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Radiometer Medical ApS, Åkandevej 21, DK-2700 Brønshøj, Tel: +45 38 27 38 27, radiometer PowerPoint 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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slide1

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
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

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
slide21

Radiometer Training Center, June 2006

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