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`Measurement site and photodetector size considerations in
`optimizing power consumption of a wearable reflectance pulse
`oximeter
`Publisher: IEEE
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`Y. Mendelson ; C. Pujary All Authors
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`Abstract
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`Document Sections
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`1.
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`Introduction
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`II. METHODOLOGY
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`III. RESULTS
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`IV. Discussion
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`V. Conclusion
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`Abstract:Site selection and power consumption play a crucial role in optimizing the
`design of a wearable pulse oximeter for long-term telemedicine application. In this study
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`Abstract:
`Site selection and power consumption play a crucial role in optimizing the design of a
`wearable pulse oximeter for long-term telemedicine application. In this study we
`investigated the potential power saving in the design of a reflectance pulse oximeter
`taking into consideration measurement site and sensor configuration. In-vivo
`experiments suggest that battery longevity could be extended considerably by
`employing a wide annularly shaped photodetector ring configuration and performing
`SpO/sub 2/ measurements from the forehead region.
`
`Published in: Proceedings of the 25th Annual International Conference of the IEEE
`Engineering in Medicine and Biology Society (IEEE Cat. No.03CH37439)
`
`Date of Conference: 17-21 Sept. 2003
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`INSPEC Accession Number: 7954280
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`Date Added to IEEE Xplore: 05 April 2004
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`DOI: 10.1109/IEMBS.2003.1280775
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`Print ISBN:0-7803-7789-3
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`Publisher: IEEE
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`Print ISSN: 1094-687X
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`Conference Location: Cancun, Mexico
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` Contents
`
`1. Introduction
`Noninvasive pulse oximetry is a widely accepted method for monitoring
`arterial hemoglobin oxygen saturation (SpO ). Oxygen saturation is an
`Sign in to Continue Reading
`2
`important physiological variable since insufficient oxygen supply to vital
`organs can quickly lead to irreversible brain damage or result in death.
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`Proceedings oflhe 25'Annual lnlemational Conference of the IEEE EMBS
`Cancun, Mexico. September 17-21,2003
`Measurement Site and Photodetector Size Considerations iin Optimizing Power
`Consumption of a Wearable Reflectance Pulse (Oximeter
`Y. Mendelson, Ph.D., C. Pujary, B.E.
`Department of Biomedical Engineering, and Bioengineering Institute
`Worcester Polytechnic Institute, Worcester, MA 01609, USA
`
`Keywords- pulse oximeter, wearable sensors, telemedicine
`
`1. INTRODUCTION
`
`Absrroct- Site selection and power consumption play a
`crucial role in optimizing the design of a wearable pulse
`oximeter for long-term telemedicine application. I n this study
`we investigated the potential power saving in the design of a
`reflectance pulse oximeter
`taking
`into
`consideration
`measurement
`site
`and
`sensor
`configuration.
`In-vivo
`experiments suggest that battery longevity could he extended
`considerably by employing a wide annularly
`shaped
`pholodetector
`ring configuration and performing SpOl
`measurements from (he forehead region.
`
`because of the relative1.y thin skin covering the skull
`combined with a higher density of blood vessels. On the
`contrary, other anatomical locations, such as the limbs or
`torso, have a much lower density of blood vessels and, in
`lack a dominant skeletal structure
`in close
`addition,
`proximity to the skin that helps to reflect some of the
`the AC components of the
`incident
`light. Therefore,
`reflected PPGs from these body locations are considerably
`it is more difficult to perform
`smaller. Consequently,
`accurate pulse oximetry measurement from these body
`locations without enhancing cutaneous circulation using
`artificial vasodilatation.
`transmission or
`commercial
`Sensors used with
`reflection pulse oximeters employ a single PD element,
`is a widely accepted
`Noninvasive pulse oximetry
`typically with an active area of ahout 12-15mm2. Normally,
`method
`for monitoring arterial hemoglobin oxygen
`a relatively small PD chip is adequate for measuring strong
`saturation (SpO,). Oxygen saturation
`is an important
`transmission PPGs since most of the light emitted from the
`physiological variable since insufficient oxygen supply to
`LEDs is diftksed by the skin and subcutaneous tissues
`vital organs can quickly lead to irreversible brain damage or
`predominantly in a forward-scattering direction. However,
`result in death.
`in reflection mode, only a small fraction of the incident light
`is based on
`spectrophotometric
`Pulse oximetry
`is backscattered by the subcutaneous layers. Additionally,
`measurements of changes in blood color. The method relies
`the backscattered light intensity reaching the skin surface is
`on the detection of a photoplethysmographic (PPG) signal
`normally distributed over a relatively large area surrounding
`produced by variations in the quantity of arterial blood
`the LEDs. Hence, the de:sign of a reflectance-mode pulse
`associated with periodic cardiac contraction and relaxation.
