Abstract

Motion artifact reduction in photoplethysmography, and therefore by implication in pulse oximetry, is achieved with a novel nonlinear methodology. The physical origins of the photoplethysmographic signals are explored in relation to a nonlinear measure of the observed intensity fluctuations. It is demonstrated that the nonlinearity renormalizes the received pulsations with optical information in a manner that aids physical interpretation. A heuristic physical model for the motion artifact is introduced and experimentally justified, with an inversion for artifact reduction being simplified by the nonlinearity. A practical implementation technique is discussed with emphasis placed on the resultant rescaling of the static and the dynamic portions of the signals. It is noted that this implementation also has the desirable effect of reducing any residual ambient artifact. The scope and power of this methodology is investigated with the presentation of results from a practical electronic system.

© 1998 Optical Society of America

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    [Crossref]
  2. I. Yoshiya, Y. Shimada, K. Tanaka, “Spectrophotometric monitoring of arterial oxygen saturation in the finger tip,” Med. Biol. Eng. Comput. 18, 27–32 (1980).
    [Crossref] [PubMed]
  3. N. S. Trivedi, A. F. Ghouri, N. K. Shah, E. Lai, S. J. Barker, “Effects of motion, ambient light, and hypoperfusion on pulse oximeter function,” J. Clin. Anesth. 9, 179–183 (1997).
    [Crossref] [PubMed]
  4. A. T. Costarino, D. A. David, T. P. Keon, “Falsely normal readings with the pulse oximeter,” Anesthesiology 67, 830–831 (1987).
    [Crossref] [PubMed]
  5. F. E. Block, “Interference in a pulse oximeter from a fibre-optic light source,” J. Clin. Monit. 3, 210–211 (1987).
    [Crossref] [PubMed]
  6. L. H. Norton, B. Squires, N. P. Craig, G. McLeay, P. McGrath, K. I. Norton, “Accuracy of pulse oximetry during exercise stress testing,” Int. J. Sports Med. 13, 523–527 (1992).
    [Crossref] [PubMed]
  7. H. Benoit, F. Costes, L. Feasson, J. R. Lacour, F. Roche, C. Denis, A. Geyssant, J. C. Barthelemy, “Accuracy of pulse oximetry during intense exercise under severe hypoxic conditions,” Eur. J. Appl. Physiol. and Occup. Physiol. 76, 260–263 (1997).
    [Crossref]
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    [Crossref]
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    [PubMed]
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    [Crossref] [PubMed]
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    [Crossref] [PubMed]
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    [Crossref]
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  25. K. I. Hopcraft, P. R. Smith, An Introduction to Electromagnetic Inverse Scattering (Kluwer, London, 1992).
    [Crossref]
  26. C. C. Johnson, “Optical diffusion in blood,” IEEE Trans. Biomed. Eng. 17, 129–133 (1970).
    [Crossref] [PubMed]
  27. Y. Shimada, I. Yoshiya, N. Oka, K. Mamaguri, “Effects of multiple scattering and peripheral circulation on arterial oxygen saturation, measured with a pulse-type oximeter,” Med. Biol. Eng. Comput. 22, 475–478 (1984).
    [Crossref] [PubMed]
  28. P. D. Manheimer, J. R. Casciani, M. E. Fein, S. L. Nierlich, “Wavelength selection for low-saturation pulse oximetry,” IEEE Trans. Biomed. Eng. 44, 148–158 (1997).
    [Crossref]

1997 (6)

N. S. Trivedi, A. F. Ghouri, N. K. Shah, E. Lai, S. J. Barker, “Effects of motion, ambient light, and hypoperfusion on pulse oximeter function,” J. Clin. Anesth. 9, 179–183 (1997).
[Crossref] [PubMed]

H. Benoit, F. Costes, L. Feasson, J. R. Lacour, F. Roche, C. Denis, A. Geyssant, J. C. Barthelemy, “Accuracy of pulse oximetry during intense exercise under severe hypoxic conditions,” Eur. J. Appl. Physiol. and Occup. Physiol. 76, 260–263 (1997).
[Crossref]

C. F. Poets, V. A. Stebbens, “Detection of movement artifact in recorded pulse oximeter saturation,” Eur. J. Pediatrics 156, 808–811 (1997).
[Crossref]

S. J. Barker, N. K. Shah, “The effects of motion on the performance of pulse oximeters in volunteers,” Anesthesiology 86, 101–108 (1997).
[Crossref] [PubMed]

J. L. Plummer, A. H. Ilsley, R. R. L. Fronsko, H. Owen, “Identification of movement artifact by the Nellcor N-200 and N-3000 pulse oximeters,” J. Clin. Monit. 13, 109–113 (1997).
[Crossref] [PubMed]

P. D. Manheimer, J. R. Casciani, M. E. Fein, S. L. Nierlich, “Wavelength selection for low-saturation pulse oximetry,” IEEE Trans. Biomed. Eng. 44, 148–158 (1997).
[Crossref]

1996 (1)

C. Dumas, J. A. Wahr, K. K. Tremper, “Clinical evaluation of a prototype motion artifact resistant pulse oximeter in the recovery room,” Anesth. Analg. 83, 269–272 (1996).
[PubMed]

