters. Additionally, pulse oximeter error tends to increase as patients desaturate, a time when swift, accurate measurements are most critical.5Webb R.K. Ralston A.C. Runciman W.B. Potential errors in pulse oximetry. II. Effects of changes in saturation and signal quality.Anaesthesia. 1991; 46: 207-212Crossref PubMed Scopus (129) Google Scholar The problem with calibration is partly due to the ethical concerns of desaturating healthy patients to standardize the device in this range.5Webb R.K. Ralston A.C. Runciman W.B. Potential errors in pulse oximetry. II. Effects of changes in saturation and signal quality.Anaesthesia. 1991; 46: 207-212Crossref PubMed Scopus (129) Google Scholar A number of clinical conditions can affect pulse oximeter accuracy. For example, pulse oximeters may struggle to obtain readings in patients with poor fingertip perfusion, such as those with hypovolemia, heart failure, or vasoconstriction.2Chan E.D. Chan M.M. Chan M.M. Pulse oximetry: understanding its basic principles facilitates appreciation of its limitations.Respir Med. 2013; 107: 789-799Abstract Full Text Full Text PDF PubMed Scopus (327) Google Scholar,6Kelly K.L. Carlson A.R. Allison T.G. Johnson B.D. A comparison of finger and forehead pulse oximeters in heart failure patients during maximal exercise.Heart Lung. 2020; 49: 259-264Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar Pulse oximeters also can provide false readings during carbon monoxide poisoning, severe anemia, or sepsis, and in patients wearing nail polish.2Chan E.D. Chan M.M. Chan M.M. Pulse oximetry: understanding its basic principles facilitates appreciation of its limitations.Respir Med. 2013; 107: 789-799Abstract Full Text Full Text PDF PubMed Scopus (327) Google Scholar Moreover, pulse oximeters tend to be less effective at monitoring the Spo2 levels of exercising patients because of motion artifact.6Kelly K.L. Carlson A.R. Allison T.G. Johnson B.D. A comparison of finger and forehead pulse oximeters in heart failure patients during maximal exercise.Heart Lung. 2020; 49: 259-264Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar Exercise also can worsen underlying perfusion issues such as heart failure.6Kelly K.L. Carlson A.R. Allison T.G. Johnson B.D. A comparison of finger and forehead pulse oximeters in heart failure patients during maximal exercise.Heart Lung. 2020; 49: 259-264Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar Forehead pulse oximeters tend to work better in these situations,6Kelly K.L. Carlson A.R. Allison T.G. Johnson B.D. A comparison of finger and forehead pulse oximeters in heart failure patients during maximal exercise.Heart Lung. 2020; 49: 259-264Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar but they are more conspicuous and can be distracting for patients who need to monitor Spo2 during activities of daily living. It is therefore best for health care providers to consider carefully the type of pulse oximeter for each individual patient and situation. A final, glaring issue with pulse oximeters has been made distressingly evident because of the recent and enduring COVID-19 pandemic: pulse oximeters produce systematic errors in populations of color.7Valbuena V.S.M. Barbaro R.P. Claar D. et al.Racial bias in pulse oximetry measurement among patients about to undergo extracorporeal membrane oxygenation in 2019-2020: a retrospective cohort study.Chest. 2022; 161: 971-978Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar,8Sjoding M.W. Dickson R.P. Iwashyna T.J. Gay S.E. Valley T.S. Racial bias in pulse oximetry measurement.N Engl J Med. 2020; 383: 2477-2478Crossref PubMed Scopus (305) Google Scholar The source of error begins with melanin, the pigment found in skin, which absorbs light across a broad range of wavelengths and limits the amount of light transmitted through the finger. This results in the path length of light that returns to the detector decreasing with increasing absorbance. Thus, with more melanin, the tissue sampled will primarily come from the skin surface, whereas lower melanin will permit sampling deeper tissues. This could result in a significant systematic error in comparing high-melanin and low-melanin tissues. This phenomenon of decreasing path length with absorbance in tissues is well known in the field and has been directly observed in work on transmural cardiac illumination (Robert S. Balaban, PhD, personal communication, December 2022). Another concern is that the calibration of pulse oximeters is not a standardized process.1Miyasaka K. Shelley K. Takahashi S. et al.Tribute to Dr. Takuo Aoyagi, inventor of pulse oximetry.J Anesth. 