`oximeter depcnds on the ability to fabricate a sensor that has
`improved sensitivity and can detect sufficiently strong PPGs
`Pulse oximeter sensors are comprised of light emitting
`from various
`locations on
`the body combined with
`diodes (LEDs) and a silicon photodetector (PD). Typically,
`sophisticated digital sig,nal algorithms
`to process
`the
`a red (R) LED with a peak emission wavelength around 660
`relatively weak and often noisy signals.
`nm, and an infrared (IR) LED with a peak emission
`wavelength around 940 nm are used as light sources. SpO,
`To improve the accuracy and reliability of reflection
`values are derived based on an empirically calibrated
`pulse oximeters, several sensor designs have been described
`function by which the time-varying (AC) signal component
`based on a radial arrangement of discrete PDs or LEDs. For
`is divided by
`the
`the PPG at each wavelength
`of
`and Konig et al [ 3 ]
`example, Mendelson et al [1]-[Z]
`corresponding time-invariant (DC) component which is due
`addressed the aspect of unfavorable SNR by developing a
`to light absorption and scattering by bloodless tissue,
`reflectance sensor prototype consisting of multiple discrete
`residual arterial blood volume during diastole, and non-
`PDs mounted symmetrically around a pair of R and IR
`pulsatile venous blood.
`LEDs. Takatani et a/ [41-[5] described a different sensor
`configuration based on 10 LEDs arranged symmetrically
`in either
`SpO, measurements can be performed
`around a single PD chip.
`transmission or reflection modes. In transmission mode, the
`sensor is usually attached across a fingertip or earlobe such
`The U S military has
`long been
`in
`interested
`that the LEDs and PD are placed on opposite sides of a
`combining noninvasive physiological sensors with wireless
`pulsating vascular bed. Alternatively, in reflection pulse
`communication and global positioning to monitor soldier's
`oximetry, the LEDs and PD are both mounted side-by-side
`vital signs in real-time. Similarly, remote monitoring of a
`facing the same side of the vascular bed. This configuration
`person's health status who is located in a dangerous
`enables measurements from multiple locations on the body
`environment, such as mountain climbers or divers, could be
`where transmission measurements are not feasible.
`beneficial. However, to gain better acceptability and address
`the unmet demand for long term continuous monitoring,
`Backscattered light ixensity can vary significantly
`several technical issues must be solved in order to design
`between different anatomical locations. For example, optical
`more compact sensors and instrumentation that are power
`reflectance from the forehead region is typically strong
`3016
`0-7803-7789-3/03/$17 .OO 02003 IEEE
`
`Authorized licensed use limited to: IEEE Staff. Downloaded on April 30,2021 at 16:48:07 UTC from IEEE Xplore. Restrictions apply.
`
`6
`
`

`

`efficient, low-weight, reliable and comfortable to wear
`before they could be used routinely in remote monitoring
`applications.
`For
`instance,
`real-time
`continuous
`physiological monitoring from soldiers during combat using
`existing pulse oximeters is unsuitable because commercial
`oximeters involve unwieldy wires connected to the sensor,
`and sensor attachment to a fingertip restrains normal
`activity. Therefore, there is a need to develop a battery-
`efficient pulse oximeter
`that could monitor oxygen
`saturation and heart rate noninvasively from other locations
`on the body besides the fingertips.
`To meet future needs, low power management without
`compromising signal quality becomes a key requirement in
`optimizing
`the .design of a wearable pulse oximeter.
`However, high brightness LEDs commonly used in pulse
`oximeters requires relatively high current pulses, typically
`in the range between 100-2OOmA. Thus, minimizing the
`drive currents supplied to the LEDs would contribute
`considerably toward the overall power saving in the design
`of a more efficient pulse oximeter, particularly in wearable
`wireless applications. In previous studies we showed that
`the driving currents supplied to the LEDs in a reflection and
`transmission pulse oximeter sensors could be lowered
`significantly without compromising the quality of the PPGs
`by increasing the overall size of the PD [6]-[8]. Hence, by
`maximizing the light collected by the sensor, a very low
`power-consuming sensor could be developed,
`thereby
`extending the overall battery life of a pulse oximeter
`intended for telemedicine applications. In this paper we
`investigate the power savings achieved by widening the
`overall active area of the PD and comparing the LEDs
`driving currents required to produce acceptable PPG signals
`from the wrist and forehead regions as two examples of
`convenient body locations for monitoring Sp02 utilizing a
`prototype reflectance pulse oximeter.
