Key result
A forehead-based photoplethysmogram sensor demonstrated strong agreement with standard wrist-based pulse oximetry for heart rate monitoring in critically unwell neonates, achieving a positive percentage agreement of 98.87%.
Why the study?
Peripheral blood supply is reduced in critically unwell infants, making peripheral limb pulse oximetry challenging. Forehead photoplethysmogram monitoring could overcome this and preserve limb access.
Does a forehead-based PPG sensor accurately measure heart rate compared to a wrist-based pulse oximeter in critically unwell infants in neonatal intensive care?
Observational (n=19)
No
Does a forehead-based PPG sensor accurately measure heart rate compared to a wrist-based pulse oximeter in critically unwell infants in neonatal intensive care?
Effect estimate: Spearman's correlation coefficient 0.9816
p-value: p=<0.001
A forehead-based PPG sensor provides a reliable and accurate alternative to wrist-based pulse oximetry for continuous heart rate monitoring in critically ill neonates.
May support forehead PPG as alternative for neonatal HR monitoring; leaves open need for larger prospective validation.
Heart rate is an extremely important physiological parameter to measure in critically unwell infants, as it is the main physiological marker that changes in response to a change in infant condition. Heart rate is routinely measured peripherally on a limb with a pulse oximeter. However, when infants are critically unwell, the blood supply to these peripheries is reduced in preference for central perfusion of vital organs such as the brain and heart. Measurement of heart rate with a reflection mode photoplethysmogram (PPG) sensor on the forehead could help minimise this problem and make it easier for other important medical equipment, such as cannulas, to be placed on the limbs. This study compares heart rates measured with a forehead-based PPG sensor against a wrist-based PPG sensor in 19 critically unwell infants in neonatal intensive care collecting 198 h of data. The two heart rates were compared using positive percentage agreement, Spearman's correlation coefficient and Bland-Altman analysis. The forehead PPG sensor showed good agreement with the wrist-based PPG sensor with limits of agreement of 8.44 bpm, bias of -0.22 bpm; positive percentage agreement of 98.87%; and Spearman's correlation coefficient of 0.9816. The analysis demonstrates that the forehead is a reliable alternative location for measuring vital signs using the PPG.
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Stockwell et al. (2023) conducted an observational in Critically unwell infants in neonatal intensive care (n=19). Forehead-based photoplethysmogram (fhPPG) sensor vs. Wrist-based pulse oximeter was evaluated on Heart rate measurement agreement (Spearman's correlation coefficient 0.9816, p=<0.001). A forehead-based photoplethysmogram sensor demonstrated strong agreement with standard wrist-based pulse oximetry for heart rate monitoring in critically unwell neonates, achieving a positive percentage agreement of 98.87%.
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