1994 (2)

A. R. Visram, R. D. M. Jones, M. G. Irwin, J. Bacon-Shone, “Use of two oximeters to investigate a method of movement artifact rejection using photoplethysmographic signals,” Br. J. Anaesth. 72, 388–392 (1994).
[Crossref] [PubMed]

D. R. Marble, D. H. Burns, P. W. Cheung, “Diffusion-based model of pulse oximetry: in vitro and in vivo comparisons,” Appl. Opt. 33, 1279–1285 (1994).
[Crossref] [PubMed]

1992 (1)

L. H. Norton, B. Squires, N. P. Craig, G. McLeay, P. McGrath, K. I. Norton, “Accuracy of pulse oximetry during exercise stress testing,” Int. J. Sports Med. 13, 523–527 (1992).
[Crossref] [PubMed]

1990 (1)

W. F. Cheong, S. A. Prahl, A. J. Welch, “A review of the optical properties of biological tissues,” IEEE J. Quantum Electron. 26, 2166–2185 (1990).
[Crossref]

1989 (1)

1987 (2)

A. T. Costarino, D. A. David, T. P. Keon, “Falsely normal readings with the pulse oximeter,” Anesthesiology 67, 830–831 (1987).
[Crossref] [PubMed]

F. E. Block, “Interference in a pulse oximeter from a fibre-optic light source,” J. Clin. Monit. 3, 210–211 (1987).
[Crossref] [PubMed]

1984 (1)

Y. Shimada, I. Yoshiya, N. Oka, K. Mamaguri, “Effects of multiple scattering and peripheral circulation on arterial oxygen saturation, measured with a pulse-type oximeter,” Med. Biol. Eng. Comput. 22, 475–478 (1984).
[Crossref] [PubMed]

1980 (1)

I. Yoshiya, Y. Shimada, K. Tanaka, “Spectrophotometric monitoring of arterial oxygen saturation in the finger tip,” Med. Biol. Eng. Comput. 18, 27–32 (1980).
[Crossref] [PubMed]

1970 (1)

C. C. Johnson, “Optical diffusion in blood,” IEEE Trans. Biomed. Eng. 17, 129–133 (1970).
[Crossref] [PubMed]

1937 (1)

A. B. Hertzman, “Photoelectric plethysmograph of the fingers and toes in man,” Proc. Soc. Exp. Biol. Med. 37, 529 (1937).
[Crossref]

Bacon-Shone, J.

A. R. Visram, R. D. M. Jones, M. G. Irwin, J. Bacon-Shone, “Use of two oximeters to investigate a method of movement artifact rejection using photoplethysmographic signals,” Br. J. Anaesth. 72, 388–392 (1994).
[Crossref] [PubMed]

Barker, S. J.

S. J. Barker, N. K. Shah, “The effects of motion on the performance of pulse oximeters in volunteers,” Anesthesiology 86, 101–108 (1997).
[Crossref] [PubMed]

N. S. Trivedi, A. F. Ghouri, N. K. Shah, E. Lai, S. J. Barker, “Effects of motion, ambient light, and hypoperfusion on pulse oximeter function,” J. Clin. Anesth. 9, 179–183 (1997).
[Crossref] [PubMed]

Barnett, D. M.

M. J. Hayes, P. R. Smith, D. M. Barnett, M. D. L. Morgan, S. Singh, D. D. Vara, “Quantitative investigation of artefact in photoplethysmography and pulse oximetry for respiratory exercise testing,” in Proceedings of the Seventh International Symposium CNVD (Computer-aided Noninvasive Vascular Diagnostics), V. Blažek, U. Schultz-Ehrenburg, eds. (VDI-Verlag, Düsseldorf, Germany, 1998, Vol. 263, pp. 117–124.

Barthelemy, J. C.

H. Benoit, F. Costes, L. Feasson, J. R. Lacour, F. Roche, C. Denis, A. Geyssant, J. C. Barthelemy, “Accuracy of pulse oximetry during intense exercise under severe hypoxic conditions,” Eur. J. Appl. Physiol. and Occup. Physiol. 76, 260–263 (1997).
[Crossref]

Benoit, H.

H. Benoit, F. Costes, L. Feasson, J. R. Lacour, F. Roche, C. Denis, A. Geyssant, J. C. Barthelemy, “Accuracy of pulse oximetry during intense exercise under severe hypoxic conditions,” Eur. J. Appl. Physiol. and Occup. Physiol. 76, 260–263 (1997).
[Crossref]

Blažek, V.

V. Blažek, U. Schultz-Ehrenburg, Quantitative Photoplethysmography. Basic Facts and Examination Tests for Evaluating Peripheral Vascular Functions (VDI-Verlag, Düsseldorf, Germany, 1996).

Block, F. E.

F. E. Block, “Interference in a pulse oximeter from a fibre-optic light source,” J. Clin. Monit. 3, 210–211 (1987).
[Crossref] [PubMed]

Burns, D. H.

Casciani, J. R.

P. D. Manheimer, J. R. Casciani, M. E. Fein, S. L. Nierlich, “Wavelength selection for low-saturation pulse oximetry,” IEEE Trans. Biomed. Eng. 44, 148–158 (1997).
[Crossref]

Chance, B.

