Engineering Evaluation of the Performance of an Automatic Peripheral Oxygen Controller Using a Neonatal Respiratory Model

2018 ◽  
Vol 12 (3) ◽  
Author(s):  
Akram Faqeeh ◽  
Roger Fales ◽  
John Pardalos ◽  
Ramak Amjad ◽  
Isabella Zaniletti ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Arterial Oxygen Saturation ◽  
Respiratory Support ◽  
Arterial Oxygen ◽  
Target Range ◽  
Care Providers ◽  
Manual Adjustment ◽  
Fraction Of Inspired Oxygen ◽  
Dynamic Adaptability ◽  
Inspired Oxygen

Premature infants often require respiratory support with a varying concentration of the fraction of inspired oxygen FiO2 to keep the arterial oxygen saturation typically measured using a peripheral sensor (SpO2) within the desired range to avoid both hypoxia and hyperoxia. The widespread practice for controlling the fraction of inspired oxygen is by manual adjustment. Automatic control of the oxygen to assist care providers is desired. A novel closed-loop respiratory support device with dynamic adaptability is evaluated nonclinically by using a neonatal respiratory response model. The device demonstrated the ability to improve oxygen saturation control over manual control by increasing the proportion of time where SpO2 is within the desired range while minimizing the episodes and periods where SpO2 of the neonatal respiratory model is out of the target range.

Quantitative analysis of the effect of fraction of inspired oxygen on peripheral oxygen saturation in healthy volunteers

2020 ◽  
Author(s):  
Ji-Yeon Bang ◽  
Changhun Cho ◽  
Eun-Kyung Lee ◽  
Byung-Moon Choi ◽  
Gyu-Jeong Noh
Keyword(s):  
Oxygen Saturation ◽  
Acute Hypoxia ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Peripheral Oxygen Saturation ◽  
Turnover Model ◽  
Inhibitory Function ◽  
Short Term Exposure ◽  
Fraction Of Inspired Oxygen ◽  
Inspired Oxygen

Abstract Background The international organization for standardization (ISO) 80601-2-61 dictates that the accuracy of a pulse oximeter should be assessed by a controlled desaturation study. We aimed to characterize the relationship between the fraction of inspired oxygen (FiO 2 ) and peripheral oxygen saturation (SpO 2 ) using a turnover model by retrospectively analyzing the data obtained from previous controlled desaturation studies. We also measured the changes in biomarkers expected to be related to hypoxia (i.e., lactate, carboxyhemoglobin (COHb), and methemoglobin (MetHb)) in response to short-term exposure to hypoxia.Methods Volunteers were exposed to various levels of induced hypoxia over 70−100% arterial oxygen saturation (SaO 2 ). The study period consisted of two rounds of hypoxia and the volunteers were maintained in room air between each round. FiO 2 and SpO 2 were recorded continuously during the study period. A population pharmacodynamic analysis was performed with the NONMEM VII level 4 (ICON Development Solutions, Ellicott City, MD, USA). Lactate, COHb, and MetHb were measured using a CO-oximeter.Results In total, 2899 SpO 2 data points obtained from 20 volunteers were used to determine the pharmacodynamic characteristics. The pharmacodynamic parameters were as follows: k out = 0.942 1/min, Imax = 0.802, IC 50 = 85.3%, γ = 27.3. The changes in SpO 2 due to decreases in FiO 2 well explained by the turnover model with inhibitory function as a sigmoidal model. As SpO 2 decreased, lactate and COHb increased as a whole, and COHb showed the best correlation (Pearson’s correlation, R 2 =0.3263, P < 0.0001).Conclusion The potency of FiO 2 required to reduce SpO 2 from 100% to 70% was 14.7%. Carboxyhemoglobin has the potential to be a useful biomarker for acute hypoxia.

scholarly journals Designing a Remote Closed-Loop Automatic Oxygen Control in Preterm Infants

