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Canadian Medical Education Journal Nov 2023
Topics: Emotions; Behavior, Addictive; Heart Rate
PubMed: 38045083
DOI: 10.36834/cmej.78130 -
Journal of Medical Virology Jan 2023
Topics: Humans; COVID-19; Heart Rate; SARS-CoV-2
PubMed: 36203197
DOI: 10.1002/jmv.28194 -
Nigerian Journal of Clinical Practice Nov 2023The physical examination is a key part of a continuum that extends from the history of the present illness to the therapeutic outcome. An understanding of the... (Review)
Review
The physical examination is a key part of a continuum that extends from the history of the present illness to the therapeutic outcome. An understanding of the pathophysiological mechanism behind a physical sign is essential for arriving at the correct diagnosis. Early detection of deteriorating physical/vital signs and their appropriate interpretation is thus the key to achieve correct and timely management. By definition, vital signs are "the signs of life that may be monitored or measured, namely pulse rate, respiratory rate, body temperature, and blood pressure." Vital signs are the simplest, cheapest and probably the most inexpensive information gathered bedside in outpatient or hospitalized patients. The pulse oximeter was introduced in the 1980s. It is an accurate and non-invasive method for the measurement of arterial hemoglobin oxygen saturation (SaO2). Pulse oximetry-based arterial oxygen saturation can be effectively used bedside in in-hospital and ambulatory patients with diagnosed or suspected lung disease. The present pandemic of COVID-19 should be considered as a wake-up call. Articles related to arterial oxygen saturation and its importance as a vital sign in patient care were searched online especially in PubMed. Available studies were studied in full length and data was extracted. Discussion: A. Clinical Utility of Oxygen Saturation Monitoring: There are many studies reporting the clinical applicability and usefulness of pulse oximetry in the early detection of hypoxemic events during intraoperative and postoperative periods. B. Role of clinical expertise accompanied by knowledge of physiology: A diagnostic sign is useful only if it is interpreted accurately and applied appropriately while evaluating a patient. The World Health Organisation also appreciates these facts and published "The WHO Pulse Oximetry Training Manual." Understanding the physiology behind and overcoming limitations of the diagnostic sign by clinical expertise is important. While using pulse oximetry, a clinician needs to keep in mind the sigmoidal nature of the oxygen-Hb dissociation curve. Considering these benefits of SaO2 measurement, there have been several references in the past to consider oxygen saturation as the fifth vital sign. In the present pandemic oxygen saturation i.e., SpO2 (arterial oxygen saturation) measured by pulse oxymeter, has been the single most important warning and prognostic sign be it for households, offices, street vendors, hospitals or governments. Measurement of trends of SaO2 added with respiratory rate will provide clinicians with a holistic overview of respiratory functions and multidimensional conditions associated with hypoxemia.
Topics: Humans; Heart Rate; Hypoxia; Oximetry; Oxygen; Oxygen Saturation
PubMed: 38044759
DOI: 10.4103/njcp.njcp_2026_21 -
The Journal of Neuroscience : the... Jan 2022Previous studies have shown that timing of sensory stimulation during the cardiac cycle interacts with perception. Given the natural coupling of respiration and cardiac...
