EAROMICS -2015

Prof.Dr.O.Ferrer-Roca, 2015

EAROMICSH2O = Humanization of Healthcare

Prof.Dr. O.Ferrer-Roca, 2015


PULSEOXIMETRYThe noninvasive measurement of arterial oxygen saturation (SpO2) by pulse oximetry has become a standard of care. In addition to oxygen saturation values, many pulse oximeters display a photoelectric plethysmographic waveform, which reflects a combination of volume and flow changes in skin microcirculation.

Plethysmographic wave displayed is highly processed and filtered signal (Inverted, autocentered, autogained, and after a bandpass filtering.


ABP versus PPG

• Utility of the Photoplethysmogram in Circulatory Monitoring

• Anesthesiology. 2008;108(5):950-958. doi:10.1097/ALN.0b013e31816c89e1

Photoplethysmography

Arterial blood pressure


Digital Pulse Analysis (DPA) is the next evolution in pulse wave velocity (PWV), and is based on the measurement of reflected infrared light (IR).

At a frequency of 805 nm, both oxygenated and deoxygenated blood have the same absorption, thereby ensuring accuracy based on blood flow alone.

In fact only IR signal at 940 nm is presented in the PPGs becauseIt is much more stable in time if compared with the Red signal at 660 nm that is more susceptible of changes in oxygen saturation.

PI (perfussion index) = (AC pulsating IR signal/ AD non-pulsating IR signal ) x 100 %AC= Alternate curve componentDC= Direct curve component (venousmovement = right atrial contraction + ventilation )


Clasical Pulseoxymeter


PPG analysis. I.- FFT (frequency domain)

Frequencies of the Autonomic Nervous System:1.- VLF (very low frequency) 0.0033-0.04 Hz2.- LF (low frequency) Mayer waves 0.04-0.15 Hz3.- HF (high frequency) Vagus Nerve 0.15-0.4 HzSympathetic predominance

LF norm = LF/LF+HFParasympathetic predominance

HF norm = HF/ LF+HF


PPG analysis. II.- Time domain


HRV = Heart rate variabilityvaluable indicator of phrophylactic cardiovascular interventions

SD1= Short term beat-to-beat variabilitySD2= Long term beat-to-beat variability

x= HHI or RRI sequencesVar= variance of sequencesSDNN= SD of HHI or RRI

Selvaraj, N.; Jaryal, A.; Santhosh, J.; Deepak, K.K.; Anand, S. Assessment of heart rate variability derived from finger-tip photoplethysmography as compared to electrocardiography. J. Med. Eng. Tech. 2008, 32, 479-484.

PRV= Pulse rate variabilitynow is used from PPG


Healthy CV patients have a well defined “dicrotic wave” in the diastolic phase at D, whereas 98% of overt arteriosclerotic patients had significant decrease or disappearance of the wave

Elements of PTG (Systolic Phase)1. S (Starting Point)Starting point of systolic phase of arterial pulse-wave. Aortic valve opens and the blood of the LV is ejected into aorta.2. P (Percussion Wave) Wave caused from LV ejection that increases the blood volume within artery.Higher point means stronger LV ejection and higher compliance oflarger artery.3. T (Tidal Wave)Reflected wave from the small artery. Higher point means contraction and stiffness of small artery.4. C (Incisura)End-point of systolic phase, then aortic valve is closed.Less drop from pulse height (PH) means larger resistance (arterialcontraction & tension).


Second peak value


Second derivative APG wave


Second derivative APG wave


Differences of sensitivity


Respiratory frequency


LVED= Left Ventricular End Diastolic Pressure

Capable to indicate and grade CHF = Chronic Heart Failure


Comprensive measuring


Compressive reporting


Report


Now everything is available 24h/day• H2O = Humanization of

Healthcare• EAROMICS with PPG from the

ear• Costumized and hack4health

Oxirate ®

Flip ®Ear-o-Smart ®


Extended to GSR & EDA

GSR= Galvanic Skin ResponseEDA= Electrodermal Activity


Extended to EEG


Extended to eating habits


Extended to GlucosaeNIR glucometer by Arduino

InGaAs photodiode, 8 LEDs(2 x Green, 2 x NIR @ 1550nm, 1 IR @ 960nm, 1 Red) an Atmega328p, and the circuits required to run those. Also it contains a small LiPo in order to be able to test, or take training data. Two separate circuit boards and the ADC is channeled through an MCP3421 and then i2c goes across a connector at the bottom which also supplies the regulated 3.3V


4P (preventive-pervasive-proactive-personalized)

DIY data HSD (health small data)