2020 ◽  
Vol 30 (4) ◽  
Author(s):  
Mohammad Reza Moradi ◽  
Sharareh R. Niakan Kalhori ◽  
Marian Ghazi Saeedi ◽  
Mohammad Reza Zarkesh ◽  
Abbas Habibelahi ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Pulse Oximeter ◽  
Closed Loop ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Target Range ◽  
Preterm Neonates ◽  
Oxygen Control ◽  
Fraction Of Inspired Oxygen ◽  
To Receive

Background: Different automated systems have been developed to improve the maintenance of target range of arterial oxygen saturation (SPO2) in premature infants with respiratory distress. Objectives: This study aimed to develop a remote closed-loop automatic oxygen control (RCLAC) as an efficient monitoring device. Then the means of the fraction of inspired oxygen (FIO2) and SPO2 by routine manual control (RMC) and RCLAC were compared. Methods: A developmental-descriptive study was carried out in an Iranian hospital (Tehran, Iran; 2015 - 2017). Twenty-two preterm infants with gestational age 24 - 28 weeks entered the study. A database was prepared based on pulse oximeter parameters. A Wi-Fi module was implemented to receive data from a pulse oximeter and send inputs to the user’s mobile. Vibrate alarm was implemented for high or low FIO2. After receiving notifications associated with an increase or decrease of FIO2 levels and user’s confirmation; the alterations were applied on the ventilator. Results: The mean FIO2 in the RMC system was significantly higher than the RCLAC system (98.1 ± 2.67 vs 79.5 ± 16.03; P = 0.0001). According to the results, when the SPO2 reached close to target SPO2 range and consequently FIO2 changed (decreased or increased based on target SPO2), heart rate showed a regular beating with a decrease in the numbers. Conclusions: Remote closed-loop automatic oxygen control system as a simple device could prevent preterm neonates from sustained hypo-hyperoxemic and arrhythmia episodes. Moreover, by using RCLAC, there was no need for continuous monitoring that may reduce the workload of NICU medical staff. Collecting reliable data and recording information in digital forms were also other benefits. Further studies with larger sample size are strongly suggested.

Effect of hyperoxia and hypoxia on exercise-induced breathlessness in normal subjects

1988 ◽  
Vol 74 (5) ◽  
pp. 531-537 ◽  
Author(s):  
N. Chronos ◽  
L. Adams ◽  
A. Guz
Keyword(s):  
Oxygen Saturation ◽  
Oxygen Concentration ◽  
Time Course ◽  
Minute Ventilation ◽  
Arterial Oxygen Saturation ◽  
Normal Subjects ◽  
Secondary Response ◽  
Arterial Oxygen ◽  
Air Breathing ◽  
Inspired Oxygen

1. The subjective changes accompanying alterations in inspired oxygen concentration during heavy exercise have been investigated single blind, in normal subjects. 2. In particular, the intensity of the sensation of breathlessness was quantified using a visual analogue scale and changes were compared with those in objective ventilatory measures. 3. Eleven subjects performed three steady-state workload exercise tests on different days and 100% O2, 15% O2 or air were randomly administered for a fixed interval during each test. 4. Compared with air breathing, all subjects felt less breathless during 100% O2 breathing, and ten of them felt more breathless when inspiring 15% O2; these changes were reversed on return to air breathing. 5. During and after 100% O2, the time course of changes in breathlessness was similar to those for ear arterial oxygen saturation and minute ventilation such that it could be a secondary response to either. However, during and after inspiration of 15% O2, changes in breathlessness occurred relatively more quickly than those in ventilation, more closely reflecting changes in oxygen saturation; this suggests that hypoxia, per se, could contribute to the genesis of this sensation. 6. Individual variability in breathlessness responses to exercise and changes in inspired oxygen concentration did not correlate with objective ventilatory changes; neither were changes in breathlessness in the group particularly associated with changes in respiratory frequency or tidal volume.

scholarly journals Influence of Dietary Nitrate Supplementation on High-Intensity Intermittent Running Performance at Different Doses of Normobaric Hypoxia in Endurance-Trained Males