2021; 35: 671-709Crossref Scopus (12) Google Scholar This raises questions about the diversity of volunteers used to generate reference values. If subjects are not recruited from a sufficiently diverse population, then calibration may potentially skew readings for populations of color. The net effect is that pulse oximeters often overestimate Spo2 in populations of color, placing these patients in significantly greater risk of occult hypoxemia, a dangerous condition in which arterial oxygen saturation is less than 88% but Spo2 appears over 92%.7Valbuena V.S.M. Barbaro R.P. Claar D. et al.Racial bias in pulse oximetry measurement among patients about to undergo extracorporeal membrane oxygenation in 2019-2020: a retrospective cohort study.Chest. 2022; 161: 971-978Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar,8Sjoding M.W. Dickson R.P. Iwashyna T.J. Gay S.E. Valley T.S. Racial bias in pulse oximetry measurement.N Engl J Med. 2020; 383: 2477-2478Crossref PubMed Scopus (305) Google Scholar These errors, combined with various socioeconomic disparities, can lead to worse outcomes for these populations in the treatment of COVID-19.9Fawzy A. Wu T.D. Wang K. et al.Racial and ethnic discrepancy in pulse oximetry and delayed identification of treatment eligibility among patients with COVID-19.JAMA Intern Med. 2022; 182: 730-738Crossref PubMed Scopus (45) Google Scholar The severity of this issue prompted the US Food and Drug Administration to review data on the ongoing flaws in pulse oximeters. They are considering an update to their safety communication on pulse oximeter accuracy, which was originally issued on February 19, 2021.10Pulse Oximeter Accuracy and Limitations: FDA Safety Communication, US Food and Drug Administration; 2021. Accessed December 11, 2022. https://www.fda.gov/medical-devices/safety-communications/pulse-oximeter-accuracy-and-limitations-fda-safety-communicationGoogle Scholar Many publications recognize the errors in pulse oximeters, a step in the right direction, but few provide solutions or prototypes for improvement. We believe others will agree that it is time to walk the walk in improving the accuracy of pulse oximeters for all populations. One promising approach is the recent development of a green-light pulse oximeter.11Gokhale S.G. Daggubati V. Alexandrakis G. Innovative technology to eliminate the racial bias in non-invasive, point-of-care (POC) haemoglobin and pulse oximetry measurements.BMJ Innov. 2023; 9: 73-77Crossref Scopus (3) Google Scholar This device is based on the premise that the difference in absorbance spectra between Hb and OHb is greatest in green light.11Gokhale S.G. Daggubati V. Alexandrakis G. Innovative technology to eliminate the racial bias in non-invasive, point-of-care (POC) haemoglobin and pulse oximetry measurements.BMJ Innov. 2023; 9: 73-77Crossref Scopus (3) Google Scholar The researchers account for melanin using the Von Luschan Chromatic Scale, a color chart of skin pigments ranging from 1 to 36, with 1 being the fairest skin tone and 36 being the darkest. This scale was used to adjust for overestimation of Spo2.11Gokhale S.G. Daggubati V. Alexandrakis G. Innovative technology to eliminate the racial bias in non-invasive, point-of-care (POC) haemoglobin and pulse oximetry measurements.BMJ Innov. 2023; 9: 73-77Crossref Scopus (3) Google Scholar We believe that this or other related melanin-adjusting strategies should be implemented in all current and future pulse oximeter devices. We are also excited to announce that the National Heart, Lung, and Blood Institute has recently released a Small Business Innovation Research proposal (PHS-2023-1 NIH/NHLBI Topic 114). The Small Business Innovation Research offers two phases of funding to develop a novel pulse oximeter for patients at risk of desaturation, including those recovered from COVID-19. It must be wireless and motion insensitive, and must interface with mobile devices to make user-friendly data available during exercise, activities of daily living, or sleep. This will help decrease barriers of access to pulse oximeter information by allowing continuous, at-home, and unsupervised monitoring. The proposal also stresses the importance of subject diversity in measurements to avoid systematic error in individuals with darker skin tones. Takuo Aoyagi may not have won the 2013 Nobel Prize for which he was nominated,1Miyasaka K. Shelley K. Takahashi S. et al.Tribute to Dr. Takuo Aoyagi, inventor of pulse oximetry.J Anesth. 2021; 35: 671-709Crossref Scopus (12) Google Scholar but his invention of the pulse oximeter revolutionized the way health care providers manage patients’ oxygen needs. He was also aware of the need to expand on the theory that underpinned it.1Miyasaka K. Shelley K. Takahashi S. et al.Tribute to Dr. Takuo Aoyagi, inventor of pulse oximetry.J Anesth. 2021; 35: 671-709Crossref Scopus (12) Google Scholar We hope that the development of new pulse oximeter technologies will honor Aoyagi’s legacy and offer providers and patients a more reliable and trustworthy device (Fig 1). The authors were funded by the Intramural Research Program, National Institutes of Health/National Heart, Lung, and Blood Institute." @default.