Cheong, W. F.

W. F. Cheong, S. A. Prahl, A. J. Welch, “A review of the optical properties of biological tissues,” IEEE J. Quantum Electron. 26, 2166–2185 (1990).
[Crossref]

Cheung, P. W.

Costarino, A. T.

A. T. Costarino, D. A. David, T. P. Keon, “Falsely normal readings with the pulse oximeter,” Anesthesiology 67, 830–831 (1987).
[Crossref] [PubMed]

Costes, F.

H. Benoit, F. Costes, L. Feasson, J. R. Lacour, F. Roche, C. Denis, A. Geyssant, J. C. Barthelemy, “Accuracy of pulse oximetry during intense exercise under severe hypoxic conditions,” Eur. J. Appl. Physiol. and Occup. Physiol. 76, 260–263 (1997).
[Crossref]

Craig, N. P.

L. H. Norton, B. Squires, N. P. Craig, G. McLeay, P. McGrath, K. I. Norton, “Accuracy of pulse oximetry during exercise stress testing,” Int. J. Sports Med. 13, 523–527 (1992).
[Crossref] [PubMed]

David, D. A.

A. T. Costarino, D. A. David, T. P. Keon, “Falsely normal readings with the pulse oximeter,” Anesthesiology 67, 830–831 (1987).
[Crossref] [PubMed]

Denis, C.

H. Benoit, F. Costes, L. Feasson, J. R. Lacour, F. Roche, C. Denis, A. Geyssant, J. C. Barthelemy, “Accuracy of pulse oximetry during intense exercise under severe hypoxic conditions,” Eur. J. Appl. Physiol. and Occup. Physiol. 76, 260–263 (1997).
[Crossref]

Diab, M. K.

M. K. Diab, “Signal processing apparatus,” International Patent ApplicationWO 96/12435 (2May1996).

Dumas, C.

C. Dumas, J. A. Wahr, K. K. Tremper, “Clinical evaluation of a prototype motion artifact resistant pulse oximeter in the recovery room,” Anesth. Analg. 83, 269–272 (1996).
[PubMed]

Feasson, L.

H. Benoit, F. Costes, L. Feasson, J. R. Lacour, F. Roche, C. Denis, A. Geyssant, J. C. Barthelemy, “Accuracy of pulse oximetry during intense exercise under severe hypoxic conditions,” Eur. J. Appl. Physiol. and Occup. Physiol. 76, 260–263 (1997).
[Crossref]

Fein, M. E.

P. D. Manheimer, J. R. Casciani, M. E. Fein, S. L. Nierlich, “Wavelength selection for low-saturation pulse oximetry,” IEEE Trans. Biomed. Eng. 44, 148–158 (1997).
[Crossref]

Feshbach, H.

P. M. Morse, H. Feshbach, Methods of Theoretical Physics (McGraw-Hill, New York, 1953).

Fronsko, R. R. L.

J. L. Plummer, A. H. Ilsley, R. R. L. Fronsko, H. Owen, “Identification of movement artifact by the Nellcor N-200 and N-3000 pulse oximeters,” J. Clin. Monit. 13, 109–113 (1997).
[Crossref] [PubMed]

Geyssant, A.

H. Benoit, F. Costes, L. Feasson, J. R. Lacour, F. Roche, C. Denis, A. Geyssant, J. C. Barthelemy, “Accuracy of pulse oximetry during intense exercise under severe hypoxic conditions,” Eur. J. Appl. Physiol. and Occup. Physiol. 76, 260–263 (1997).
[Crossref]

Ghouri, A. F.

N. S. Trivedi, A. F. Ghouri, N. K. Shah, E. Lai, S. J. Barker, “Effects of motion, ambient light, and hypoperfusion on pulse oximeter function,” J. Clin. Anesth. 9, 179–183 (1997).
[Crossref] [PubMed]

Hayes, M. J.

M. J. Hayes, P. R. Smith, D. M. Barnett, M. D. L. Morgan, S. Singh, D. D. Vara, “Quantitative investigation of artefact in photoplethysmography and pulse oximetry for respiratory exercise testing,” in Proceedings of the Seventh International Symposium CNVD (Computer-aided Noninvasive Vascular Diagnostics), V. Blažek, U. Schultz-Ehrenburg, eds. (VDI-Verlag, Düsseldorf, Germany, 1998, Vol. 263, pp. 117–124.

Hertzman, A. B.

A. B. Hertzman, “Photoelectric plethysmograph of the fingers and toes in man,” Proc. Soc. Exp. Biol. Med. 37, 529 (1937).
[Crossref]

Hopcraft, K. I.

K. I. Hopcraft, P. R. Smith, An Introduction to Electromagnetic Inverse Scattering (Kluwer, London, 1992).
[Crossref]

Ilsley, A. H.

J. L. Plummer, A. H. Ilsley, R. R. L. Fronsko, H. Owen, “Identification of movement artifact by the Nellcor N-200 and N-3000 pulse oximeters,” J. Clin. Monit. 13, 109–113 (1997).
[Crossref] [PubMed]

Irwin, M. G.

