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MedLine Citation:
PMID:  25480769     Owner:  NLM     Status:  Publisher    
The photoplethysmographic (PPG) waveform, also known as the pulse oximeter waveform, is one of the most commonly displayed clinical waveforms. First described in the 1930s, the technology behind the waveform is simple. The waveform, as displayed on the modern pulse oximeter, is an amplified and highly filtered measurement of light absorption by the local tissue over time. It is optimized by medical device manufacturers to accentuate its pulsatile components. Physiologically, it is the result of a complex, and not well understood, interaction between the cardiovascular, respiratory, and autonomic systems. All modern pulse oximeters extract and display the heart rate and oxygen saturation derived from the PPG measurements at multiple wavelengths. "As is," the PPG is an excellent monitor for cardiac arrhythmia, particularly when used in conjunction with the electrocardiogram (ECG). With slight modifications in the display of the PPG (either to a strip chart recorder or slowed down on the monitor screen), the PPG can be used to measure the ventilator-induced modulations which have been associated with hypovolemia. Research efforts are under way to analyze the PPG using improved digital signal processing methods to develop new physiologic parameters. It is hoped that when these new physiologic parameters are combined with a more modern understanding of cardiovascular physiology (functional hemodynamics) the potential utility of the PPG will be expanded. The clinical researcher's objective is the use of the PPG to guide early goal-directed therapeutic interventions (fluid, vasopressors, and inotropes), in effect to extract from the simple PPG the information and therapeutic guidance that was previously only obtainable from an arterial pressure line and the pulmonary artery catheter.
Aymen A Alian; Kirk H Shelley
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Publication Detail:
Type:  REVIEW     Date:  2014-9-9
Journal Detail:
Title:  Best practice & research. Clinical anaesthesiology     Volume:  28     ISSN:  1878-1608     ISO Abbreviation:  Best Pract Res Clin Anaesthesiol     Publication Date:  2014 Dec 
Date Detail:
Created Date:  2014-12-6     Completed Date:  -     Revised Date:  2014-12-7    
Medline Journal Info:
Nlm Unique ID:  101121446     Medline TA:  Best Pract Res Clin Anaesthesiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  395-406     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Ltd. All rights reserved.
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