Bipolar disorder (BD) is a common mental health condition, characterized by extreme changes in mood, energy, and behavior. BD is often managed through mood-stabilizing medications, of which lithium formulations remain the most reliable and effective at reducing the risk of suicide. To achieve adequate and consistent efficacy, lithium concentrations need to be maintained within a narrow therapeutic range (0.4 to 1.2 mmol / L). Because of its narrow therapeutic index, long-term lithium therapy is associated with serious side effects and risks of toxicity. It is believed that the availability of a personal blood lithium analyzer would benefit patients who are on lithium treatment. We detail the results of a spectrophotometric method performed on ultramicro volumes to determine blood plasma lithium concentrations as compared with reference measurements of flame photometry, and validated in samples of unknown lithium content. Applying multiple linear regression, lithium concentrations could be determined in a rapid manner using full-range spectra or triwavelength data. Both techniques highly correlated with reference standards and could predict lithium levels accurately (R2 = 0.794214 and RMSEP = 0.209584, and R2 = 0.863921 and RMSEP = 0.167524, respectively). Therefore, this method can be a useful for rapid assessment of blood lithium in nonlaboratory settings i.e., general practices, hospital clinics, and community health centers by healthcare professionals and/or by patients. Future work will now focus on completion of a miniaturized and integrated system that will deliver a portable and personal lithium-monitoring device.
Photoplethysmography (PPG) is a widely used technique for measuring blood oxygen saturation, commonly using an external pulse oximeter applied to a finger, toe, or earlobe. Previous research has demonstrated the utility of direct monitoring of the oxygen saturation of internal organs, using optical fibers to transmit light between the photodiode/light emitting diode and internal site. However, little research into the optimization and standardization of such a probe has yet been carried out. This research establishes the relationship between fiber separation distance and PPG signal, and between fiber core width and PPG signal. An ideal setup is suggested: 1000-μm fibers at a separation distance of 3 to 3.5 mm, which was found to produce signals around 0.35 V in amplitude with a low variation coefficient.
A simple laboratory method is presented for producing optical fibers with tips polished at various angles. Angled optical fiber tips are used in applications such as optical sensing and remote laser surgery, where they can be used to control the angle of light leaving the fiber or direct it to the side. This allows for greater control and allows areas to be reached that otherwise could not. Optical fibers were produced with tip angles of 45 deg using a Perspex mounting block with an aluminum base plate. The dispersion of light leaving the tip was tested using a blue (470 nm) LED. The angle imposed an angular shift on the light diffracting out of the tip of approximately 30 deg. Additionally, some light reflected from the tip surface to diffract at 90 deg through the side of the fiber. These observations are consistent with theory and those seen by other studies, validating the method. The method was simple to perform and does not require advanced manufacturing tools. The method is suitable for producing small quantities of angle-tipped optical fibers for research applications.
The aim of the current work is to investigate the possibility of augmenting pulse oximetry algorithms to enable the estimation of venous parameters in peripheral tissues. In order to further understand the contribution of venous blood to the photoplethysmographic (PPG) signal, recordings were made from six healthy volunteer subjects during an exercise in which the right hand was placed in various positions above and below heart level. The left hand was kept at heart level as a control while the right hand was moved. A custom-made two-channel dual wavelength PPG instrumentation system was used to obtain the red and infrared plethysmographic signals from both the right and left index fingers simultaneously using identical sensors. Laser Doppler flowmetry signals were also recorded from an adjacent fingertip on the right hand. Analysis of all acquired PPG signals indicated changes in both ac and dc amplitude of the right hand when the position was changed, while those obtained from the left (control) hand remained relatively constant. Most clearly, in the change from heart level to 50cm below heart level there is a substantial decrease in both dc and ac amplitudes. This decrease in dc amplitude most likely corresponds to increased venous pooling, and hence increased absorption of light. It is speculated that the decrease in ac PPG amplitude is due to reduced arterial emptying during diastole due to increased downstream resistance due to venous pooling.
Splanchnic organs are particularly vulnerable to hypoperfusion. Currently, there is no technique that allows for the continuous estimation of splanchnic blood oxygen saturation (SpO2). As a preliminary to developing a suitable splanchnic SpO2 sensor, a new reflectance fiber optic photoplethysmographic (PPG) sensor and processing system are developed. An experimental procedure to examine the effect of fiber source detector separation distance on acquired PPG signals is carried out before finalizing the sensor design. PPG signals are acquired from four volunteers for separation distances of 1 to 8 mm. The separation range of 3 to 6 mm provides the best quality PPG signals with large amplitudes and the highest signal-to-noise ratios (SNRs). Preliminary calculation of SpO2 shows that distances of 3 and 4 mm provide the most realistic values. Therefore, it is suggested that the separation distance in the design of a fiber optic reflectance pulse oximeter be in the range of 3 to 4 mm. Preliminary PPG signals from various splanchnic organs and the periphery are obtained from six anaesthetized patients. The normalized amplitudes of the splanchnic PPGs are, on average, approximately the same as those obtained simultaneously from the periphery. These observations suggest that fiber optic pulse oximetry may be a valid monitoring technique for splanchnic organs.
A two wavelength photometric fibre-optic reflectance sensor was developed for assessing abdominal organ perfusion. In
vitro tests showed that reliable photoplethysmographic (PPG) signals and blood oxygen saturation (SpO2) values were
recorded when the separation between emitting and receiving fibres was at 3mm and the emitting current was between
20mA-40mA. In a clinical study, good quality PPG signals were obtained from the small and large bowel of a patient
undergoing laparotomy. Abdominal organ SpO2 were in good agreement with those obtained from a commercial device.
These observations suggest that the fibre-optic sensor may be suitable for monitoring abdominal organ perfusion.
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