Skip to main content
SpringerLink
Log in

A procedure for determining subject-specific pulse oxygen saturation response

  • Original Article
  • Published:
Medical & Biological Engineering & Computing Aims and scope Submit manuscript

Abstract

The oxyhemoglobin dissociation curve describes the relationship between the partial pressure of oxygen and the percent of hemoglobin saturated with oxygen and varies with chemical and physical factors that differ for every patient. If variability could be determined, patient-specific oxygen therapy could be administered. We have developed a procedure for characterizing variations in the oxygen dissociation curve. The purpose of this study was to validate this procedure in surgical patients. The procedure uses an automated system to alter oxygen therapy during surgery, within safe operational levels, and fit to Hill’s equation non-invasive measurements of end-tidal oxygen and peripheral pulse oxygen saturation. The best-fit parameters for the Hill equation, estimated by iterative least squares, provide an apparent dissociation curve, meaningful of the patient-specific pulse oximeter response. Thirty-nine patients participated in this study. Using patient-specific parameter values increases correlation when compared with standard values. The procedure improved the model fit of patient saturation values significantly in 19 patients. This paper has demonstrated a procedure for determining patient-specific pulse oximeter response. This procedure determined best-fit parameters resulting in a significantly improved fit when compared with standard values. These best-fit parameters increased the coefficient of determination R2 in all cases.

This patient-specific procedure improves fit significantly compared to standard estimates

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Applegate RL II, Dorotta IL, Wells B, Juma D, Applegate PM (2016) The relationship between oxygen reserve index and arterial partial pressure of oxygen during surgery. Anesthesia and Analgesia 123(3):626

    Article  CAS  Google Scholar 

  2. Averick BM, Carter RG, Xue GL, More J (1992) The minpack-2 test problem collection. Tech. rep., Argonne National Lab., IL (United States)

  3. Berg JM, Tymoczko JL, Stryer L (2002) Hemoglobin transports oxygen efficiently by binding oxygen cooperatively. WH Freeman & Co, New York

    Google Scholar 

  4. Brockway J, Hay WW Jr (1998) Prediction of arterial partial pressure of oxygen with pulse oxygen saturation measurements. The Journal of Pediatrics 133(1):63–66

    Article  CAS  Google Scholar 

  5. Buerk DG, Bridges EW (1986) A simplified algorithm for computing the variation in oxyhemoglobin saturation with ph, pco2, t and dpg. Chem Eng Commun 47(1-3):113–124

    Article  CAS  Google Scholar 

  6. Burk KM, Kuck K, Orr JA Evaluation and application of a method for estimating nasal end-tidal o 2 fraction while administering supplemental o 2. Journal of Clinical Monitoring and Computing: 1–10

  7. Burk KM, Sakata DJ, Kuck K, Orr JA (2019) Comparing nasal end-tidal carbon dioxide measurement variation and agreement while delivering pulsed and continuous flow oxygen in volunteers and patients. Anesthesia and Analgesia

  8. Collins JA, Rudenski A, Gibson J, Howard L, O’Driscoll R (2015) Relating oxygen partial pressure, saturation and content: the haemoglobin–oxygen dissociation curve. Breathe 11(3):194– 201

    Article  Google Scholar 

  9. Dash RK, Korman B, Bassingthwaighte JB (2016) Simple accurate mathematical models of blood hbo2 and hbco2 dissociation curves at varied physiological conditions: evaluation and comparison with other models. Eur J Appl Physiol 116(1):97–113

    Article  Google Scholar 

  10. Donders W, Huberts W, van de Vosse F, Delhaas T (2015) Personalization of models with many model parameters: an efficient sensitivity analysis approach. Int J Numer Method Biomed Eng 31(10)

  11. Downs JS (1994) Prevention of hypoxemia: the simple, logical, but incorrect solution. J Clin Anesth 6 (3):180–181

    Article  CAS  Google Scholar 

  12. Dubreuil S, Berveiller M, Petitjean F, Salaün M (2014) Construction of bootstrap confidence intervals on sensitivity indices computed by polynomial chaos expansion. Reliab Eng Syst Safe 121:263–275

    Article  Google Scholar 

  13. Farmery A, Roe P (1996) A model to describe the rate of oxyhaemoglobin desaturation during apnoea. Br J Anaesth 76(2):284–291

    Article  CAS  Google Scholar 

  14. Fu ES, Downs JB, Schweiger JW, Miguel RV, Smith RA (2004) Supplemental oxygen impairs detection of hypoventilation by pulse oximetry. Chest 126(5):1552–1558

