Abstract

It is now possible to make continuous in vivo measurements of the oxygen saturation and total cardiac output of a patient on a real time basis by using the recently developed technique of fiber optics spectrophotometry. This paper describes instrumental features of a fiber optics oximeter–densitometer which has been used on experimental animals as well as on human beings for the measurement of oxygen saturation and dye concentration. The in vivo measurement made possible with this remote spectrophotometer has shown significant advantages over the in vitro method, which in the past has required withdrawal of blood samples and subsequent measurements with attendant time delays and inaccuracies. This instrument allows the correlation of oxygen saturation variations in various regions within the heart with intercardiac, ECG, and pressure measurements. The clinical data on this instrument have demonstrated its value in the diagnosis of heart defects.

© 1967 Optical Society of America

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  1. N. S. Kapany, N. Silbertrust, Nature 204, 138 (1964).
    [CrossRef]
  2. M. L. Polanyi, R. M. Hehir, Rev. Sci. Instr. 33, 1050 (1962).
    [CrossRef]
  3. Y. Enson, W. A. Briscoe, W. L. Polanyi, A. Cournand. J. Appl. Physiol. 17, 552 (1962).
  4. Y. Enson, A. G. Jameson, A. Cournand. Circulation 29, 499 (1964).
    [CrossRef]
  5. W. J. Gamble, P. G. Hugenholtz, M. L. Polanyi, R. G. Monroe, A. S. Nadas, Circulation 31, 328 (1965).
    [CrossRef]
  6. P. G. Hugenholtz, W. J. Gamble, R. G. Monroe, M. L. Polanyi, Circulation 31, 344 (1965).
    [CrossRef]
  7. P. L. Frommer, J. Ross, D. R. Mason, J. H. Gault, E. Braunwald, Am. J. Cardiol. 15, 672 (1965).
    [CrossRef]
  8. D. C. Harrison, N. S. Kapany, H. A. Miller, N. Silbertrust, W. L. Henry, R. P. Drake, Am. Heart J. 71, 766 (1966).
    [CrossRef] [PubMed]
  9. W. G. Zijlstra, A Manual of Reflection Oximetry (Van Gorcum’s Medical Library, NR 152, Assen, The Netherlands, 1958).
  10. F. Bender, Naturwiss. 45, 18 (1958).
    [CrossRef]
  11. E. H. Wood, in Medical Physics, O. Glasser, Ed. (Year Book Publishers, Inc., Chicago, 1950).
  12. M. L. Polanyi, R. M. Hehir, Rev. Sci. Instr. 31, 401 (1960).
    [CrossRef]
  13. D. C. Harrison, N. S. Kapany, H. A. Miller, N. Silbertrust, R. P. Drake, “Fiber Optics Oximetry for the Study of Hemodynamic Changes in Patients with Atrial Septal Defects.”

1966

D. C. Harrison, N. S. Kapany, H. A. Miller, N. Silbertrust, W. L. Henry, R. P. Drake, Am. Heart J. 71, 766 (1966).
[CrossRef] [PubMed]

1965

W. J. Gamble, P. G. Hugenholtz, M. L. Polanyi, R. G. Monroe, A. S. Nadas, Circulation 31, 328 (1965).
[CrossRef]

P. G. Hugenholtz, W. J. Gamble, R. G. Monroe, M. L. Polanyi, Circulation 31, 344 (1965).
[CrossRef]

P. L. Frommer, J. Ross, D. R. Mason, J. H. Gault, E. Braunwald, Am. J. Cardiol. 15, 672 (1965).
[CrossRef]

1964

N. S. Kapany, N. Silbertrust, Nature 204, 138 (1964).
[CrossRef]

Y. Enson, A. G. Jameson, A. Cournand. Circulation 29, 499 (1964).
[CrossRef]

1962

M. L. Polanyi, R. M. Hehir, Rev. Sci. Instr. 33, 1050 (1962).
[CrossRef]

Y. Enson, W. A. Briscoe, W. L. Polanyi, A. Cournand. J. Appl. Physiol. 17, 552 (1962).

1960

M. L. Polanyi, R. M. Hehir, Rev. Sci. Instr. 31, 401 (1960).
[CrossRef]

1958

F. Bender, Naturwiss. 45, 18 (1958).
[CrossRef]

Bender, F.