• W4383554518 created "2023-07-08" @default.
• W4383554518 creator A5006159934 @default.
• W4383554518 creator A5048042168 @default.
• W4383554518 date "2023-07-01" @default.
• W4383554518 modified "2023-10-18" @default.
• W4383554518 title "Evolution of the Pulse Ox" @default.
• W4383554518 cites W1523770667 @default.
• W4383554518 cites W1567738293 @default.
• W4383554518 cites W2071229756 @default.
• W4383554518 cites W2092375842 @default.
• W4383554518 cites W2983779730 @default.
• W4383554518 cites W3192762714 @default.
• W4383554518 cites W3204102067 @default.
• W4383554518 cites W4205197778 @default.
• W4383554518 cites W4281757670 @default.
• W4383554518 cites W4297282453 @default.
• W4383554518 doi "https://doi.org/10.1016/j.chest.2022.12.042" @default.
• W4383554518 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/37423695" @default.
• W4383554518 hasPublicationYear "2023" @default.
• W4383554518 type Work @default.
• W4383554518 citedByCount "1" @default.
• W4383554518 countsByYear W43835545182023 @default.
• W4383554518 crossrefType "journal-article" @default.
• W4383554518 hasAuthorship W4383554518A5006159934 @default.
• W4383554518 hasAuthorship W4383554518A5048042168 @default.
• W4383554518 hasBestOaLocation W43835545181 @default.
• W4383554518 hasConcept C120665830 @default.
• W4383554518 hasConcept C121332964 @default.
• W4383554518 hasConcept C2780167933 @default.
• W4383554518 hasConcept C71924100 @default.
• W4383554518 hasConcept C94915269 @default.
• W4383554518 hasConceptScore W4383554518C120665830 @default.
• W4383554518 hasConceptScore W4383554518C121332964 @default.
• W4383554518 hasConceptScore W4383554518C2780167933 @default.
• W4383554518 hasConceptScore W4383554518C71924100 @default.
• W4383554518 hasConceptScore W4383554518C94915269 @default.
• W4383554518 hasIssue "1" @default.
• W4383554518 hasLocation W43835545181 @default.
• W4383554518 hasLocation W43835545182 @default.
• W4383554518 hasOpenAccess W4383554518 @default.
• W4383554518 hasPrimaryLocation W43835545181 @default.
• W4383554518 hasRelatedWork W1506200166 @default.
• W4383554518 hasRelatedWork W1995515455 @default.
• W4383554518 hasRelatedWork W2048182022 @default.
• W4383554518 hasRelatedWork W2080531066 @default.
• W4383554518 hasRelatedWork W2604872355 @default.
• W4383554518 hasRelatedWork W2748952813 @default.
• W4383554518 hasRelatedWork W2899084033 @default.
• W4383554518 hasRelatedWork W3031052312 @default.
• W4383554518 hasRelatedWork W3032375762 @default.
• W4383554518 hasRelatedWork W3108674512 @default.
• W4383554518 hasVolume "164" @default.
• W4383554518 isParatext "false" @default.
• W4383554518 isRetracted "false" @default.
• W4383554518 workType "article" @default.