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RAVINDARBETHI    PULSE OXIMETRY                  principle,               applications           & interpretation
PULSE OXIMETRYis one of the most essential monitors for routine usein anesthesia and intensive care
PULSE OXIMETRYwhat does it measure ?
PULSE OXIMETRYIt measures the O2 saturation of Hb in arterial blood
PULSE OXIMETRYIt measures the heart rate
PULSE OXIMETRYgives an idea about tissue perfusion by pulse wave form
PULSE OXIMETRYgives an idea about tissue perfusion by pulse wave form
Dicrotic notch                                                   descendsPULSE OXIMETRYgives an idea about tissue perfusio...
PULSE OXIMETRYgives an idea about tissue perfusion by pulse wave form      • decreased amplitude indicates vasoconstrictio...
PULSE OXIMETRYgives an idea about tissue perfusion by pulse wave form                                 Area under the curve...
PULSE OXIMETRYgives an idea about tissue perfusion by pulse wave form   Can be used for assessment of blood flow       in...
The principle• What is oxygenation of a Hb ?
The principle• What is oxygenation ?  Oxy Hb   O2                Deoxy Hb
The principle• What is oxygenation ?  OxyHb   O2   O2                    DeoxyHb
The principle• What is oxygenation ?  OxyHb   O2   O2          O2        DeoxyHb
The principle• What is oxygenation ?  OxyHb   O2   O2          O2   O2
The principle• What is oxygenation ?O2   O2   O2   O2    O2    O2    O2    O2       O2   O2   O2   O2O2   O2   O2   O2    ...
The principle• What is oxygenation ?O2   O2   O2   O2   O2    O2    O2   O2    O2    O2   O2   O2O2   O2   O2   O2        ...
The spectrophotometry When a light of particular wavelength passes though a solution sample, the compound of interest abso...
The spectrophotometry When a light of particular wavelength passes though a solution sample, the compound of interest abso...
The spectrophotometry
The spectrophotometryOxygen saturation = Oxygen content    X 100                    Oxygen capacity
The spectrophotometryOxygen saturation =       OxyHb       X 100                      OxyHb+DeoxyHb
The spectrophotometryOxygen saturation =       OxyHb       X 100                      OxyHb+DeoxyHb
The spectrophotometryPhotosensor(2 LEDs)   Photodetector
Signals fromother sourcesthan arterial
The plethysmography
The plethysmography
Thespectrophotometry& plethysmography
ABSORPTIONPHOTOMETRY              REFLECTION             PHOTOMETRY
ABSORPTIONPHOTOMETRY              REFLECTION             PHOTOMETRY
ABG RESULTSpO2 vs SaO2               • SaO2 96 %               • PaO2 90 mmHg
ABG RESULT                              SpO2 vs SaO2                                               • SaO2 96 %            ...
ABG RESULT                              SpO2 vs SaO2                                               • SaO2 96 %            ...
SaO2 vs PaO2PRESSUREGRADIENT-1   O2
SaO2 vs PaO2PRESSUREGRADIENT-1             O2             O2
SaO2 vs PaO2PRESSUREGRADIENT-2             O2             O2
SaO2 vs PaO2PRESSUREGRADIENT-2             O2             O2
SaO2 vs PaO2O2                        O2                    PRESSURE                    GRADIENT-1
SaO2 vs PaO2O2                        O2                    PRESSURE                    GRADIENT-2
SaO2 vs PaO2O2                        O2                    PRESSURE                    GRADIENT-2
SaO2 vs PaO2
SaO2 vs PaO2SpO2 100%
SaO2 vs PaO2                PATIENT               BREATHING                100% O2
SaO2 vs PaO2   SpO2MAXIMUM 100%                               PATIENT                              BREATHING              ...
APPLICATIONS   SpO2MAXIMUM 100%                               PATIENT                              BREATHING              ...
APPLICATIONS   SpO2MAXIMUM 100%                                          PATIENT                                         B...
APPLICATIONS   SpO2MAXIMUM 100%                                       PATIENT                                      BREATHI...
APPLICATIONSSpO2100%                           PATIENT                          BREATHING                           100% O...
APPLICATIONSSpO2                           PATIENT                          BREATHING                           100% O2   ...
APPLICATIONSSpO2                       PATIENT                          BREATHING92%                         60% O2       ...
APPLICATIONSSpO2                           PATIENT92%                       BREATHING                            60% O2   ...
APPLICATIONS   SpO2MAXIMUM 100%                                      PATIENT                                     BREATHING...
APPLICATIONS   SpO2MAXIMUM 100%                                 PATIENT                                BREATHING          ...
