Journal of Clinical Monitoring

, Volume 9, Issue 4, pp 283–287

The detection of peripheral venous pulsation using the pulse oximeter as a plethysmograph

  • Kirk H. Shelley
  • Marc Dickstein
  • Steven M. Shulman
Case Reports


The pulse oximeter can serve as a sensitive photoelectric plethysmograph in the operating room. It was noted in several cases that the plethysmographic waveform showed a high degree of variability during diastole. Three patients are described with discrete diastolic peaks on the plethysmograph. Further investigation revealed that these diastolic peaks appear to correlate with peripheral venous pulsation, which seems to have a central venous origin. Evidence is presented that the plethysmographic detection of the venous pulse may be useful in estimating the changing volume status of the patient.

Key Words

Equipment pulse oximeter plethysmograph Measurement techniques pulse oximetry 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Eichhorn JH, Cooper JB, Cullen DJ, Maier WR, Philip JH, Seeman RG. Standards for patient monitoring during anesthesia at Harvard Medical School. JAMA 1986; 256: 1017–1020PubMedCrossRefGoogle Scholar
  2. 2.
    Coté CJ, Rolf N, Liu LM, et al. A single-blind study of combined pulse oximetry and capnography in children. Anesthesiology 1991; 74: 980–987PubMedCrossRefGoogle Scholar
  3. 3.
    Kim JM, Arakawa K, VonLintel T. Use of the pulsewave monitor as a measurement of diagnostic sympathetic block and of surgical sympathectomy. Anesth Analg 1975; 54: 289–296PubMedGoogle Scholar
  4. 4.
    Dorias JC, Nijboer JA. Photo-electric plethysmography as a monitoring device in anaesthesia. Br J Anaesth 1985; 57: 524–530CrossRefGoogle Scholar
  5. 5.
    Partridge BL. Use of pulse oximetry as a noninvasive indicator of intravascular volume status. J Clin Monit 1987; 3: 263–268PubMedGoogle Scholar
  6. 6.
    Pologe JA. Pulse oximetry: technical aspects of machine design. Int Anesthesiol Clin 1987; 25: 137–153PubMedCrossRefGoogle Scholar
  7. 7.
    Perel A, Pizov R, Cotev S. Systolic blood pressure variation is a sensitive indicator of hypovolemia in ventilated dogs subjected to graded hemorrhage. Anesthesiology 1987; 67: 498–502PubMedCrossRefGoogle Scholar
  8. 8.
    Lawson D, Norley I, Korbon G, Loeb R, Ellis J. Blood flow limits and pulse oximeter signal detection. Anesthesiology 1987; 67: 599–603PubMedCrossRefGoogle Scholar
  9. 9.
    Palve H, Vuori A. Minimum pulse pressure and peripheral temperature needed for pulse oximetry during cardiac surgery with cardiopulmonary bypass. J Cardiothorac Vase Anesth 1991; 5: 327–330CrossRefGoogle Scholar
  10. 10.
    Guyton AC. Vascular distensibility and functions of the arterial and venous systems. In: Guyton AC, ed, Textbook of medical physiology, 8th ed. Philadelphia: Saunders, 1991: 159–160Google Scholar
  11. 11.
    Sami MS, Kleinman SK, Lonchyna VA. Central venous pulsations associated with a falsely low oxygen saturation measured by pulse oximetry. J Clin Monit 1991; 7: 309–312PubMedCrossRefGoogle Scholar

Copyright information

© Little, Brown and Company 1993

Authors and Affiliations

  • Kirk H. Shelley
    • 1
  • Marc Dickstein
    • 2
  • Steven M. Shulman
    • 2
  1. 1.Department of Anesthesia, University Hospital, College of MedicineThe Pennsylvania State University, The Milton S. Hershey Medical CenterHershey
  2. 2.Department of AnesthesiaColumbia University, College of Physicians and SurgeonsNew York

Personalised recommendations