Generalized pulse oximetry method for persons of all skin pigmentations
The present invention is an in vivo non-invasive method and apparatus for the measurement of the arterial blood oxygen saturation status of a patient, the method is a generalized improvement on conventional pulse oximetry to correct for its skin pigmentation bias and significant errors in oxygen saturation assessment in the presence of methemoglobin. The method requires an additional red light sensor with an infrared long pass filter to conventional pulse oximetry, and utilizes red and infrared light and sensors to non-invasively measure the peripheral pulse optical plethysmograph waveforms (PPG) at three light wavelengths, red, long pass red and infrared, positioned over a finger, or ear or other extremity, and from the pulse oximetric ratio of ratios transforms the PPG measurements by a processing device that determines the subject's arterial blood oxygen saturation directly, without the need for an empirical correction as is required in conventional pulse oximetry. The method determines the red transmitted light waveform and thus quantifies the wavelength shift from the incident red light due to the subject's skin pigmentation, and from in vivo hemoglobin extinction coefficients, determines the relative concentrations of oxygenated and deoxygenated hemoglobin and methemoglobin in the subject's arterial blood.
1 . A method of quantifying the arterial blood oxygen saturation status and hemoglobin concentrations of a patient in near real time, the method comprising the steps of:
a) Place a transmission pulse optical plethysmograph device on a patient;
b) Determine the maxima and minima of the optical plethysmograph waveforms over a cardiac cycle for red, long pass red and infrared light wavelengths, wherein the long pass red wavelength results from filtering the red light waveform with a long pass red filter;
c) Determine the ratios of extinction functions for the three light wavelengths and the illuminance ratio of the long pass red to red waveforms, to quantify the wavelength of the peak intensity of the transmitted red and long pass red light;
d) Determine the in vivo extinction coefficients of oxygenated, deoxygenated and methemoglobin molecules for the three transmitted wavelengths, and compute the concentrations of these three hemoglobin molecules in the arterial blood; and
e) Display the arterial blood oxygen saturation status and hemoglobin concentrations of the patient.
2 . The method of claim 1 , wherein the device is a red and infra-red pulse optical plethysmograph sensor with an additional red light sensor fitted with an infrared long pass filter.
3 . The method of claim 2 , wherein the device is a red and infra-red pulse optical plethysmograph sensor with the additional red light sensor being a chirped photodiode or chirped phototransistor.
4 . The method of claim 1 , wherein the pulse optical plethysmograph sensor has a motion piezoelectric sensor attached.
5 . The method of claim 4 , wherein the pulse optical plethysmograph waveforms PPG are collected only when the motion piezoelectric sensor is below threshold motion criteria.
6 . The method of claim 1 , wherein the constructed transmitted red light waveform is of a skewed normal distribution.
7 . The method of claim 1 , wherein the device is a red and infra-red pulse optical plethysmograph sensor with a second red light sensor fitted with an infrared long pass filter, a third red light sensor fitted with a short pass filter to provide four (4) wavelength measurements of the ratio of ratios, determine the in vivo extinction coefficients of oxygenated, deoxygenated, methemoglobin and carboxyhemoglobin molecules for the four transmitted wavelengths, and compute the concentrations of these four hemoglobin molecules in the arterial blood.
8 . The method of claim 7 , wherein the device is a red and infra-red pulse optical plethysmograph sensor with the additional red light sensors being chirped photodiodes or chirped phototransistors.
9 . A pulse oximeter comprising:
a) a red light emitting diode or transistor for emitting a red light and an infrared light emitting diode or transistor for admitting and infrared light, the red light emitting diode or transistor and the infrared light emitting diode or transistor mounted adjacent to one side of a patient's finger or earlobe;
b) an infrared light sensor mounted on a second side of the patient's finger or earlobe, for receiving the infrared light, and producing an infrared light waveform;
c) a first red light sensor mounted on the second side of the patient's finger or earlobe, for receiving the red light, and producing a red light waveform; and
d) a second red light sensor mounted on the second side of the patient's finger or earlobe, the second red light sensor having a long pass red input filter located over the second red light sensor for producing a long pass red waveform in response to red light passing through the long pass red light filter,
wherein the infrared light waveform, the red light waveform, and the long pass red waveform represent data that is accurate for patients with varying pigmentation.