Previous studies have shown that timing of sensory stimulation during the cardiac cycle interacts with perception. Given the natural coupling of respiration and cardiac activity, we investigated here their joint effects on tactile perception. Forty-one healthy female and male human participants reported conscious perception of finger near-threshold electrical pulses (33% null trials) and decision confidence while electrocardiography, respiratory activity, and finger photoplethysmography were recorded. Participants adapted their respiratory cycle to expected stimulus onsets to preferentially occur during late inspiration/early expiration. This closely matched heart rate variation (sinus arrhythmia) across the respiratory cycle such that most frequent stimulation onsets occurred during the period of highest heart rate probably indicating highest alertness and cortical excitability. Tactile detection rate was highest during the first quadrant after expiration onset. Interindividually, stronger respiratory phase-locking to the task was associated with higher detection rates. Regarding the cardiac cycle, we confirmed previous findings that tactile detection rate was higher during diastole than systole and newly specified its minimum at 250-300 ms after the R-peak corresponding to the pulse wave arrival in the finger. Expectation of stimulation induced a transient heart deceleration which was more pronounced for unconfident decision ratings. Interindividually, stronger poststimulus modulations of heart rate were linked to higher detection rates. In summary, we demonstrate how tuning to the respiratory cycle and integration of respiratory-cardiac signals are used to optimize performance of a tactile detection task. Mechanistic studies on perception and cognition tend to focus on the brain neglecting contributions of the body. Here, we investigated how respiration and heartbeat influence tactile perception: respiration phase-locking to expected stimulus onsets corresponds to highest heart rate (and presumably alertness/cortical excitability) and correlates with detection performance. Tactile detection varies across the heart cycle with a minimum when the pulse reaches the finger and a maximum in diastole. Taken together with our previous finding of unchanged early event-related potentials across the cardiac cycle, we conclude that these effects are not a peripheral physiological artifact but a result of cognitive processes that model our body's internal state, make predictions to guide behavior, and might also tune respiration to serve the task.
Topics: Adult; Consciousness; Decision Making; Evoked Potentials, Somatosensory; Female; Heart Rate; Humans; Male; Photic Stimulation; Physical Stimulation; Respiratory Mechanics; Touch Perception; Young Adult
PubMed: 34853084
DOI: 10.1523/JNEUROSCI.0592-21.2021 -
International Journal of Biological... 2017With the fast development of wearable medical device in recent years, it becomes critical to conduct research on continuously measured physiological signals. Entropy is... (Review)
Review
With the fast development of wearable medical device in recent years, it becomes critical to conduct research on continuously measured physiological signals. Entropy is a key metric for quantifying the irregularity and/or complexity contained in human physiological signals. In this review, we focus on exploring how entropy changes in various physiological signals in cardiovascular diseases. Our review concludes that the direction of entropy change relies on the physiological signals under investigation. For heart rate variability and pulse index, the entropy of a healthy person is higher than that of a patient with cardiovascular diseases. For diastolic period variability and diastolic heart sound, the direction of entropy change is reversed. Our conclusion should not only give valuable guidance for further research on the application of entropy in cardiovascular diseases but also provide a foundation for using entropy to analyze the irregularity and/or complexity of physiological signals measured by wearable medical device.
Topics: Animals; Cardiovascular Diseases; Electrocardiography; Entropy; Heart Rate; Humans
PubMed: 29104498
DOI: 10.7150/ijbs.19462 -
CMAJ : Canadian Medical Association... Feb 2024
Topics: Humans; COVID-19; Oximetry; Heart Rate
PubMed: 38346783
DOI: 10.1503/cmaj.230221 -
Neonatology 2016Heart rate assessment immediately after birth in newborn infants is critical to the correct guidance of resuscitation efforts. There are disagreements as to the best... (Review)
Review
BACKGROUND
Heart rate assessment immediately after birth in newborn infants is critical to the correct guidance of resuscitation efforts. There are disagreements as to the best method to measure heart rate.
OBJECTIVE
The aim of this study was to assess different methods of heart rate assessment in newborn infants at birth to determine the fastest and most accurate method.
METHODS
PubMed, EMBASE and Google Scholar were systematically searched using the following terms: 'infant', 'heart rate', 'monitoring', 'delivery room', 'resuscitation', 'stethoscope', 'auscultation', 'palpation', 'pulse oximetry', 'electrocardiogram', 'Doppler ultrasound', 'photoplethysmography' and 'wearable sensors'.
RESULTS
Eighteen studies were identified that described various methods of heart rate assessment in newborn infants immediately after birth. Studies examining auscultation, palpation, pulse oximetry, electrocardiography and Doppler ultrasound as ways to measure heart rate were included. Heart rate measurements by pulse oximetry are superior to auscultation and palpation, but there is contradictory evidence about its accuracy depending on whether the sensor is connected to the infant or the oximeter first. Several studies indicate that electrocardiogram provides a reliable heart rate faster than pulse oximetry. Doppler ultrasound shows potential for clinical use, however future evidence is needed to support this conclusion.