TAKE HOME MESSAGESWhen SpO2 value can be a false reading?• in Carbon monoxide poisoning• in Methemoglobinemias
TAKE HOME MESSAGESWhy only 92% inBronchial Asthma and COPD ?
TAKE HOME MESSAGES When SpO2 gives false readings ? • ...in methylene blue therapy, deep   jaundice…
TAKE HOME MESSAGESWhen SpO2 is falsely low ?• Ambient light…tourniquet,• Compartment syndrome with  pulsatile veins…
TAKE HOME MESSAGES• When even SpO2 or PaO2 is not just enough  …if PaCO2 is low in head injury
TAKE HOME MESSAGESObserve  • ECG and SpO2 waves in arrhythmias, PEA
TAKE HOME MESSAGESObserve  Take your own   pulse oximetry while holding breath
TAKE HOME MESSAGES• How SpO 2 alone is unreliable as monitor  at intubation?
TAKE HOME MESSAGES     • Why the animals living in high altitudes have a       high RBC count ?     • Why the RBC count in...
In order to use the search light effectivelywe need to have a fairly thorough knowledge of         all the territory to be...
RAVINDAR BETHI
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Pulse oximetry

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  • Transcript of "Pulse oximetry"

    1. 1. RAVINDARBETHI PULSE OXIMETRY principle, applications & interpretation
    2. 2. PULSE OXIMETRYis one of the most essential monitors for routine usein anesthesia and intensive care
    3. 3. PULSE OXIMETRYwhat does it measure ?
    4. 4. PULSE OXIMETRYIt measures the O2 saturation of Hb in arterial blood
    5. 5. PULSE OXIMETRYIt measures the heart rate
    6. 6. PULSE OXIMETRYgives an idea about tissue perfusion by pulse wave form
    7. 7. PULSE OXIMETRYgives an idea about tissue perfusion by pulse wave form
    8. 8. Dicrotic notch descendsPULSE OXIMETRYgives an idea about tissue perfusion by pulse wave form • increased amplitude indicates vasodilatation
    9. 9. PULSE OXIMETRYgives an idea about tissue perfusion by pulse wave form • decreased amplitude indicates vasoconstriction or hypovolemia
    10. 10. PULSE OXIMETRYgives an idea about tissue perfusion by pulse wave form Area under the curve indicates stroke volume
    11. 11. PULSE OXIMETRYgives an idea about tissue perfusion by pulse wave form Can be used for assessment of blood flow  in re-vascularised limb  In re-anastamosed limb  In a digit after or during surgery
    12. 12. The principle• What is oxygenation of a Hb ?
    13. 13. The principle• What is oxygenation ? Oxy Hb O2 Deoxy Hb
    14. 14. The principle• What is oxygenation ? OxyHb O2 O2 DeoxyHb
    15. 15. The principle• What is oxygenation ? OxyHb O2 O2 O2 DeoxyHb
    16. 16. The principle• What is oxygenation ? OxyHb O2 O2 O2 O2
    17. 17. The principle• What is oxygenation ?O2 O2 O2 O2 O2 O2 O2 O2 O2 O2 O2 O2O2 O2 O2 O2 O2 O2 O2 O2 O2 O2 O2O2 O2 O2 O2 O2 O2 O2 O2 O2 O2 O2 O2O2 O2 O2 O2 O2 O2 O2 O2 O2 O2 O2 Oxygen saturation = Oxygen content X 100 Oxygen capacity
    18. 18. The principle• What is oxygenation ?O2 O2 O2 O2 O2 O2 O2 O2 O2 O2 O2 O2O2 O2 O2 O2 O2 O2 O2 O2 O2 O2 O2O2 O2 O2 O2 O2 O2 O2 O2 O2 O2 O2 O2O2 O2 O2 O2 O2 O2 O2 O2 O2 O2 O2 Oxygen saturation = Oxygen content X 100 OxyHb+DeoxyHb
    19. 19. The spectrophotometry When a light of particular wavelength passes though a solution sample, the compound of interest absorbs these specific radiations
    20. 20. The spectrophotometry When a light of particular wavelength passes though a solution sample, the compound of interest absorbs these specific radiations
