Measuring venous oxygenation using the photoplethysmograph waveform
Abstract
Objective We investigate the hypothesis that the photoplethysmograph (PPG) waveform can be analyzed to infer regional venous oxygen saturation.Methods Fundamental to the successful isolation of the venous saturation is the identification of PPG characteristics that are unique to the peripheral venous system. Two such characteristics have been identified. First, the peripheral venous waveform tends to reflect atrial contraction. Second, ventilation tends to move venous blood preferentially due to the low pressure and high compliance of the venous system. Red (660 nm) and IR (940 nm) PPG waveforms were collected from 10 cardiac surgery patients using an esophageal PPG probe. These waveforms were analyzed using algorithms written in Mathematica. Four time-domain saturation algorithms (ArtSat, VenSat, ArtInstSat, VenInstSat) and four frequency-domain saturation algorithms (RespDC, RespAC, Cardiac, and Harmonic) were applied to the data set.Results Three of the algorithms for calculating venous saturation (VenSat, VenInstSat, and RespDC) demonstrate significant difference from ArtSat (the conventional time-domain algorithm for measuring arterial saturation) using the Wilcoxon signed-rank test with Bonferroni correction (p < 0.0071).Conclusions This work introduces new algorithms for PPG analysis. Three algorithms (VenSat, VenInstSat, and RespDC) succeed in detecting lower saturation blood. The next step is to confirm the accuracy of the measurement by comparing them to a gold standard (i.e., venous blood gas).
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Venous pressure can add low-frequency noise to the PPG waveform, often between 0 and 0.5 Hz, contributing to baseline oscillations.
“Venous pressure can also add low-frequency noise to the PPG waveform, the same effects seen by respiration, which is caused by venous anatomy [129,130,131]. Often between 0 and 0.5 Hz, this noise contributes to be baseline oscillations.”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [129]
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Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring
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- Authors
- Walton, Z. D., Kyriacou, P. A., Silverman, D. G., & Shelley, K. H.
- Affiliations
- Yale University (US)
- City, University of London (GB)
- Corresponding author
- Shelley, Kirk H.
- Venue
- Journal of Clinical Monitoring and Computing
- Published
- 2010-07-20
- Volume
- 24
- Issue
- 4
- Pages
- 295-303
- ISSN
- 1387-1307 (ISSN-L)
- 1573-2614
- OpenAlex
- W2083783275
- Cited by
- 53
- References
- 30
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 3 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 5 · 2015: 8 · 2014: 4 · 2013: 7 · 2012: 4
- FWCI
- 2.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Clinical Monitoring and Computing (publishedVersion)
- PubMed (publishedVersion)
- City Research Online (City University London) (acceptedVersion)
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- photoplethysmography, venous oxygen saturation, saturation algorithm, frequency domain analysis, cardiac surgery patients, atrial contraction
- MeSH terms
- Algorithms, Data Interpretation, Statistical, Esophagus, Humans, Oxygen, Pulsatile Flow, Veins, Photoplethysmography
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