`
`11. METHODOLOGY
`A . Experimental setup
`To study the potential power savings, we constructed a
`prototype reflectance sensor comprising twelve identical
`Silicon PD chips (active chip area: 7” x 3mm) and a pair
`of R and IR LEDs. As shown schematically in Fig. 1, six
`PDs were positioned in a close inner-ring configuration at a
`radial distance of 6.0mm from the LEDs. The second set of
`six PDs spaced equally along an outer-ring, separated from
`the LEDs by a radius of 10.0mm. Each cluster of six PDs
`were wired in parallel and connected through a central hub
`to the common summing input of a current-to-voltage
`converter. The analog signals from the common current-to-
`voltage converter were subsequently separated into AC and
`DC components by signal conditioning circuitry. The analog
`signal components were then digitized at a 50Hz rate for 30
`seconds intervals using a National Instruments DAQ card
`installed in a PC under the control of a virtual instrument
`implemented using LabVIEW 6.0 softwarc.
`
`Fig. 1. Prototype reflectance sensor configuration showing the relative
`positions of the rectangular-shaped PDs and the LEDs.
`B. In Vivo Experiments
`A series of in vivo experiments were performed to
`quantify and compare the PPG magnitudes measured by the
`two sets of six PDs. The prototype sensor was mounted on
`the dorsal side of the wrist or the center of the forehead
`below
`the hairline. These representative regions were
`selected as two target locations for the development of a
`wearable telesensor because they provide a flat surface for
`mounting a reflectance sensor which for example could be
`incorporated into a wrist watch device or attached to a
`soldier’s helmet without using a double-sided adhesive tape.
`After the sensor was securely attached, the minimum peak
`currents flowing through each LED was adjusted while the
`output of the amplifier was monitored continuously to
`assure that distinguishable and stable PPGs were observed
`from each set of PDs and the electronics were not saturated.
`Two sets of measurements were acquired from each
`body location. In the first set of experiments we kept the
`currents supplied to the LEDs at a constant level and the
`magnitude of the PPGs measured from each set of six PDs
`were compared. To estimate the minimum peak currents
`required to drive the LEDs for the near and far-positioned
`PDs, we performed a second series of measurements where
`the driving currents were adjusted until the amplitude of the
`respective PPG reached approximately a constant amplitude.
`
`111. RESULTS
`Typical examples of reflected PPG signals measured by
`the inner set of six PDs from the forehead and wrist for a
`constant peak LED current (R: 8.5mA, IR. 4.21~4) are
`plotted respectively in Fig. 2.
`The relative RMS amplitudes of the PPG signals
`measured by the six near (N) and far (F) PDs, and the
`combination of all 12 PDs (N+F) are plotted in Fig. 3(a) and
`3(b) for a peak R LED drive current of 8.5mA and a peak IR
`LED drive current of 4.2mA, respectively. Analysis of the
`data revealed that there is a considerable difference between
`the signals measured by each set of PDs and amplitude of
`the respective PPG signals depends on measurement site.
`
`3017
`
`Authorized licensed use limited to: IEEE Staff. Downloaded on April 30,2021 at 16:48:07 UTC from IEEE Xplore. Restrictions apply.
`
`7
`
`

`

`Fig. 2. Raw PPG signals measured from the forehead ( 0 and b) and wnst
`(c and d) for constant LEU driving currents.
`
`(a)
`
`0 Wrist
`
`0 Forehead
`
`0.8
`
`i
`0.7 1
`0 6 ; 0.5
`=
`1 0.4
`E
`4 0.3
`0 :: 0 2
`
`0 1
`
`0
`
`I
`
`N
`
`F
`
`N + F
`
`I
`
`1.6
`
`(b)
`
`0 Wrist
`
`0 Forehead
`
`0.89
`
`m
`
`I
`
`0 1.2
`
`D 2 - 1 -
`P E 0.8
`4
`0 0.6 -
`n
`0.4 -
`0.2
`
`~
`
`~
`
`E
`
`-
`a 20
`E 1 5 - ! 6 1 0 ~
`
`9.50
`
`I
`
`-r-
`
`N
`
`--
`
`F
`
`~
`
`N + F
`
`i
`
`Fig. 4. Relative LEU peak driving currents required to maintain a constant
`PPG amplitude of 0.840V RMS for the near (N), far (F) and
`combination (N+F) PU configurations. Measurements were
`oblained from the forehead.
`
`IV. DlSCUSSiON
`The successful design of a practical wearable pulse
`oximeter presents several unique challenges. In addition to
`user acceptability, the other most important issues are sensor
`placement and power consumption. For example, utilizing
`disposable tape or a reusable spring-loaded device for
`attachment of pulse oximeter sensors, as commonly
`practiced in clinical medicine, poses significant limitations,
`especially in ambulatory applications.
`Several studies have shown that oximetry readings may
`vary significantly according to sensor location. For example,
`tissue blood volume varies in different parts of the body
`depending on the number and arrangement of blood vesscls
`near the surface of the skin. Other factors, such as sensor-to-
`skin contact, can influence the distribution of blood close to
`the skin surface and consequently can cause erroneous
`readings. Therefore, to ensure consistent performance, it is
`important to pay close attention to the design of optical
`sensors used in reflectance pulse oximetry and the selection
`of suitable sites for sensor attachment.
