Photoplethysmographic derivation of respiratory rate: A review of relevant physiology
Open accessAbstract
An abnormal respiratory rate is often the earliest sign of critical illness. A reliable estimate of respiratory rate is vital in the application of remote telemonitoring systems, which may facilitate early supported discharge from hospital or prompt recognition of physiological deterioration in high-risk patient groups. Traditional approaches use analysis of respiratory sinus arrhythmia from the electrocardiogram (ECG), but this phenomenon is predominantly limited to the young and healthy. Analysis of the photoplethysmogram (PPG) waveform offers an alternative means of non-invasive respiratory rate monitoring, but further development is required to enable reliable estimates. This review conceptualizes the challenge by discussing the effect of respiration on the PPG waveform and the key physiological mechanisms that underpin the derivation of respiratory rate from the PPG.
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Respiration and cardiac output are inherently linked, as an increase in respiration rate can directly affect the variation of heart rate through the nervous system reduced inhibitory control.
“Physiologically, respiration and cardiac output are inherently linked, as an increase in respiration rate can directly affect the variation of heart rate through the nervous system reduced inhibitory control [118].”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [118]
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- Authors
- Meredith, D. J., Clifton, D., Charlton, P., Brooks, J., Pugh, C. W., & Tarassenko, L.
- Affiliations
- University of Oxford (GB)
- St Thomas' Hospital (GB)
- Corresponding author
- Meredith, D. J.
- Venue
- Journal of Medical Engineering & Technology
- Publisher
- Informa UK Limited
- Published
- 2011-12-20
- Volume
- 36
- Issue
- 1
- Pages
- 1-7
- ISSN
- 0309-1902 (ISSN-L)
- 1464-522X
- OpenAlex
- W2075109859
- Cited by
- 226
- References
- 34
- Citations by year
- 2026: 12 · 2025: 17 · 2024: 17 · 2023: 17 · 2022: 20 · 2021: 19 · 2020: 22 · 2019: 14 · 2018: 16 · 2017: 23 · 2016: 17 · 2015: 13 · 2014: 10 · 2013: 8 · 2012: 1
- FWCI
- 0.49
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Locations
- Journal of Medical Engineering & Technology (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Wellcome Trust (088877/Z/09/Z)
- Engineering and Physical Sciences Research Council (EP/F058845/1, EP/H019944/1)
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Keywords
- photoplethysmography, respiratory rate estimation, non-invasive respiratory monitoring, remote patient monitoring, critical illness, physiological deterioration, respiratory sinus arrhythmia
- MeSH terms
- Humans, Monitoring, Physiologic, Respiration, Photoplethysmography, Respiratory Rate
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