A. R. Visram, R. D. M. Jones, M. G. Irwin, J. Bacon-Shone, “Use of two oximeters to investigate a method of movement artifact rejection using photoplethysmographic signals,” Br. J. Anaesth. 72, 388–392 (1994).
[Crossref] [PubMed]

Johnson, C. C.

C. C. Johnson, “Optical diffusion in blood,” IEEE Trans. Biomed. Eng. 17, 129–133 (1970).
[Crossref] [PubMed]

Jones, R. D. M.

A. R. Visram, R. D. M. Jones, M. G. Irwin, J. Bacon-Shone, “Use of two oximeters to investigate a method of movement artifact rejection using photoplethysmographic signals,” Br. J. Anaesth. 72, 388–392 (1994).
[Crossref] [PubMed]

Keon, T. P.

A. T. Costarino, D. A. David, T. P. Keon, “Falsely normal readings with the pulse oximeter,” Anesthesiology 67, 830–831 (1987).
[Crossref] [PubMed]

Lacour, J. R.

H. Benoit, F. Costes, L. Feasson, J. R. Lacour, F. Roche, C. Denis, A. Geyssant, J. C. Barthelemy, “Accuracy of pulse oximetry during intense exercise under severe hypoxic conditions,” Eur. J. Appl. Physiol. and Occup. Physiol. 76, 260–263 (1997).
[Crossref]

Lai, E.

N. S. Trivedi, A. F. Ghouri, N. K. Shah, E. Lai, S. J. Barker, “Effects of motion, ambient light, and hypoperfusion on pulse oximeter function,” J. Clin. Anesth. 9, 179–183 (1997).
[Crossref] [PubMed]

Lossau, I.

U. Schmeink, Th. Schmeink, I. Lossau, V. Roschansky, “D-PPG and duplex-ultrasound: correlation of results in the diagnosis of deep vein insufficiency,” in Proceedings of the Seventh International Symposium CNVD (Computer-aided Noninvasive Vascular Diagnostics), V. Blažek, U. Schultz-Ehrenburg, eds. (VDI-Verlag, Düsseldorf, Germany, 1998), Vol. 263, pp. 161–164.

Mamaguri, K.

Y. Shimada, I. Yoshiya, N. Oka, K. Mamaguri, “Effects of multiple scattering and peripheral circulation on arterial oxygen saturation, measured with a pulse-type oximeter,” Med. Biol. Eng. Comput. 22, 475–478 (1984).
[Crossref] [PubMed]

Manheimer, P. D.

P. D. Manheimer, J. R. Casciani, M. E. Fein, S. L. Nierlich, “Wavelength selection for low-saturation pulse oximetry,” IEEE Trans. Biomed. Eng. 44, 148–158 (1997).
[Crossref]

Marble, D. R.

Matthews, G. R.

G. R. Matthews, “Pulse responsive device,” International Patent ApplicationWO 91/18550 (12December1991).

McGrath, P.

L. H. Norton, B. Squires, N. P. Craig, G. McLeay, P. McGrath, K. I. Norton, “Accuracy of pulse oximetry during exercise stress testing,” Int. J. Sports Med. 13, 523–527 (1992).
[Crossref] [PubMed]

McLeay, G.

L. H. Norton, B. Squires, N. P. Craig, G. McLeay, P. McGrath, K. I. Norton, “Accuracy of pulse oximetry during exercise stress testing,” Int. J. Sports Med. 13, 523–527 (1992).
[Crossref] [PubMed]

Morgan, M. D. L.

M. J. Hayes, P. R. Smith, D. M. Barnett, M. D. L. Morgan, S. Singh, D. D. Vara, “Quantitative investigation of artefact in photoplethysmography and pulse oximetry for respiratory exercise testing,” in Proceedings of the Seventh International Symposium CNVD (Computer-aided Noninvasive Vascular Diagnostics), V. Blažek, U. Schultz-Ehrenburg, eds. (VDI-Verlag, Düsseldorf, Germany, 1998, Vol. 263, pp. 117–124.

Morse, P. M.

P. M. Morse, H. Feshbach, Methods of Theoretical Physics (McGraw-Hill, New York, 1953).

Nierlich, S. L.

P. D. Manheimer, J. R. Casciani, M. E. Fein, S. L. Nierlich, “Wavelength selection for low-saturation pulse oximetry,” IEEE Trans. Biomed. Eng. 44, 148–158 (1997).
[Crossref]

Norton, K. I.

L. H. Norton, B. Squires, N. P. Craig, G. McLeay, P. McGrath, K. I. Norton, “Accuracy of pulse oximetry during exercise stress testing,” Int. J. Sports Med. 13, 523–527 (1992).
[Crossref] [PubMed]

Norton, L. H.

L. H. Norton, B. Squires, N. P. Craig, G. McLeay, P. McGrath, K. I. Norton, “Accuracy of pulse oximetry during exercise stress testing,” Int. J. Sports Med. 13, 523–527 (1992).
[Crossref] [PubMed]

Oka, N.

Y. Shimada, I. Yoshiya, N. Oka, K. Mamaguri, “Effects of multiple scattering and peripheral circulation on arterial oxygen saturation, measured with a pulse-type oximeter,” Med. Biol. Eng. Comput. 22, 475–478 (1984).
[Crossref] [PubMed]

Owen, H.

