Combined photoplethysmographic monitoring of respiration rate and pulse: A comparison between different measurement sites in spontaneously breathing subjects
Abstract
BACKGROUND: The non-invasive photoplethysmographic (PPG) signal reflects blood flow and volume in a tissue. The PPG signal shows variation synchronous with heartbeat (PPGc), as used in pulse oximetry, and variations synchronous with breathing (PPGr). PPGr has been used for non-invasive monitoring of respiration with promising results. Our aim was to investigate PPG signals recorded from different skin sites in order to find suitable locations for parallel monitoring of variations synchronous with heartbeat and breathing. METHODS: PPG sensors were applied to the forearm, finger, forehead, wrist and shoulder on 48 awake healthy volunteers. From these sites, seven PPG signals were simultaneously recorded during normal spontaneous breathing over 10 min. Capnometry served as respiration and electrocardiogram (ECG) as pulse reference signals. PPG signals were compared with respect to power spectral content and squared coherence. RESULTS: Forearm PPG measurement showed significantly higher power within the respiratory region of the power spectrum [median (quartile range) 42 (26)%], but significantly lower power within the cardiac region [9 (10)%] compared with the other skin sites. PPG finger measurement showed the opposite; in transmission mode, the power within the respiratory region was significantly lower [4 (10)%] and within the cardiac region significantly higher [45 (25)%] than the other sites. PPGc coherence values were generally high [>0.96 (0.08)], and PPGr coherence values lower [0.83 (0.35)-0.94 (0.17)]. CONCLUSION: Combined PPG respiration and pulse monitoring is possible, but there are significant differences between the respiratory and cardiac components of the PPG signal at different sites.
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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 [130]
The forearm had a high respiratory rate spectral power content compared to anatomies such as the finger, which had signal primarily derived from heart rate.
“It was found that the forearm had a high respiratory rate spectral power content compared to anatomies such as the finger, which had signal primarily derived from heart rate [130].”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [130]
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- Authors
- Nilsson, L., Goscinski, T., Kalman, S., Lindberg, L. ‐., & Johansson, A.
- Affiliations
- Linköping University Hospital (SE)
- Linköping University (SE)
- Corresponding author
- Nilsson, L.
- Venue
- Acta Anaesthesiologica Scandinavica
- Publisher
- Wiley
- Published
- 2007-08-15
- Volume
- 51
- Issue
- 9
- Pages
- 1250-1257
- ISSN
- 0001-5172 (ISSN-L)
- 1399-6576
- OpenAlex
- W1976734044
- Cited by
- 88
- References
- 27
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 7 · 2023: 9 · 2022: 8 · 2021: 10 · 2020: 8 · 2019: 6 · 2018: 4 · 2017: 7 · 2016: 2 · 2015: 1 · 2014: 4 · 2013: 3 · 2012: 2
- FWCI
- 1.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Acta Anaesthesiologica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- 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 › Heart Rate Variability and Autonomic Control
- Keywords
- photoplethysmography, respiratory monitoring, pulse monitoring, measurement site comparison, power spectrum analysis, coherence analysis, spontaneous breathing, finger PPG, non-invasive monitoring
- MeSH terms
- Adult, Aged, Analysis of Variance, Electrocardiography, Female, Heart Rate, Humans, Male, Middle Aged, Signal Processing, Computer-Assisted, Skin, Respiratory Mechanics, Photoplethysmography, Capnography
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