SignificanceOur goal is to understand the root cause of reported oxygen saturation (SpO2) overestimation in heavily pigmented skin types to devise solutions toward enabling equity in pulse oximeter designs.AimWe aim to gain theoretical insights into the effect of skin tone on SpO2-R curves using a three-dimensional, four-layer tissue model representing a finger.ApproachA finger tissue model, comprising the epidermis, dermis, two arteries, and a bone, was developed using a Monte Carlo-based approach in the MCmatlab software. Two skin tones—light and dark—were simulated by adjusting the absorption and scattering properties within the epidermal layer. Following this, SpO2-R curves were generated in various tissue configurations, including transmission and reflection modes using red and infrared wavelengths. In addition, the influence of source–detector (SD) separation distances on both light and dark skin tissue models was studied.ResultsIn transmission mode, SpO2-R curves did not deviate with changes in skin tones because both pulsatile and non-pulsatile terms experienced equal attenuation at red and infrared wavelengths. However, in reflection mode, measurable variations in SpO2-R curves were evident. This was due to differential attenuation of the red components, which resulted in a lower perfusion index at the red wavelength in darker skin. As the SD separation increased, the effect of skin tone on SpO2-R curves in reflection mode became less pronounced, with the largest SD separation exhibiting effects similar to those observed in transmission mode.ConclusionsMonte Carlo simulations have demonstrated that different light pathlengths within the tissue contribute to the overestimation of SpO2 in people with darker skin in reflection mode pulse oximetry. Increasing the SD separation may mitigate the effect of skin tone on SpO2 readings. These trends were not observed in transmission mode; however, further planned research using more complex models of the tissue is essential.
Fibre Bragg grating (FBG) optical fibre sensors provide highly sensitive measurements of mechanical movements of the skin surface. However, state of the art interrogators are bulky, bench top components that are not compatible with long term, ambulatory monitoring. We are interested in continuous blood pressure monitoring. The standard techniques for blood pressure measurements face several difficulties due to the continuous measurement of blood pressure requires an invasive procedure by arterial catheterisation, whereas the standard non-invasive devices do not provide a continuous reading.
The wearable/ambulatory FBG interrogator consists of a miniature interrogator (FiSpec FBG X100, FiSens, Rolleiwerke GmbH) and a microcontroller (ESP32 WROOM 32D, Espressif, Shanghai) communicated using UART, then signal information transmitted is parsed in the microcontroller and streamed in a web application via Wi-Fi. The power management of the device uses batteries with a typical cycle life of 300 – 500 (charge, discharge cycles). Using this device, the movement in blood vessels due to pulsatile blood flow synchronous to the cardiac cycle was measured in a human participant. Moreover Pulse Transit Time (PTT) measurements for continuous blood pressure were performed in a cardiovascular phantom.
Compression therapy is a widespread clinical treatment requiring the application of therapeutic pressures to the lower limbs of patients using bandages or hosiery. The amount of pressure applied to the limb is critical in promoting patient recovery. Initial results from a fibre optic cantilever pressure sensor incorporating Fibre Bragg Gratings (FBGs) are reported. Calibration and bandaging experiments performed on a phantom leg model are presented, alongside a comparison to a reference sub-bandage pressure monitor. The proposed sensor shows increased pressure sensitivity in comparison to a previously reported design in which an FBG is encapsulated in a polymer and shows potential for application in the context of healthcare wearables.
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