J. L. Plummer, A. H. Ilsley, R. R. L. Fronsko, H. Owen, “Identification of movement artifact by the Nellcor N-200 and N-3000 pulse oximeters,” J. Clin. Monit. 13, 109–113 (1997).
[Crossref] [PubMed]

Parker, D.

D. Parker, “Optical monitor (oximeter, etc.) with motion artifact suppression,” International Patent ApplicationWO 94/03102 (17February1994).

Patterson, M. S.

Plummer, J. L.

J. L. Plummer, A. H. Ilsley, R. R. L. Fronsko, H. Owen, “Identification of movement artifact by the Nellcor N-200 and N-3000 pulse oximeters,” J. Clin. Monit. 13, 109–113 (1997).
[Crossref] [PubMed]

Poets, C. F.

C. F. Poets, V. A. Stebbens, “Detection of movement artifact in recorded pulse oximeter saturation,” Eur. J. Pediatrics 156, 808–811 (1997).
[Crossref]

Prahl, S. A.

W. F. Cheong, S. A. Prahl, A. J. Welch, “A review of the optical properties of biological tissues,” IEEE J. Quantum Electron. 26, 2166–2185 (1990).
[Crossref]

Roche, F.

H. Benoit, F. Costes, L. Feasson, J. R. Lacour, F. Roche, C. Denis, A. Geyssant, J. C. Barthelemy, “Accuracy of pulse oximetry during intense exercise under severe hypoxic conditions,” Eur. J. Appl. Physiol. and Occup. Physiol. 76, 260–263 (1997).
[Crossref]

Roschansky, V.

U. Schmeink, Th. Schmeink, I. Lossau, V. Roschansky, “D-PPG and duplex-ultrasound: correlation of results in the diagnosis of deep vein insufficiency,” in Proceedings of the Seventh International Symposium CNVD (Computer-aided Noninvasive Vascular Diagnostics), V. Blažek, U. Schultz-Ehrenburg, eds. (VDI-Verlag, Düsseldorf, Germany, 1998), Vol. 263, pp. 161–164.

Schmeink, Th.

U. Schmeink, Th. Schmeink, I. Lossau, V. Roschansky, “D-PPG and duplex-ultrasound: correlation of results in the diagnosis of deep vein insufficiency,” in Proceedings of the Seventh International Symposium CNVD (Computer-aided Noninvasive Vascular Diagnostics), V. Blažek, U. Schultz-Ehrenburg, eds. (VDI-Verlag, Düsseldorf, Germany, 1998), Vol. 263, pp. 161–164.

Schmeink, U.

U. Schmeink, Th. Schmeink, I. Lossau, V. Roschansky, “D-PPG and duplex-ultrasound: correlation of results in the diagnosis of deep vein insufficiency,” in Proceedings of the Seventh International Symposium CNVD (Computer-aided Noninvasive Vascular Diagnostics), V. Blažek, U. Schultz-Ehrenburg, eds. (VDI-Verlag, Düsseldorf, Germany, 1998), Vol. 263, pp. 161–164.

Schultz-Ehrenburg, U.

V. Blažek, U. Schultz-Ehrenburg, Quantitative Photoplethysmography. Basic Facts and Examination Tests for Evaluating Peripheral Vascular Functions (VDI-Verlag, Düsseldorf, Germany, 1996).

Shah, N. K.

N. S. Trivedi, A. F. Ghouri, N. K. Shah, E. Lai, S. J. Barker, “Effects of motion, ambient light, and hypoperfusion on pulse oximeter function,” J. Clin. Anesth. 9, 179–183 (1997).
[Crossref] [PubMed]

S. J. Barker, N. K. Shah, “The effects of motion on the performance of pulse oximeters in volunteers,” Anesthesiology 86, 101–108 (1997).
[Crossref] [PubMed]

Shimada, Y.

Y. Shimada, I. Yoshiya, N. Oka, K. Mamaguri, “Effects of multiple scattering and peripheral circulation on arterial oxygen saturation, measured with a pulse-type oximeter,” Med. Biol. Eng. Comput. 22, 475–478 (1984).
[Crossref] [PubMed]

I. Yoshiya, Y. Shimada, K. Tanaka, “Spectrophotometric monitoring of arterial oxygen saturation in the finger tip,” Med. Biol. Eng. Comput. 18, 27–32 (1980).
[Crossref] [PubMed]

Singh, S.

M. J. Hayes, P. R. Smith, D. M. Barnett, M. D. L. Morgan, S. Singh, D. D. Vara, “Quantitative investigation of artefact in photoplethysmography and pulse oximetry for respiratory exercise testing,” in Proceedings of the Seventh International Symposium CNVD (Computer-aided Noninvasive Vascular Diagnostics), V. Blažek, U. Schultz-Ehrenburg, eds. (VDI-Verlag, Düsseldorf, Germany, 1998, Vol. 263, pp. 117–124.

Smith, P. R.

