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A1073
October 24, 2015
4:00:00 PM - 5:30:00 PM
Room Upper 11A
The Evolution of Pulse Oximetry
Wenxi Gao, M.Sc., Edward R. Kaminski, M.D.
Wayne State University School of Medicine, Detroit, Michigan, United States
Disclosures: W. Gao: None. E.R. Kaminski: None.
Background: Pulse oximetry has been one of the most impactful innovations in anesthesia and critical care. The safety of anesthesia world-wide has been improved since its introduction. It was not, however, invented overnight and there have been many stepwise monumental milestones that have led to the modern pulse oximeter that we all use today.

Objective: To review the evolution of pulse oximetry throughout history.

Results: Pulse oximetry stems back to the 1860s, when hemoglobin was discovered to be the oxygen carrier in blood by Stokes. 70 years later, Matthes developed the first oxygen saturation meter, which used a 2-wavelength light source with red and green filters (1). One of the main issues with this device was its difficult calibration. This was solved by the late 1930s by Squire, who created a self-calibrating oximeter. In the 1940s, British scientist Millikan introduced the first aviation ear oximeter, which was used in pilot training in World War II. A few years later, at Mayo Clinic, Wood had improved this device with the addition of an inflatable balloon to stop blood flow for calibration (1). In 1964, Hewlett Packard used eight wavelengths of light to further enhance the oximeter, however due to its size and cost, it was mainly used in sleep laboratories. Then, in 1972, through the monumental work of Takuo Aoyagi, a Japanese bioengineer, oximetry finally became clinically feasible (2). He had developed a pulse oximeter based on the ratio of red to infrared light absorption in blood (3). In fact, this technology is still used in today’s pulse oximeters. Finally, in 1977, the company Minolta marketed the first pulse oximeter, which drove the market to improve oximetry technology. By 1986, pulse oximetry had become the standard of care in American operating rooms and quickly spread to other hospital units in subsequent years.

Conclusions: Pulse oximetry has been evolving for the past 150 years to become what it is today. Research continues to improve oximetry with new innovations such as guiding fluid replacement (4) and identifying ventilation changes such as upper airway obstructions (5).

References:

1. Kamat, Vijaylakshmi. Pulse Oximetry. Indian J Anaesth. 2002; 46(6): 261-268.

2. Severinghaus, John W, Honda, Yoshiyuki. History of Blood Gas Analysis. VII. Pulse Oximetry. J Clin Monit. 1978; 3:135-138.

3. Severinghaus, John W. Takuo Aoyagi: Discovery of Pulse Oximetry. Anesth Analg. 2007; 105 (6):S1-4.

4. Addison, Paul S. A Review of Signal Processing Used in the Implementation of the Pulse Oximetry Photoplethysmographic Fluid Responsiveness Parameter. Anesth Analg. 2014; 116(6):1293-1305.

5. Perel, Azriel. Excessive Variations in the Plethysmographic Waveform During Spontaneous Ventilation: An Important Sign of Upper Airway Obstruction. Anesth Analg. 2014; 116(6):1288-1292.

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