    Article  Google Scholar 

  15. Gomez-Cambronero J (2001) The oxygen dissociation curve of hemoglobin: bridging the gap between biochemistry and physiology. J Chem Educ 78(6):757

    Article  CAS  Google Scholar 

  16. Hardman JG, Wills JS, Aitkenhead AR (2000) Factors determining the onset and course of hypoxemia during apnea: an investigation using physiological modelling. Anesthesia & Analgesia 90(3):619–624

    Article  CAS  Google Scholar 

  17. Hay WW, Brockway JM, Eyzaguirre M (1989) Neonatal pulse oximetry: accuracy and reliability. Pediatrics 83(5):717–722

    PubMed  Google Scholar 

  18. Heitman SJ, Atkar RS, Hajduk EA, Wanner RA, Flemons WW (2002) Validation of nasal pressure for the identification of apneas/hypopneas during sleep. American Journal of Respiratory and Critical Care Medicine 166(3):386–391

    Article  Google Scholar 

  19. Hemmings HC, Hopkins PM (2006) Foundations of anesthesia: basic sciences for clinical practice. Elsevier Health Sciences

  20. Hsia CC (1998) Respiratory function of hemoglobin. New England J Med 338(4):239–248

    Article  CAS  Google Scholar 

  21. Jones E, Oliphant T, Peterson P, et al. (2001) SciPy: open source scientific tools for Python. http://www.scipy.org/. Online: Accessed 01/01/2019

  22. Keidan I, Gravenstein D, Berkenstadt H, Ziv A, Shavit I, Sidi A (2008) Supplemental oxygen compromises the use of pulse oximetry for detection of apnea and hypoventilation during sedation in simulated pediatric patients. Pediatrics 122(2):293–298

    Article  Google Scholar 

  23. Leow MKS (2007) Configuration of the hemoglobin oxygen dissociation curve demystified: a basic mathematical proof for medical and biological sciences undergraduates. Advances in Physiology Education 31(2):198–201

    Article  Google Scholar 

  24. Myles P, Heap M, Langley M (1993) Agreement between end-tidal oxygen concentration and the alveolar gas equation: pre and post cardiopulmonary bypass. Anaesth Intensive Care 21:240–1

    Article  Google Scholar 

  25. Næraa N, Boye E (1962) The influence of simultaneous, independent changes in ph and carbon dioxide tension on the in-vitro oxygen tension-saturation relationship of human whole blood. Acta Anaesthesiol Scand 6:20–20

    Article  Google Scholar 

  26. Severinghaus J (1958) Oxyhemoglobin dissociation curve correction for temperature and ph variation in human blood. J Appl Physiol 12(3):485–486

    Article  CAS  Google Scholar 

  27. Siggaard-Andersen O, Salling N (1971) Oxygen-linked hydrogen ion binding of human hemoglobin. effects of carbon dioxide and 2, 3-diphosphoglycerate. ii. studies on whole blood. Scandinavian Journal of Clinical and Laboratory Investigation 27(4):361–366

    Article  CAS  Google Scholar 

  28. Siggaard-Andersen O, Wimberley P, Göthgen I, Siggaard-Andersen M (1984) A mathematical model of the hemoglobin-oxygen dissociation curve of human blood and of the oxygen partial pressure as a function of temperature. Clin Chem 30(10):1646–1651

    Article  CAS  Google Scholar 

  29. Thurnheer R, Xie X, Bloch KE (2001) Accuracy of nasal cannula pressure recordings for assessment of ventilation during sleep. American Journal of Respiratory and Critical Care Medicine 164(10):1914–1919

    Article  CAS  Google Scholar 

Download references

Funding

This work was financially supported by a Utah Space Grant Consortium Graduate Research Fellowship (K.M.B.) and was partially funded by Dynasthetics, LLC.

Author information

Authors and Affiliations

  1. Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, 84132, USA

    Kyle M. Burk & Joseph A. Orr

  2. Department of Anesthesiology, University of Utah, Salt Lake City, UT, 84132, USA

    Kyle M. Burk & Joseph A. Orr

Authors
  1. Kyle M. Burk
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joseph A. Orr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joseph A. Orr.

Ethics declarations

Conflict of interest

Kyle Burk: Dynasthetics, LLC and Joseph Orr: Dynasthetics, LLC

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable standards.

Informed consent was obtained from all individual participants included in the study.

This article does not contain any studies with animals performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Burk, K.M., Orr, J.A. A procedure for determining subject-specific pulse oxygen saturation response. Med Biol Eng Comput 58, 753–761 (2020). https://doi.org/10.1007/s11517-019-02105-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11517-019-02105-8

Keywords

Search

Navigation