M. J. Hayes, P. R. Smith, D. M. Barnett, M. D. L. Morgan, S. Singh, D. D. Vara, “Quantitative investigation of artefact in photoplethysmography and pulse oximetry for respiratory exercise testing,” in Proceedings of the Seventh International Symposium CNVD (Computer-aided Noninvasive Vascular Diagnostics), V. Blažek, U. Schultz-Ehrenburg, eds. (VDI-Verlag, Düsseldorf, Germany, 1998, Vol. 263, pp. 117–124.

K. I. Hopcraft, P. R. Smith, An Introduction to Electromagnetic Inverse Scattering (Kluwer, London, 1992).
[Crossref]

Squires, B.

L. H. Norton, B. Squires, N. P. Craig, G. McLeay, P. McGrath, K. I. Norton, “Accuracy of pulse oximetry during exercise stress testing,” Int. J. Sports Med. 13, 523–527 (1992).
[Crossref] [PubMed]

Stebbens, V. A.

C. F. Poets, V. A. Stebbens, “Detection of movement artifact in recorded pulse oximeter saturation,” Eur. J. Pediatrics 156, 808–811 (1997).
[Crossref]

Swedlow, D. B.

D. B. Swedlow, “Oximeter with motion detection for alarm modification,” International Patent ApplicationWO 94/22360 (13October1994).

Tanaka, K.

I. Yoshiya, Y. Shimada, K. Tanaka, “Spectrophotometric monitoring of arterial oxygen saturation in the finger tip,” Med. Biol. Eng. Comput. 18, 27–32 (1980).
[Crossref] [PubMed]

Tremper, K. K.

C. Dumas, J. A. Wahr, K. K. Tremper, “Clinical evaluation of a prototype motion artifact resistant pulse oximeter in the recovery room,” Anesth. Analg. 83, 269–272 (1996).
[PubMed]

Trivedi, N. S.

N. S. Trivedi, A. F. Ghouri, N. K. Shah, E. Lai, S. J. Barker, “Effects of motion, ambient light, and hypoperfusion on pulse oximeter function,” J. Clin. Anesth. 9, 179–183 (1997).
[Crossref] [PubMed]

Vara, D. D.

M. J. Hayes, P. R. Smith, D. M. Barnett, M. D. L. Morgan, S. Singh, D. D. Vara, “Quantitative investigation of artefact in photoplethysmography and pulse oximetry for respiratory exercise testing,” in Proceedings of the Seventh International Symposium CNVD (Computer-aided Noninvasive Vascular Diagnostics), V. Blažek, U. Schultz-Ehrenburg, eds. (VDI-Verlag, Düsseldorf, Germany, 1998, Vol. 263, pp. 117–124.

Visram, A. R.

A. R. Visram, R. D. M. Jones, M. G. Irwin, J. Bacon-Shone, “Use of two oximeters to investigate a method of movement artifact rejection using photoplethysmographic signals,” Br. J. Anaesth. 72, 388–392 (1994).
[Crossref] [PubMed]

Wahr, J. A.

C. Dumas, J. A. Wahr, K. K. Tremper, “Clinical evaluation of a prototype motion artifact resistant pulse oximeter in the recovery room,” Anesth. Analg. 83, 269–272 (1996).
[PubMed]

Welch, A. J.

W. F. Cheong, S. A. Prahl, A. J. Welch, “A review of the optical properties of biological tissues,” IEEE J. Quantum Electron. 26, 2166–2185 (1990).
[Crossref]

Wilson, B. C.

Yorkey, T. J.

T. J. Yorkey, “Method and apparatus for removing motion artifact and noise from pulse oximetry,” International Patent ApplicationWO 97/00041 (3January1997).

Yoshiya, I.

Y. Shimada, I. Yoshiya, N. Oka, K. Mamaguri, “Effects of multiple scattering and peripheral circulation on arterial oxygen saturation, measured with a pulse-type oximeter,” Med. Biol. Eng. Comput. 22, 475–478 (1984).
[Crossref] [PubMed]

I. Yoshiya, Y. Shimada, K. Tanaka, “Spectrophotometric monitoring of arterial oxygen saturation in the finger tip,” Med. Biol. Eng. Comput. 18, 27–32 (1980).
[Crossref] [PubMed]

Anesth. Analg. (1)

C. Dumas, J. A. Wahr, K. K. Tremper, “Clinical evaluation of a prototype motion artifact resistant pulse oximeter in the recovery room,” Anesth. Analg. 83, 269–272 (1996).
[PubMed]

Anesthesiology (2)

S. J. Barker, N. K. Shah, “The effects of motion on the performance of pulse oximeters in volunteers,” Anesthesiology 86, 101–108 (1997).
[Crossref] [PubMed]

A. T. Costarino, D. A. David, T. P. Keon, “Falsely normal readings with the pulse oximeter,” Anesthesiology 67, 830–831 (1987).
[Crossref] [PubMed]

Appl. Opt. (2)

Br. J. Anaesth. (1)

A. R. Visram, R. D. M. Jones, M. G. Irwin, J. Bacon-Shone, “Use of two oximeters to investigate a method of movement artifact rejection using photoplethysmographic signals,” Br. J. Anaesth. 72, 388–392 (1994).
[Crossref] [PubMed]