`The current consumed by the LEDs in a battery
`powered pulse oximeter is inversely proportional to the
`battery life. Hence, minimizing the current required to drive
`the LEDs is a critical design consideration, particularly in
`optimizing the overall power consumption of a wearable
`pulse oximeter. However, reduced LED driving currents
`directly impacts the incident light intensity and, therefore,
`could lead to deterioration in the quality of the measured
`PPGs. Consequently, lower LED drive currents could result
`in unreliable and inaccurate reading by a pulse oximeter.
`From the data presented in Fig. 2, it is evident that the
`amplitude and quality of
`the
`recorded PPGs vary
`significantly between the forehead and the wrist. We also
`observed that using relatively
`low peak LED driving
`currents, we had to apply a considerable amount of external
`pressure on the sensor in order to measure discernable PPG
`
`N
`
`F
`
`N + F
`
`I
`
`Fig. 3. PPG signal amplihrdes measured by the near (N), far (F) and
`combination (N+F) PDs from the wrist and forehead for
`constant R and IR LED drive currents corresponding to 8.5mA
`(a) and 4.2mA (b), respectively.
`
`Fig. 4 compares the relative peak LED currents required to
`maintain a constant AC RMS amplitude of approximately
`0.840(+0.017)V for the N, F and (N+F) PDs measured from
`the forehead.
`
`3018
`
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`
`8
`
`

`

`power demand imposed by othai components of a wearable
`pulse oximeter. Nevertheless, the considerable differences
`in the estimated power consumptions clearly points out the
`practical advantage gained by using a reflection sensor
`comprising a large ring-shaped PD area to perform SpOa
`measurements from the forehead region.
`
`V. CONCLUSION
`Site selection and LED driving currents are critical
`in optimizing the overall power
`design consideration
`consumption of a wearable battery-operated reflectance
`pulse oximeter. In this study we investigated the potential
`in a
`power saving
`ring-shaped sensor configuration
`comprising
`two sets of photodetectors arranged
`in a
`concentric ring configuration. In-vivo experiments revealed
`that battery longevity could he extended considerably by
`employing a wide annular PD and
`limiting SpOz
`measurements to the forehead region.
`
`ACKNOWLEDGMENT
`the support by
`the
`We gratefully acknowledge
`Department of Defense under Cooperative Agreement
`DAMD 17-03-2-0006.
`
`REFERENCES
`[ I ] Y. Mendelson, J.C. Kent. B.L. Yocum and M.J. Birle, "Design and
`Evaluation of new reflectance pulse oximeter sensor," Medico1
`Vol. 22, no. 4 , pp. 167-173, Aug. 1988.
`I n ~ i r ~ m e n ~ a ~ i ~ n ,
`[2] Y. Mendelson, M.I. McGinn, "Skin reflectance pulse oximetry: in vivo
`measuremenls from the forearm and calf," Journal o/Clinicai Moniroring,
`Vol.37(l),pp.7-12, 1991.
`[3] V . Konig, R. Ruch, A. Huch, "Reflectance pulse oximetry - principles
`and obstetric application in the Zurich system," Journal of Clinicol
`Moniroring,Vol. 14, pp. 403-412, 1998.
`[4] S . Takatani, C. Davits, N. Sakakibara, ct al, "Experimental and clinical
`evaluation of a noninvasive reflectance pulse oximeter scnsor," Josmol.
`Clinical M ~ n i I ~ r i n g . 8(4), p p . 257-266, 1992.
`151 M. Nogawa, C.T. Ching, T. Ida, K. Itakura, S. Takatani, "A new hybrid
`reflectance optical pulse oximetry sensor for lower oxygen saturation
`measurement and for broader clinical application," in Pioc SPIE, Vol.
`2976, pp. 78-87, 1997.
`[6] C. Pujary, M. Savage, Y. Mendelson, "Photodetector size considerations
`in the design of a noninvasive reflectance pulse oximeter for tclemedicine
`applications," in Proe. IEEE 2Y" Annu. Northeast Bioengineering Conf,
`Newark, USA, 2003.
`171 M. Savage, C. Pujary, Y. Mendelson, "Optimizing power consumption
`in the design of a wearable wireless telesensor: Comparison of pulse
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`
`I
`
`PD CONFIGURATION
`
`BATTERY LIFE [Days]
`
`I
`
`20.3
`Far
`52.5
`Near+Far
`Note that the estimated values given in Table 1 are very
`conservative since they rely only on the power consumed by
`the LEDs without taking into consideration the additional
`
`3019
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