2020 ◽  
pp. 1-8
Author(s):  
George P. Robinson ◽  
Sophie C. Killer ◽  
Zdravko Stoyanov ◽  
Harri Stephens ◽  
Luke Read ◽  
...  
Keyword(s):  
High Intensity ◽  
Arterial Oxygen Saturation ◽  
Normobaric Hypoxia ◽  
Arterial Oxygen ◽  
Altitude Training ◽  
Beetroot Juice ◽  
Running Performance ◽  
Fraction Of Inspired Oxygen ◽  
Inspired Oxygen ◽  
Different Doses

This study investigated whether supplementation with nitrate-rich beetroot juice (BR) can improve high-intensity intermittent running performance in trained males in normoxia and different doses of normobaric hypoxia. Eight endurance-trained males (, 62 ± 6 ml·kg−1·min−1) completed repeated 90 s intervals at 110% of peak treadmill velocity, from an initial step incremental test, interspersed by 60 s of passive recovery until exhaustion (Tlim). Participants completed the first three experimental trials during days 3, 5, and 7 of BR or nitrate-depleted beetroot juice (PLA) supplementation and completed the remaining experimental visits on the alternative supplement following at least 7 days of washout. The fraction of inspired oxygen during visits 1–3 was either 0.209, 0.182, or 0.157, equivalent to an altitude of 0, 1,200, and 2,400 m, respectively, and this order was replicated on visits 4–6. Arterial oxygen saturation declined dose dependently as fraction of inspired oxygen was lowered (p < .05). Plasma nitrite concentration was higher pre- and postexercise after BR compared with PLA supplementation (p < .05). There was no difference in Tlim between PLA and BR at 0 m (445 [324, 508] and 410 [368, 548] s); 1,200 m (341 [270, 390] and 332 [314, 356] s); or 2,400 m (233 [177, 373] and 251 [221, 323] s) (median and [interquartile range]; p > .05). The findings from this study suggest that short-term BR supplementation does not improve high-intensity intermittent running performance in endurance-trained males in normoxia or at doses of normobaric hypoxia that correspond to altitudes at which athletes typically train while on altitude training camps.

Remote Closed-Loop Automatic Oxygen Control in Preterm Infants

2019 ◽  
Author(s):  
Mohammad Reza Moradi ◽  
Sharareh R. Niakan Kalhori ◽  
Marian Ghazi Saeedi ◽  
Mohammad Reza Zarkesh ◽  
Abbas Habibelahi ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Pulse Oximeter ◽  
Closed Loop ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Target Range ◽  
Preterm Neonates ◽  
Oxygen Control ◽  
The Mean ◽  
Fraction Of Inspired Oxygen

Abstract Background Different automated systems have been developed to improve maintenance of target range of arterial oxygen saturation (SPO2) in premature infants with respiratory distress. This study aimed to develop a Remote Closed-Loop Automatic Oxygen Control (RCLAC) as an efficient monitoring device. Then the mean of fraction of inspired oxygen (FIO2) and SPO2 by routine manual control (RMC) and RCLAC were compared.Methods A developmental-descriptive study was carried out in an Iranian hospital (Tehran-Iran; 2015-2017). Eighteen preterm infants with gestational age 24-28 weeks entered the study. A database was prepared based on pulse oximeter parameters. A Wi-Fi module was implemented to receive data from pulse oximeter and send inputs to user's mobile. Vibrate alarm was implemented for high or low FIO2. After receiving notifications associated with increase or decrease of FIO2 levels and user's confirmation; the alterations were applied on the ventilator.Results The mean FIO2 in RMC system was significantly higher than RCLAC system (98.1± 2.67 vs. 79.5±16.03; p = 0.0001). According to the results, when the SPO2 reached close to target SPO2 range and consequently FIO2 changed (decreased or increased based on target SPO2), heart rate showed a regular beating with decrease in the numbers.Conclusion Remote Closed-Loop Automatic Oxygen Control system as a simple device could prevent preterm neonates from sustained hypo-hyperoxemic and arrhythmia episodes. Moreover by using RCLAC, there was no need for continuous monitoring that may reduce workload of NICUs medical staff. Collecting reliable data and recording information in digital forms were also other benefits.