Eur. J. Appl. Physiol. and Occup. Physiol. (1)

H. Benoit, F. Costes, L. Feasson, J. R. Lacour, F. Roche, C. Denis, A. Geyssant, J. C. Barthelemy, “Accuracy of pulse oximetry during intense exercise under severe hypoxic conditions,” Eur. J. Appl. Physiol. and Occup. Physiol. 76, 260–263 (1997).
[Crossref]

Eur. J. Pediatrics (1)

C. F. Poets, V. A. Stebbens, “Detection of movement artifact in recorded pulse oximeter saturation,” Eur. J. Pediatrics 156, 808–811 (1997).
[Crossref]

IEEE J. Quantum Electron. (1)

W. F. Cheong, S. A. Prahl, A. J. Welch, “A review of the optical properties of biological tissues,” IEEE J. Quantum Electron. 26, 2166–2185 (1990).
[Crossref]

IEEE Trans. Biomed. Eng. (2)

P. D. Manheimer, J. R. Casciani, M. E. Fein, S. L. Nierlich, “Wavelength selection for low-saturation pulse oximetry,” IEEE Trans. Biomed. Eng. 44, 148–158 (1997).
[Crossref]

C. C. Johnson, “Optical diffusion in blood,” IEEE Trans. Biomed. Eng. 17, 129–133 (1970).
[Crossref] [PubMed]

Int. J. Sports Med. (1)

L. H. Norton, B. Squires, N. P. Craig, G. McLeay, P. McGrath, K. I. Norton, “Accuracy of pulse oximetry during exercise stress testing,” Int. J. Sports Med. 13, 523–527 (1992).
[Crossref] [PubMed]

J. Clin. Anesth. (1)

N. S. Trivedi, A. F. Ghouri, N. K. Shah, E. Lai, S. J. Barker, “Effects of motion, ambient light, and hypoperfusion on pulse oximeter function,” J. Clin. Anesth. 9, 179–183 (1997).
[Crossref] [PubMed]

J. Clin. Monit. (2)

F. E. Block, “Interference in a pulse oximeter from a fibre-optic light source,” J. Clin. Monit. 3, 210–211 (1987).
[Crossref] [PubMed]

J. L. Plummer, A. H. Ilsley, R. R. L. Fronsko, H. Owen, “Identification of movement artifact by the Nellcor N-200 and N-3000 pulse oximeters,” J. Clin. Monit. 13, 109–113 (1997).
[Crossref] [PubMed]

Med. Biol. Eng. Comput. (2)

Y. Shimada, I. Yoshiya, N. Oka, K. Mamaguri, “Effects of multiple scattering and peripheral circulation on arterial oxygen saturation, measured with a pulse-type oximeter,” Med. Biol. Eng. Comput. 22, 475–478 (1984).
[Crossref] [PubMed]

I. Yoshiya, Y. Shimada, K. Tanaka, “Spectrophotometric monitoring of arterial oxygen saturation in the finger tip,” Med. Biol. Eng. Comput. 18, 27–32 (1980).
[Crossref] [PubMed]

Proc. Soc. Exp. Biol. Med. (1)

A. B. Hertzman, “Photoelectric plethysmograph of the fingers and toes in man,” Proc. Soc. Exp. Biol. Med. 37, 529 (1937).
[Crossref]

Other (10)

M. J. Hayes, P. R. Smith, D. M. Barnett, M. D. L. Morgan, S. Singh, D. D. Vara, “Quantitative investigation of artefact in photoplethysmography and pulse oximetry for respiratory exercise testing,” in Proceedings of the Seventh International Symposium CNVD (Computer-aided Noninvasive Vascular Diagnostics), V. Blažek, U. Schultz-Ehrenburg, eds. (VDI-Verlag, Düsseldorf, Germany, 1998, Vol. 263, pp. 117–124.

V. Blažek, U. Schultz-Ehrenburg, Quantitative Photoplethysmography. Basic Facts and Examination Tests for Evaluating Peripheral Vascular Functions (VDI-Verlag, Düsseldorf, Germany, 1996).

U. Schmeink, Th. Schmeink, I. Lossau, V. Roschansky, “D-PPG and duplex-ultrasound: correlation of results in the diagnosis of deep vein insufficiency,” in Proceedings of the Seventh International Symposium CNVD (Computer-aided Noninvasive Vascular Diagnostics), V. Blažek, U. Schultz-Ehrenburg, eds. (VDI-Verlag, Düsseldorf, Germany, 1998), Vol. 263, pp. 161–164.

M. K. Diab, “Signal processing apparatus,” International Patent ApplicationWO 96/12435 (2May1996).

G. R. Matthews, “Pulse responsive device,” International Patent ApplicationWO 91/18550 (12December1991).

D. B. Swedlow, “Oximeter with motion detection for alarm modification,” International Patent ApplicationWO 94/22360 (13October1994).

D. Parker, “Optical monitor (oximeter, etc.) with motion artifact suppression,” International Patent ApplicationWO 94/03102 (17February1994).

T. J. Yorkey, “Method and apparatus for removing motion artifact and noise from pulse oximetry,” International Patent ApplicationWO 97/00041 (3January1997).