F. Bender, Naturwiss. 45, 18 (1958).
[CrossRef]

Braunwald, E.

P. L. Frommer, J. Ross, D. R. Mason, J. H. Gault, E. Braunwald, Am. J. Cardiol. 15, 672 (1965).
[CrossRef]

Briscoe, W. A.

Y. Enson, W. A. Briscoe, W. L. Polanyi, A. Cournand. J. Appl. Physiol. 17, 552 (1962).

Cournand, A.

Y. Enson, A. G. Jameson, A. Cournand. Circulation 29, 499 (1964).
[CrossRef]

Y. Enson, W. A. Briscoe, W. L. Polanyi, A. Cournand. J. Appl. Physiol. 17, 552 (1962).

Drake, R. P.

D. C. Harrison, N. S. Kapany, H. A. Miller, N. Silbertrust, W. L. Henry, R. P. Drake, Am. Heart J. 71, 766 (1966).
[CrossRef] [PubMed]

D. C. Harrison, N. S. Kapany, H. A. Miller, N. Silbertrust, R. P. Drake, “Fiber Optics Oximetry for the Study of Hemodynamic Changes in Patients with Atrial Septal Defects.”

Enson, Y.

Y. Enson, A. G. Jameson, A. Cournand. Circulation 29, 499 (1964).
[CrossRef]

Y. Enson, W. A. Briscoe, W. L. Polanyi, A. Cournand. J. Appl. Physiol. 17, 552 (1962).

Frommer, P. L.

P. L. Frommer, J. Ross, D. R. Mason, J. H. Gault, E. Braunwald, Am. J. Cardiol. 15, 672 (1965).
[CrossRef]

Gamble, W. J.

P. G. Hugenholtz, W. J. Gamble, R. G. Monroe, M. L. Polanyi, Circulation 31, 344 (1965).
[CrossRef]

W. J. Gamble, P. G. Hugenholtz, M. L. Polanyi, R. G. Monroe, A. S. Nadas, Circulation 31, 328 (1965).
[CrossRef]

Gault, J. H.

P. L. Frommer, J. Ross, D. R. Mason, J. H. Gault, E. Braunwald, Am. J. Cardiol. 15, 672 (1965).
[CrossRef]

Harrison, D. C.

D. C. Harrison, N. S. Kapany, H. A. Miller, N. Silbertrust, W. L. Henry, R. P. Drake, Am. Heart J. 71, 766 (1966).
[CrossRef] [PubMed]

D. C. Harrison, N. S. Kapany, H. A. Miller, N. Silbertrust, R. P. Drake, “Fiber Optics Oximetry for the Study of Hemodynamic Changes in Patients with Atrial Septal Defects.”

Hehir, R. M.

M. L. Polanyi, R. M. Hehir, Rev. Sci. Instr. 33, 1050 (1962).
[CrossRef]

M. L. Polanyi, R. M. Hehir, Rev. Sci. Instr. 31, 401 (1960).
[CrossRef]

Henry, W. L.

D. C. Harrison, N. S. Kapany, H. A. Miller, N. Silbertrust, W. L. Henry, R. P. Drake, Am. Heart J. 71, 766 (1966).
[CrossRef] [PubMed]

Hugenholtz, P. G.

W. J. Gamble, P. G. Hugenholtz, M. L. Polanyi, R. G. Monroe, A. S. Nadas, Circulation 31, 328 (1965).
[CrossRef]

P. G. Hugenholtz, W. J. Gamble, R. G. Monroe, M. L. Polanyi, Circulation 31, 344 (1965).
[CrossRef]

Jameson, A. G.

Y. Enson, A. G. Jameson, A. Cournand. Circulation 29, 499 (1964).
[CrossRef]

Kapany, N. S.