Effects of Inspired Hypoxic and Hypercapnic Gas Mixtures on Cerebral Oxygen Saturation in Neonates with Univentricular Heart Defects

2002 ◽  
Vol 96 (2) ◽  
pp. 283-288 ◽  
Author(s):  
Chandra Ramamoorthy ◽  
Sarah Tabbutt ◽  
C. Dean Kurth ◽  
James M. Steven ◽  
Lisa M. Montenegro ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Mean Arterial Pressure ◽  
Oxygen Saturation ◽  
Single Ventricle ◽  
Cerebral Oxygenation ◽  
Arterial Oxygen Saturation ◽  
Cerebral Oxygen Saturation ◽  
Arterial Oxygen ◽  
Cerebral Oxygen ◽  
Inspired Oxygen

Background Neonates with functional single ventricle often require hypoxic or hypercapnic inspired gas mixtures to reduce pulmonary overcirculation and improve systemic perfusion. Although the impact of these treatments on arterial oxygen saturation has been described, the effects on cerebral oxygenation remain uncertain. This study examined the effect of these treatments on cerebral oxygen saturation and systemic hemodynamics. Methods Neonates with single ventricle mechanically ventilated with room air were enrolled in a randomized crossover trial of 17% inspired oxygen or 3% inspired carbon dioxide. Each treatment lasted 10 min, followed by a 10-20-min washout period. Cerebral and arterial oxygen saturation were measured by cerebral and pulse oximetry, respectively. Cerebral oxygen saturation, arterial oxygen saturation, and other physiologic data were continuously recorded. Results Three percent inspired carbon dioxide increased cerebral oxygen saturation (56 +/- 13 to 68 +/- 13%; P &lt; 0.01), whereas 17% inspired oxygen had no effect (53 +/- 13 to 53 +/- 14%; P = 0.8). Three percent inspired carbon dioxide increased the mean arterial pressure (45 +/- 8 to 50 +/- 9 mmHg; P &lt; 0.01), whereas 17% inspired oxygen had no effect. And 3% inspired carbon dioxide decreased arterial pH and increased arterial carbon dioxide and oxygen tensions. Conclusions Inspired 3% carbon dioxide improved cerebral oxygenation and mean arterial pressure. Treatment with 17% inspired oxygen had no effect on either.

scholarly journals Accuracy of two pulse-oximetry measurements for INTELLiVENT-ASV in mechanically ventilated patients: a prospective observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shinshu Katayama ◽  
Jun Shima ◽  
Ken Tonai ◽  
Kansuke Koyama ◽  
Shin Nunomiya
Keyword(s):  
Oxygen Saturation ◽  
Pulse Oximetry ◽  
Prospective Observational Study ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Arterial Blood Gas ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Arterial Blood ◽  
Ventilated Patients

AbstractRecently, maintaining a certain oxygen saturation measured by pulse oximetry (SpO2) range in mechanically ventilated patients was recommended; attaching the INTELLiVENT-ASV to ventilators might be beneficial. We evaluated the SpO2 measurement accuracy of a Nihon Kohden and a Masimo monitor compared to actual arterial oxygen saturation (SaO2). SpO2 was simultaneously measured by a Nihon Kohden and Masimo monitor in patients consecutively admitted to a general intensive care unit and mechanically ventilated. Bland–Altman plots were used to compare measured SpO2 with actual SaO2. One hundred mechanically ventilated patients and 1497 arterial blood gas results were reviewed. Mean SaO2 values, Nihon Kohden SpO2 measurements, and Masimo SpO2 measurements were 95.7%, 96.4%, and 96.9%, respectively. The Nihon Kohden SpO2 measurements were less biased than Masimo measurements; their precision was not significantly different. Nihon Kohden and Masimo SpO2 measurements were not significantly different in the “SaO2 < 94%” group (P = 0.083). In the “94% ≤ SaO2 < 98%” and “SaO2 ≥ 98%” groups, there were significant differences between the Nihon Kohden and Masimo SpO2 measurements (P < 0.0001; P = 0.006; respectively). Therefore, when using automatically controlling oxygenation with INTELLiVENT-ASV in mechanically ventilated patients, the Nihon Kohden SpO2 sensor is preferable.Trial registration UMIN000027671. Registered 7 June 2017.

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