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Radiometer Medical ApS, Åkandevej 21, DK-2700 Brønshøj, Tel: +45 38 27 38 27, radiometer PowerPoint PPT Presentation


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Transcutaneous measuring principles – tc and saturation. RTC, June 2006. Radiometer Medical ApS, Åkandevej 21, DK-2700 Brønshøj, Tel: +45 38 27 38 27, www.radiometer.com. Agenda. Saturation s O 2 , p O 2 (a), ODC SpO 2 Light emission Light detection Animations Calibration curves

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Radiometer medical aps kandevej 21 dk 2700 br nsh j tel 45 38 27 38 27 radiometer

Transcutaneous

measuring principles – tc and saturation

RTC, June 2006

Radiometer Medical ApS, Åkandevej 21, DK-2700 Brønshøj, Tel: +45 38 27 38 27, www.radiometer.com


Agenda

Agenda

  • Saturation

    • sO2, pO2(a), ODC

    • SpO2

    • Light emission

    • Light detection

    • Animations

    • Calibration curves

    • Cautions/limitations

  • tc

    • New illustrations

    • New animations

  • Summing up - table


Methods of measuring blood gas

Methods of measuring blood gas


S o 2 and p o 2

sO2 and pO2

http://www.nellcor.com/_Catalog/PDF/Edu/MON_F.a.00838v1 ClinicalMonoPul.pdf


S o 2 and the odc

sO2 and the ODC

  • sO2 vs. pO2(a)

  • Standard ODC:

    • sO2= 90 % corresponds topO2(a)= 60 mmHg

  • Abnormal/critical ODC:

    • Shifts due to temperature, pH, 2,3-DPG, pCO2(a)

At a constant pO2 of 45 mmHg/6 kPa, sO2 may be either 80 % or 88 % depending on whether arterial pH is 7.25 or 7.40

  • Conclusions:

  • sO2 is not suited for detection of hyperoxemia (high pO2(a))

  • sO2 cannot be used to predict pO2(a)


Definition of saturation s o 2

Definition of saturation, sO2

  • Arterial oxygen saturation

  • Utilization of oxygen transport capacity

  • Normal range 95-99 %

  • When sO2 is below normal range, the patient can benefit from supplemental oxygen

  • NO information about tHb, ventilation or O2 release to tissue

  • Available from BG CO-ox analyzers, BG analyzers, pulse oximeters


What does pulse oximetry measure

What does pulse oximetry measure?

  • Arterial oxygen saturation

  • SpO2

  • Measuring range 70-100 %

  • SpO2 based on empirically determined sO2(a) calibration curves

  • I.e. SpO2 is NOT identical to sO2(a), which is measured by CO-ox analyzers

    • From measured O2Hb and HHb

  • And SpO2 is NOT identical to sO2(e), which is estimated by BG analyzers

    • From pO2(a) and pH-corrected standard ODC

    • E.g. ABL5


Light emission hemoglobin absorption

Light emission -hemoglobin absorption

  • Dual light source

    • Red light 660 nm

    • Infrared light 900 nm

    • Alternating diode cycles

  • O2Hb absorbs more IR light

    • I.e. it looks more red

  • HHb absorbs more red light

    • I.e. it looks less red

http://www.nellcor.com/_Catalog/PDF/Product/OxiMaxTechNote.pdf


Light detection pulse amplitude

Light detection – pulse amplitude

  • Photodetector

    • One detector for both wavelengths

  • Isolate absorption from pulsating arterial blood

    • I.e. discard the ”base line” absorption

http://www.nellcor.com/_Catalog/PDF/Product/OxiMaxTechNote.pdf


Baseline animation

Baseline animation


S o 2 animation

sO2 animation


From light absorption to spo 2

From light absorption to SpO2

  • Red-to-infrared pulse Modulation Ratio (R)

  • Ratio translated to SpO2 from calibration curve

http://www.nellcor.com/_Catalog/PDF/Product/OxiMaxTechNote.pdf


Choosing the right calibration curve

Choosing the right calibration curve

  • Curve defined for each sensor

  • Each LED has its own characteristics

  • Grouped and paired with a corresponding resistor

  • Resistor housed in sensor plug

  • Monitor recognizes resistor value and chooses the appropriate calibration curve


Spo 2 when to be cautious

SpO2– when to be cautious?

  • Extreme hypoxemia (< 70 %) and hyperoxemia (> 95 %)

  • Sensor matching to site

  • DysHb – SpO2 may be normal despite low tHb

  • Anemia – SpO2 may be normal despite low tHb

  • Dye used for medical purposes

    • E.g. Methylene blue (likewise for CO-oximetry)

  • Low perfusion (likewise for tc)

  • Hypothermia (likewise for tc)

    • Peripheral constriction

    • Shivering (motion artifacts)

  • Medication (likewise for tc)

    • Peripheral constriction

  • Light interference

  • Nail polish


Tc new sensor illustrations

  • E5280

  • Combi tcpO2/tcpCO2

  • E5260

  • Single tcpCO2

tc – new sensor illustrations

  • E5250

  • Single tcpO2


Tc new e5250 animation

tc – new E5250 animation


Tc new e5260 animation

tc – new E5260 animation


Tc new e5280 animation

tc – new E5280 animation


Tc new physiological measuring princ animation

tc– new physiological measuring princ. animation


Table to summarize

Table to summarize


Radiometer medical aps kandevej 21 dk 2700 br nsh j tel 45 38 27 38 27 radiometer

Radiometer Training Center, June 2006

Radiometer Medical ApS, Åkandevej 21, DK-2700 Brønshøj, Tel: +45 38 27 38 27, www.radiometer.com


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