D. C. Harrison, N. S. Kapany, H. A. Miller, N. Silbertrust, W. L. Henry, R. P. Drake, Am. Heart J. 71, 766 (1966).
[CrossRef] [PubMed]

N. S. Kapany, N. Silbertrust, Nature 204, 138 (1964).
[CrossRef]

D. C. Harrison, N. S. Kapany, H. A. Miller, N. Silbertrust, R. P. Drake, “Fiber Optics Oximetry for the Study of Hemodynamic Changes in Patients with Atrial Septal Defects.”

Mason, D. R.

P. L. Frommer, J. Ross, D. R. Mason, J. H. Gault, E. Braunwald, Am. J. Cardiol. 15, 672 (1965).
[CrossRef]

Miller, H. A.

D. C. Harrison, N. S. Kapany, H. A. Miller, N. Silbertrust, W. L. Henry, R. P. Drake, Am. Heart J. 71, 766 (1966).
[CrossRef] [PubMed]

D. C. Harrison, N. S. Kapany, H. A. Miller, N. Silbertrust, R. P. Drake, “Fiber Optics Oximetry for the Study of Hemodynamic Changes in Patients with Atrial Septal Defects.”

Monroe, R. G.

P. G. Hugenholtz, W. J. Gamble, R. G. Monroe, M. L. Polanyi, Circulation 31, 344 (1965).
[CrossRef]

W. J. Gamble, P. G. Hugenholtz, M. L. Polanyi, R. G. Monroe, A. S. Nadas, Circulation 31, 328 (1965).
[CrossRef]

Nadas, A. S.

W. J. Gamble, P. G. Hugenholtz, M. L. Polanyi, R. G. Monroe, A. S. Nadas, Circulation 31, 328 (1965).
[CrossRef]

Polanyi, M. L.

W. J. Gamble, P. G. Hugenholtz, M. L. Polanyi, R. G. Monroe, A. S. Nadas, Circulation 31, 328 (1965).
[CrossRef]

P. G. Hugenholtz, W. J. Gamble, R. G. Monroe, M. L. Polanyi, Circulation 31, 344 (1965).
[CrossRef]

M. L. Polanyi, R. M. Hehir, Rev. Sci. Instr. 33, 1050 (1962).
[CrossRef]

M. L. Polanyi, R. M. Hehir, Rev. Sci. Instr. 31, 401 (1960).
[CrossRef]

Polanyi, W. L.

Y. Enson, W. A. Briscoe, W. L. Polanyi, A. Cournand. J. Appl. Physiol. 17, 552 (1962).

Ross, J.

P. L. Frommer, J. Ross, D. R. Mason, J. H. Gault, E. Braunwald, Am. J. Cardiol. 15, 672 (1965).
[CrossRef]

Silbertrust, N.

D. C. Harrison, N. S. Kapany, H. A. Miller, N. Silbertrust, W. L. Henry, R. P. Drake, Am. Heart J. 71, 766 (1966).
[CrossRef] [PubMed]

N. S. Kapany, N. Silbertrust, Nature 204, 138 (1964).
[CrossRef]

D. C. Harrison, N. S. Kapany, H. A. Miller, N. Silbertrust, R. P. Drake, “Fiber Optics Oximetry for the Study of Hemodynamic Changes in Patients with Atrial Septal Defects.”

Wood, E. H.

E. H. Wood, in Medical Physics, O. Glasser, Ed. (Year Book Publishers, Inc., Chicago, 1950).

Zijlstra, W. G.

W. G. Zijlstra, A Manual of Reflection Oximetry (Van Gorcum’s Medical Library, NR 152, Assen, The Netherlands, 1958).

Am. Heart J.

D. C. Harrison, N. S. Kapany, H. A. Miller, N. Silbertrust, W. L. Henry, R. P. Drake, Am. Heart J. 71, 766 (1966).
[CrossRef] [PubMed]

Am. J. Cardiol.