CONCLUSION
Heart rate assessment is important and there are many measurement methods. The accuracy of routinely applied methods varies, with palpation and auscultation being the least accurate and electrocardiogram being the most accurate. More research is needed on Doppler ultrasound before its clinical use.
Topics: Heart Function Tests; Heart Rate; Humans; Infant, Newborn; Neonatal Screening; Resuscitation
PubMed: 26684743
DOI: 10.1159/000441940 -
Einstein (Sao Paulo, Brazil) 2023The World Health Organization and Centers for Disease Control and Prevention recommend the use of face masks in public. This study aimed to evaluate the effects of face...
OBJECTIVE
The World Health Organization and Centers for Disease Control and Prevention recommend the use of face masks in public. This study aimed to evaluate the effects of face masks on pulse rate and partial blood oxygen saturation in patients without cardiorespiratory disorders.
METHODS
A total of 150 volunteers of both sexes were divided into three groups (n=50) according to age (children, young adults, and older adults). The partial blood oxygen saturation and pulse rate were measured for each volunteer using a digital oximeter while wearing a facial mask and remaining at rest. The masks were removed for two minutes, and partial blood oxygen saturation and pulse rate were remeasured. The materials and types of masks used were recorded. The t -test for paired samples was used to compare the mean values obtained before and after removing the masks.
RESULTS
The most frequently used mask was a two-layered cloth (64.7%). A decrease in pulse rate was observed after removing the face mask in males, particularly in children (p=0.006) and young adults (p=0.034). Partial blood oxygen saturation levels increased in young adult males after mask removal (p=0.01).
CONCLUSION
The two-layer cotton tissue face masks are associated with a higher pulse rate and reduced arterial blood oxygen saturation without associated clinical disorders, mainly in adult men with a lower tolerance to breathing and ear discomfort.
Topics: Male; Child; Female; Young Adult; Humans; Aged; Masks; Heart Rate; Lung; Oxygen
PubMed: 37970950
DOI: 10.31744/einstein_journal/2023AO0349 -
The Journal of Thoracic and... Mar 2020
Topics: Heart Rate; Heart-Assist Devices; Hemorrhage; Humans; von Willebrand Factor
PubMed: 31126660
DOI: 10.1016/j.jtcvs.2019.04.023 -
Progress in Neurobiology Oct 2023The relevance of interactions between autonomic and central nervous systems remains unclear for human brain function and health, particularly when both systems are...
The relevance of interactions between autonomic and central nervous systems remains unclear for human brain function and health, particularly when both systems are challenged under sleep deprivation (SD). We measured brain activity (with fMRI), pulse and respiratory signals, and baseline brain amyloid beta burden (with PET) in healthy participants. We found that SD relative to rested wakefulness (RW) resulted in a significant increase in synchronized low frequency (LF, < 0.1 Hz) activity in an autonomically-related network (AN), including dorsal attention, visual, and sensorimotor regions, which we previously found to have consistent temporal coupling with LF pulse signal changes (regulated by sympathetic tone). SD resulted in a significant phase coherence between the LF component of the pulse signal and a medial network with peak effects in the midbrain reticular formation, and between LF component of the respiratory variations (regulated by respiratory motor output) and a cerebellar network. The LF power of AN during SD was significantly and independently correlated with pulse-medial network and respiratory-cerebellar network phase coherences (total adjusted R = 0.78). Higher LF power of AN during SD (but not RW) was associated with lower amyloid beta burden (Cohen's d = 0.8). In sum, SD triggered an autonomic mode of synchronized brain activity that was associated with distinct autonomic-central interactions. Findings highlight the direct relevance of global cortical synchronization to brain clearance mechanisms.
Topics: Humans; Amyloid beta-Peptides; Autonomic Nervous System; Brain; Heart Rate; Nervous System Physiological Phenomena
PubMed: 37516341
DOI: 10.1016/j.pneurobio.2023.102510