Biomedical Instrumentation

BIE 291
Blood oxygenation: oximetry.

Steve Matcher
S.J.Matcher@sheffield.ac.uk
Overview
Haemoglobin oxygenation
Clinical relevance
Definition of saturation
Oximetry
Co-oximeter
Pulse-oximeter
 Blood oxygenation.
d
O2 = Q tHb 4 - O&2
dt

Delivery = Q [tHb] 4 only if all Hb molecules

bind O2.
Blood is then fully oxygenated.
In practice not all Hbs are bound to O2
[tHb] = [Hb] + [HbO2]
Haemoglobin absorption spectrum

Intense light absorption in blue region:

Greater absorption in red by Hb cf HbO2
 Beer-Lambert law
I I 0 10l
I0 I C
I 0
Attenuation OD log10 Cl
I
l

is the extinction coefficient

is the molar extinction coefficient
C is the molar concentration of the absorber
 Spectroscopic analysis
Two distinct compounds A and B,
concentrations CA and CB.

OD
CA A CBB
l
To find two unknowns we need two
independent measurements e.g.
OD 1 CA A 1 l CBB 2 l
OD 2 CA A 2 l CBB 2 l
 Oximetry

Measure OD of a blood sample

at two or more wavelengths 1,
2 etc.

Assume known values for Hb

and HbO2 at 1 & 2

Solve for [Hb] l & [HbO2] l

 Haemoglobin saturation
l is in general unknown.
Total haemoglobin [tHb] can be found
from a blood test.
Hence define fractional saturation SO2

SO2
HbO2 HbO2 l

Hb + HbO2 Hb l HbO2 l
d
O2 = Q tHb SO2 4 - O
&
2
dt
 Arteries Capillaries Veins
Q Q

O2
O2 offloaded to cells in capillary compartment.
Hence HbO2 converted to Hb whilst [tHb] stays
constant.
Define arterial & venous saturations
SaO2 & SvO2

SaO2 > SvO2

 Haematology lab.
Co-oximeter

Analyse drawn blood sample

Typically < 0.1 mL

Multiple wavelengths hence

tHb
SO2
Methaemoglobin
Carboxyhaemoglobin
www.gmi-inc.com
 Pulse oximeter
Use NIR light in-vivo measurement
No need to draw blood samples
Problem to overcome: unknown attenuation
due to tissue scattering:-
 OD Hb Hbl HbO2 Hbl G
In general, G is unknown in-vivo.
Complicated dependence on
Major problem to extract [Hb] etc from OD values
 Solution (Nakajima, 1977)
Measure ODs versus time during cardiac cycle
OD values change ~ few % between systole and
diastole
OD

diastole

systole
time
 KEY IDEA
Change in OD between systole and diastole is
purely due to arterial blood
I diastolic
ODsystolic-diastolic log10
I
systolic
Hb arterial Hb l HbO2 arterial HbO2 l

HbO2 arterial l
Sa O 2
Hb arterial l HbO2 arterial l
 Typical block diagram

www.robots.ox.ac.uk
 Photodiode and I-V converter
Photodiode
A reverse-biased diode through which a
leakage current light intensity flows

www.robots.ox.ac.uk
"The pulse oximeter is arguably
the most significant
technological advance ever
made in monitoring the
wellbeing and safety of
patients during anaesthesia,
recovery and critical care

Severinghaus & Astrup (1986)

 Summary
Adequate O2 delivery requires
adequate blood haemoglobin
saturation.
Apply optical spectroscopy
oximetry
Co-oximeter uses blood samples
Pulse oximeter is non-invasive
Only measures arterial saturation