Determination of saturation, heart rate, and respiratory rate at forearm using a Nellcor™ forehead SpO2-saturation sensor
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Alterations in arterial blood oxygen saturation, heart rate (HR), and respiratory rate (RR) are strongly associated with intra-hospital cardiac arrests and resuscitations. A wireless, easy-to-use, and comfortable method for monitoring these important clinical signs would be highly useful. We investigated whether the Nellcor™ OxiMask MAX-FAST forehead sensor could provide data for vital sign measurements when located at the distal forearm instead of its intended location at the forehead to provide improved comfortability and easy placement. In a prospective setting, we recruited 30 patients undergoing surgery requiring postoperative care. At the postoperative care unit, patients were monitored for two hours using a standard patient monitor and with a study device equipped with a Nellcor™ Forehead SpO2 sensor. The readings were electronically recorded and compared in post hoc analysis using Bland–Altman plots, Spearman’s correlation, and root-mean-square error (RMSE). Bland–Altman plot showed that saturation (SpO2) differed by a mean of −0.2 % points (SD, 4.6), with a patient-weighted Spearman’s correlation (r) of 0.142, and an RMSE of 4.2 points. For HR measurements, the mean difference was 0.6 bpm (SD, 2.5), r = 0.997, and RMSE = 1.8. For RR, the mean difference was −0.5 1/min (4.1), r = 0.586, and RMSE = 4.0. The SpO2 readings showed a low mean difference, but also a low correlation and high RMSE, indicating that the Nellcor™ saturation sensor cannot reliably assess oxygen saturation at the forearm when compared to finger PPG measurements.
KeywordsIntraoperative monitoring Plethysmography Pulse oximetry Heart rate Respiratory rate
The authors wish to thank the Paulo Foundation, Finnish Society of Anaesthesiologists and the Finnish Cultural Foundation, Pirkanmaa Regional Fund for grants, as well as the Medieta Oy (Helsinki, Finland), which provided the study device.
Compliance with ethical standards
Conflicts of interest
SL and NO have a pending patent on RR measurement. NO has been a shareholder on a former company Medieta. AV and PK have been former employees on a former company Medieta. JH, VL, and AY-H declare no conflicts of interest.
This study was approved by the Pirkanmaa Hospital district ethics committee. All procedures involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee, as well as with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- 24.Oksala N, Liuhanen S (2015) Method and device for the detection of respiratory rate. PCT/FI2015/050023.Google Scholar
- 25.Charlton PH (2016) In: Synthetic dataset: dataset for verification of algorhitm implementions. Charlton Peter H. http://peterhcharlton.github.io/RRest/synthetic_dataset.html. Accessed 10 Aug 2016.
- 30.Finnish Standards association (2011) Medical electrical equipment—Part 2–61: particular requirements for basic safety and essential performance of pulse oximeter equipment (ISO 80601-2-61:2011).Google Scholar
- 34.Tendera M, Aboyans V, Bartelink M, Baumgartner I, Clement D, Collet J, Cremonesi A, De Carlo M, Erbel R, Fowkes FG, Heras M, Kownator S, Minar E, Ostergren J, Poldermans D, Riambau V, Roffi M, Röther J, Sievert H, van Sambeek M, Zeller T. ESC Guidelines on the diagnosis and treatment of peripheral artery diseases. Eur Heart J. 2011;32:2851–906.CrossRefPubMedGoogle Scholar