K. I. Hopcraft, P. R. Smith, An Introduction to Electromagnetic Inverse Scattering (Kluwer, London, 1992).
[Crossref]

P. M. Morse, H. Feshbach, Methods of Theoretical Physics (McGraw-Hill, New York, 1953).

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Figures (5)

Fig. 1
Fig. 1

Probability distribution of the ratio of normalized dynamics before and after the artificial induction of motion artifact. The mean of near unity and the low standard deviation indicate that a multiplicative artifact model is more physically appropriate than the commonly utilized additive assumption.

Fig. 2
Fig. 2

Demonstration of the reduction of severe probe-coupling artifact induced by bending the finger within a transmission-mode probe. Spectral quantification indicates that the unequalized signal consists of 74% artifact, whereas the equalized signal is just 4% artifact.

Fig. 3
Fig. 3

Quantitative comparison of the degree of artifact reduction achieved with respect to two different classes of motion artifact. Less severe artifacts of either class are predominantly manifested as dynamics in the optical probe coupling, resulting in their reduction to a level below the 10% sensitivity limit imposed by the spectral artifact quantification. More-severe artifacts can cause additional effects, such as the skewing of probe geometry observed when waving the hand, that result in a lesser degree of artifact reduction. It is further observed that in all experiments, the equalized signal displayed a significantly lower artifact measure than the unequalized signal.

Fig. 4
Fig. 4

Demonstration of the reduction of motion artifact caused by pseudorandom movements of the hand. The broad spectral range of this class of artifacts precludes quantification with spectral techniques, although visual inspection highlights both the unequalized signal corruption and the high degree of artifact reduction achieved.

Fig. 5
Fig. 5

Demonstration of the origin of residual ambient artifact. Despite the high multiplexing speed (5 kHz), high-precision analog subtraction and bandwidth-limiting filters, high-frequency residual ambient artifact can still be observed when the probe is in close proximity to a high-intensity artificial light source. The nonlinear motion artifact reduction technique also reduces this residual ambient artifact, with the degree of reduction being determined by the relative source intensities.

Equations (28)

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I t ,   λ = j = 1 n   I j t α j t + β j t ,   λ + γ j t ,   λ ,
γ j t ,   λ = γ j λ p j t .
D 2 ϕ r - μ a ϕ r = - S r ,
D = 1 3 μ a + μ s 1 - g - 1 ,
S r = P 0 δ r - r ,
ϕ r = P 0 4 π D exp - μ a D 1 / 2   R R ,
J r = - D ϕ r ,
J z r = P 0 4 π   z   exp - R δ d 1 δ d R 2 + 1 R 3 ,
P z = P 0 η A 4 π z exp - z δ d 1 δ d + 1 z .
β + γ p t = 1 P 0   P z + Δ z t ,   δ d + Δ δ d t ,   μ s + Δ μ s t ,
β + γ p t = η A 4 π z   exp - z δ d 1 δ d + 1 z × 1 - Δ z t z 2 + z 2 δ d z + δ d - Δ δ d t z 1 + δ d z + Δ μ s t μ s .
γ p t β = - Δ z t z 2 + z 2 δ d z + δ d - Δ δ d t z × 1 + δ d z + Δ μ s t μ s .
γ β - 1 z 2 + z 2 δ d z + δ d .
ν t ,   λ = ν 0   ln 1 + i ph t ,   λ Z ,
ν t ,   λ = ν 0 ln 1 + ZR j λ I j α j + β j λ + γ j λ p j t ,
ν t ,   λ ν 0   ln 1 + ZR j λ I j α j + β j λ + ν 0 γ j λ p j t α j + β j λ ,
ν t ,   λ ac ν 0 Δ z j t z j 2 + z j 2 δ d λ z j + δ d λ ,
α j = const ,
β j t = β j 1 + b j t 1 + m t ,
γ j t = γ j 1 + m t p j t ,
I t ,   λ = j = 1 n   I j t α j + β j λ 1 + m t × 1 + b j t + γ j λ β j λ   p j t .
ac normalized ac normalized = ac p . p . + a p . p . ac p . p . = 1 + a p . p . dc p . p . .
ν j t ,   λ = ν 0   ln ZR j I j β j + ν 0   ln 1 + m t + ν 0   ln 1 + b j t + γ j λ p j t β j λ .
v jk eq t ,   λ ,   b = 0 = v j - v k = v 0   ln R j I j R k I k + v 0   ln β j λ + γ j λ p j t β k λ + γ k λ p k t ,
ν jk eq t ,   λ ,   b = 0 = ν 0   ln R j I j β j λ R k I k β k λ + ν 0 γ j λ p j t β j λ ,
ν t + T s + ν t + T s - ν t = ν t + T s + T s d ν t d t .
ν t ,   λ ν 0   ln 1 + ZR j λ I j α j + β j λ + ν 0 γ j λ p j t α j + β j λ + R a a t I j R j λ α j + β j λ ,
ν jk eq t ,   λ ,   b = 0 ,   m = 0 = ν 0   ln R j I j β j λ R k I k β k λ + ν 0 γ j λ p j t β j λ + R a a t R k I k β k λ - R j I j β j λ R k I k β k λ R j I j β j λ

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