    21. 21. The spectrophotometry
    22. 22. The spectrophotometryOxygen saturation = Oxygen content X 100 Oxygen capacity
    23. 23. The spectrophotometryOxygen saturation = OxyHb X 100 OxyHb+DeoxyHb
    24. 24. The spectrophotometryOxygen saturation = OxyHb X 100 OxyHb+DeoxyHb
    25. 25. The spectrophotometryPhotosensor(2 LEDs) Photodetector
    26. 26. Signals fromother sourcesthan arterial
    27. 27. The plethysmography
    28. 28. The plethysmography
    29. 29. Thespectrophotometry& plethysmography
    30. 30. ABSORPTIONPHOTOMETRY REFLECTION PHOTOMETRY
    31. 31. ABSORPTIONPHOTOMETRY REFLECTION PHOTOMETRY
    32. 32. ABG RESULTSpO2 vs SaO2 • SaO2 96 % • PaO2 90 mmHg
    33. 33. ABG RESULT SpO2 vs SaO2 • SaO2 96 % • PaO2 90 mmHgNon functional Haemoglobins Oxy Hb SaO2 50% SpO2 100%
    34. 34. ABG RESULT SpO2 vs SaO2 • SaO2 96 % • PaO2 90 mmHgNon functional Haemoglobins Oxy Hb SaO2 50% OXIMETRY GAP SpO2 100%
    35. 35. SaO2 vs PaO2PRESSUREGRADIENT-1 O2
    36. 36. SaO2 vs PaO2PRESSUREGRADIENT-1 O2 O2
    37. 37. SaO2 vs PaO2PRESSUREGRADIENT-2 O2 O2
    38. 38. SaO2 vs PaO2PRESSUREGRADIENT-2 O2 O2
    39. 39. SaO2 vs PaO2O2 O2 PRESSURE GRADIENT-1
    40. 40. SaO2 vs PaO2O2 O2 PRESSURE GRADIENT-2
    41. 41. SaO2 vs PaO2O2 O2 PRESSURE GRADIENT-2
    42. 42. SaO2 vs PaO2
    43. 43. SaO2 vs PaO2SpO2 100%
    44. 44. SaO2 vs PaO2 PATIENT BREATHING 100% O2
    45. 45. SaO2 vs PaO2 SpO2MAXIMUM 100% PATIENT BREATHING 100% O2
    46. 46. APPLICATIONS SpO2MAXIMUM 100% PATIENT BREATHING 100% O2
    47. 47. APPLICATIONS SpO2MAXIMUM 100% PATIENT BREATHING 100% O2 ALKALOSIS, HYPOT HERMIA
    48. 48. APPLICATIONS SpO2MAXIMUM 100% PATIENT BREATHING 100% O2 EFFECT OF PREOXYGENATION
    49. 49. APPLICATIONSSpO2100% PATIENT BREATHING 100% O2 BRONCHIAL ASTHMA
    50. 50. APPLICATIONSSpO2 PATIENT BREATHING 100% O2 BRONCHIAL ASTHMA ALVEOLAR COLLAPSE
    51. 51. APPLICATIONSSpO2 PATIENT BREATHING92% 60% O2 BRONCHIAL ASTHMA
    52. 52. APPLICATIONSSpO2 PATIENT92% BREATHING 60% O2 OXYGEN DIFFUSES OUT BRONCHIAL ASTHMA NITROGEN SAVES LIFE !!
    53. 53. APPLICATIONS SpO2MAXIMUM 100% PATIENT BREATHING 100% O2 COPD
    54. 54. APPLICATIONS SpO2MAXIMUM 100% PATIENT BREATHING 100% O2 COPD Hypercarbia hypoxia
    55. 55. TAKE HOME MESSAGESWhen SpO2 value can be a false reading?• in Carbon monoxide poisoning• in Methemoglobinemias
    56. 56. TAKE HOME MESSAGESWhy only 92% inBronchial Asthma and COPD ?
    57. 57. TAKE HOME MESSAGES When SpO2 gives false readings ? • ...in methylene blue therapy, deep jaundice…
    58. 58. TAKE HOME MESSAGESWhen SpO2 is falsely low ?• Ambient light…tourniquet,• Compartment syndrome with pulsatile veins…
    59. 59. TAKE HOME MESSAGES• When even SpO2 or PaO2 is not just enough …if PaCO2 is low in head injury
    60. 60. TAKE HOME MESSAGESObserve • ECG and SpO2 waves in arrhythmias, PEA
    61. 61. TAKE HOME MESSAGESObserve Take your own pulse oximetry while holding breath
    62. 62. TAKE HOME MESSAGES• How SpO 2 alone is unreliable as monitor at intubation?
    63. 63. TAKE HOME MESSAGES • Why the animals living in high altitudes have a high RBC count ? • Why the RBC count increases in high altitudes?O2O2
    64. 64. In order to use the search light effectivelywe need to have a fairly thorough knowledge of all the territory to be searched.
    65. 65. RAVINDAR BETHI
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