P. L. Frommer, J. Ross, D. R. Mason, J. H. Gault, E. Braunwald, Am. J. Cardiol. 15, 672 (1965).
[CrossRef]

Circulation

Y. Enson, A. G. Jameson, A. Cournand. Circulation 29, 499 (1964).
[CrossRef]

W. J. Gamble, P. G. Hugenholtz, M. L. Polanyi, R. G. Monroe, A. S. Nadas, Circulation 31, 328 (1965).
[CrossRef]

P. G. Hugenholtz, W. J. Gamble, R. G. Monroe, M. L. Polanyi, Circulation 31, 344 (1965).
[CrossRef]

J. Appl. Physiol.

Y. Enson, W. A. Briscoe, W. L. Polanyi, A. Cournand. J. Appl. Physiol. 17, 552 (1962).

Nature

N. S. Kapany, N. Silbertrust, Nature 204, 138 (1964).
[CrossRef]

Naturwiss.

F. Bender, Naturwiss. 45, 18 (1958).
[CrossRef]

Rev. Sci. Instr.

M. L. Polanyi, R. M. Hehir, Rev. Sci. Instr. 31, 401 (1960).
[CrossRef]

M. L. Polanyi, R. M. Hehir, Rev. Sci. Instr. 33, 1050 (1962).
[CrossRef]

Other

W. G. Zijlstra, A Manual of Reflection Oximetry (Van Gorcum’s Medical Library, NR 152, Assen, The Netherlands, 1958).

D. C. Harrison, N. S. Kapany, H. A. Miller, N. Silbertrust, R. P. Drake, “Fiber Optics Oximetry for the Study of Hemodynamic Changes in Patients with Atrial Septal Defects.”

E. H. Wood, in Medical Physics, O. Glasser, Ed. (Year Book Publishers, Inc., Chicago, 1950).

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Figures (7)

Fig. 1
Fig. 1

Schematic and block diagram of the fiber optics in vivo oximeter and catheter for continuously monitoring oxygen saturation.

Fig. 2
Fig. 2

A dual recording showing the oxygen saturation variations related to the intracardiac electrocardiogram of a patient with atrial septal defect (a heart defect in which blood is shunted through an abnormal hole in the wall between the left and right sides of the heart). In this recording the fiber optics catheter is withdrawn from the left ventricle into the left atrium then through the hole in the atrial septum and then into the superior vena cava.

Fig. 3
Fig. 3

(A) X-ray photograph of an intracardiac fiber optics catheter in a human. The catheter has been passed down the superior vena cava through the right atrium and ventricle and into the pulmonary artery where the tip is seen in the figure. (B) Schematic diagram of cardiac catheter introduced into the right side of the heart.

Fig. 4
Fig. 4

Intracardiac catheters: (A) fiber optics bundle encased in a polyethylene tube and inserted into a 9 French Teflon catheter. The fiber optics extends to the proximal end of the “bird’s eye” and an annular space is left for sampling the blood. (B) fiber optics potted into a 7 French electrode catheter. The platinum electrode at the tip can be used for intracardiac ECG. (C) fiber optics in one lumen of a 7 French double-lumen catheter. The other lumen is used for sampling and pressure monitoring.

Fig. 5
Fig. 5

Intravascular fiber optics catheters: (A) fiber optics bundle inside of a large catheter which provides an annular space for withdrawing samples and monitoring pressure; and (C) an 0.038-in. (1-mm) fiber bundle in a Teflon tube which can be inserted into the vascular system through the needle (B).

Fig. 6
Fig. 6

Typical record from a dog that was ventilated on 8% oxygen. The absolute oxygen saturation scale is shown at the left and various events which were changed are listed in the margins. Note the rapid return to 95% oxygen saturation in the arterial blood upon ventilation with 100% oxygen.

Fig. 7
Fig. 7

Oximeter recording of a patient with an atrial septal defect. Note the higher oxygen saturation in the right ventricle and pulmonary artery which follows the shunt as compared with the lower saturation of the superior and inferior venae cavae. The right atrium in which the mixing occurs has an oxygen saturation that is between these two levels.

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