title: Pulse oximetry in the pulmonary tissue for the non-invasive measurement of mixed venous oxygen saturation.
abstract: The oxygen saturation of the systemic arterial blood is associated with the adequacy of respiration, and can be measured non-invasively by pulse oximetry in the systemic tissue. The oxygen saturation of the blood in the pulmonary artery, the mixed venous blood, reflects the balance between oxygen supply to the systemic tissues and their oxygen demand. The mixed venous oxygen saturation has also clinical significance because it is used in Fick equation for the quantitative measurement of cardiac output. At present the measurement of the mixed venous oxygen saturation is invasive and requires insertion of a Swan-Ganz catheter into the pulmonary artery. We suggest a noninvasive method for the measurement of the mixed venous oxygen saturation in infants, pulmonary pulse oximetry. The method is similar to the systemic pulse oximetry, which is based on the different light absorption curves of oxygenated and deoxygenated hemoglobin and on the analysis of photoplethysmographic curves in two wavelengths. The proposed pulmonary pulse oximeter includes light-sources of two wavelengths in the infrared, which illuminate the pulmonary tissue through the thoracic wall. Part of the light which is scattered back from the pulmonary tissue and passes through the thoracic wall is detected, and for each wavelength a pulmonary photoplethysmographic curve is obtained. The pulmonary photoplethysmographic curves reflect blood volume increase during systole in the pulmonary arteries in the lung tissue, which contain mixed venous blood. The ratio R of the amplitude-to-baseline ratio for the two wavelengths is related to the mixed venous oxygen saturation through equations derived for the systemic pulse oximetry. The method requires the use of extinction coefficients values for oxygenated and deoxygenated hemoglobin, which can be found in the literature.
authors.affiliation: Department of Applied Physics/Medical Engineering, Jerusalem College of Technology, 21 Havaad Haleumi Street, POB 16031, Jerusalem 91160, Israel. nitzan@jct.ac.il
authors.forename: Meir
authors.initials: M
authors.lastname: Nitzan
authors.forename: Itamar
authors.initials: I
authors.lastname: Nitzan
mesh_terms: D006801:Humans; D008168:Lung / Q000378:metabolism*; D008962:Models, Theoretical; D010092:Oximetry / Q000379:methods*; D010100:Oxygen / Q000097:blood*; D014680:Veins / Q000378:metabolism*
chemical_list: D010100:Oxygen