Automated Validation of Capillary Refill Time Measurements Using Photo-plethysmogram from a Portable Device for Effective Triage in Children
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Date
2011
Journal Title
Journal ISSN
Volume Title
Publisher
Global Humanitarian Technology Conference
Abstract
Capillary refill time (CRT) is an important tool for the clinical assessment of trauma and dehydration. Indeed, it
has been incorporated into advanced life support guidelines as part of the rapid assessment of critically ill patients. However,
digitalized CRT techniques are not readily available and the standard assessment based on the visual inspection of CRT lacks
standardization and is prone to a high inter-observer variability. We present an algorithm for the automatic validation of the
CRT measurement on the finger using photo-plethysmogram recordings on a small portable device. It is based on a set of
deterministic rules for the classification of finger pressure and regular plethysmographic pulses. Validation studies using the
classification of 93 pediatric recordings from Canada and Uganda showed that the novel algorithm reliably detects invalid CRT
measurements (sensitivity 98.4%). This includes patterns such as insufficient pressure, low perfusion signals, and artifacts. Since
our device consists of widely available components already in use, the promising results suggest that the algorithm could be readily integrated in operating rooms and intensive care units around the world. This more robust assessment of CRT would produce a more powerful diagnostic tool for clinical triage in critical care settings.
Description
Keywords
photo-plethysmogram, capillary refill time, pulse oximeter monitoring, anesthesia, children, segmentation, classification
Citation
Karlen, W., Pickard, A., Daniels, J., Kwizera, A., Ibingira, C., Dumont, G., & Ansermino, J. M. (2011, October). Automated validation of capillary refill time measurements using photo-plethysmogram from a portable device for effective triage in children. In 2011 IEEE Global Humanitarian Technology Conference (pp. 66-71). IEEE.