Featured Publications
Inaccuracy of pulse oximetry with dark skin pigmentation: clinical implications and need for improvement
Kyriacou PA, Charlton PH, Al-Halawani R, Shelley KH. Inaccuracy of pulse oximetry with dark skin pigmentation: clinical implications and need for improvement. British Journal Of Anaesthesia 2022, 130: e33-e36. PMID: 35430087, DOI: 10.1016/j.bja.2022.03.011.Peer-Reviewed Original ResearchAmplitude and phase measurements from harmonic analysis may lead to new physiologic insights: lower body negative pressure photoplethysmographic waveforms as an example
Alian A, Shelley K, Wu HT. Amplitude and phase measurements from harmonic analysis may lead to new physiologic insights: lower body negative pressure photoplethysmographic waveforms as an example. Journal Of Clinical Monitoring And Computing 2022, 37: 127-137. PMID: 35896756, DOI: 10.1007/s10877-022-00866-6.Peer-Reviewed Original ResearchCOVID-19: Pulse oximeters in the spotlight
Michard F, Shelley K, L’Her E. COVID-19: Pulse oximeters in the spotlight. Journal Of Clinical Monitoring And Computing 2020, 35: 11-14. PMID: 32578070, PMCID: PMC7308445, DOI: 10.1007/s10877-020-00550-7.Peer-Reviewed Original ResearchConceptsPeripheral perfusion indexAcute respiratory failureManagement of patientsIntensive care unitCoronavirus disease 2019Preload-modifying maneuverPulse oximetry waveformRespiratory failureCare unitFluid therapyPreload responsivenessPerfusion indexRespiratory effortDisease 2019Oxygen saturationPulse oximetryHospital wardsPulse oximeterSpO2PatientsTherapyOximetryWardsA new approach to complicated and noisy physiological waveforms analysis: peripheral venous pressure waveform as an example
Wu HT, Alian A, Shelley K. A new approach to complicated and noisy physiological waveforms analysis: peripheral venous pressure waveform as an example. Journal Of Clinical Monitoring And Computing 2020, 35: 637-653. PMID: 32529454, DOI: 10.1007/s10877-020-00524-9.Peer-Reviewed Original Research
2023
Improving pulse oximetry accuracy in dark-skinned patients: technical aspects and current regulations
Cabanas A, Martín-Escudero P, Shelley K. Improving pulse oximetry accuracy in dark-skinned patients: technical aspects and current regulations. British Journal Of Anaesthesia 2023, 131: 640-644. PMID: 37544838, DOI: 10.1016/j.bja.2023.07.005.Peer-Reviewed Original ResearchUsing the ear photoplethysmographic waveform as an early indicator of central hypovolemia in healthy volunteers utilizing LBNP induced hypovolemia model
Eid A, Elgamal M, Gonzalez-Fiol A, Shelley K, Wu H, Alian A. Using the ear photoplethysmographic waveform as an early indicator of central hypovolemia in healthy volunteers utilizing LBNP induced hypovolemia model. Physiological Measurement 2023, 44: 055008. PMID: 37116503, DOI: 10.1088/1361-6579/acd165.Peer-Reviewed Original ResearchConceptsLower body negative pressureCentral hypovolemiaHealthy volunteersNon-invasive cardiac output monitorProgressive lower body negative pressureNoninvasive blood pressure monitorBody negative pressureCardiac output monitorBlood pressure monitorPhotoplethysmographic waveformPulse oximetry probeHypoperfusion symptomsSymptomatic subjectsHemodynamic indicesLBNP stageStroke volumeEarly predictorLT groupHypovolemiaEarly stagesPressure monitorWaveform indicesEarly indicatorWaveform morphologySymptoms
2021
Tribute to Dr. Takuo Aoyagi, inventor of pulse oximetry
Miyasaka K, Shelley K, Takahashi S, Kubota H, Ito K, Yoshiya I, Yamanishi A, Cooper JB, Steward DJ, Nishida H, Kiani J, Ogino H, Sata Y, Kopotic RJ, Jenkin K, Hannenberg A, Gawande A. Tribute to Dr. Takuo Aoyagi, inventor of pulse oximetry. Journal Of Anesthesia 2021, 35: 671-709. PMID: 34338865, PMCID: PMC8327306, DOI: 10.1007/s00540-021-02967-z.Peer-Reviewed Original Research
2020
Should We Monitor Pulsus Paradoxus via Pulse Oximetry in Patients with COVID-19 and Acute Respiratory Failure?
Michard F, Shelley K. Should We Monitor Pulsus Paradoxus via Pulse Oximetry in Patients with COVID-19 and Acute Respiratory Failure? American Journal Of Respiratory And Critical Care Medicine 2020, 202: 770-771. PMID: 32492351, PMCID: PMC7462392, DOI: 10.1164/rccm.202004-1504le.Peer-Reviewed Original Research
2018
Using support vector machines on photoplethysmographic signals to discriminate between hypovolemia and euvolemia
Reljin N, Zimmer G, Malyuta Y, Shelley K, Mendelson Y, Blehar DJ, Darling CE, Chon KH. Using support vector machines on photoplethysmographic signals to discriminate between hypovolemia and euvolemia. PLOS ONE 2018, 13: e0195087. PMID: 29596477, PMCID: PMC5875841, DOI: 10.1371/journal.pone.0195087.Peer-Reviewed Original ResearchConceptsBlood lossTrauma patientsTraditional vital signsLast time pointBlood pressureHemorrhagic shockCombat casualty careBlood withdrawalHealthy volunteersPhotoplethysmographic recordingsHeart rateBlood volumeEuvolemiaVital signsHypovolemiaPercentage changeTime pointsAbsolute changeCasualty carePatientsBattlefield settingsEarly stagesHemorrhageRecordingsHospital
2016
Ventilation-Induced Modulation of Pulse Oximeter Waveforms
Alian AA, Atteya G, Gaal D, Golembeski T, Smith BG, Dai F, Silverman DG, Shelley K. Ventilation-Induced Modulation of Pulse Oximeter Waveforms. Anesthesia & Analgesia 2016, 123: 346-356. PMID: 27284998, DOI: 10.1213/ane.0000000000001377.Peer-Reviewed Original ResearchConceptsSystolic blood pressureArterial pressure waveformBlood volumeFluid resuscitationBlood pressureOnly systolic blood pressurePressure waveformAirway pressure waveformFinger pulse oximetrySubstantial blood lossDynamic preload indicesVenous blood volumeArterial pressure measurementsArterial waveform parametersP-valuePulse oximeter waveformWilcoxon signed-rank testArterial pressureBlood lossBlood transfusionEarly bleedingPediatric patientsPreload indexHemodynamic dataScoliosis surgeryDisclosures, What Is Necessary and Sufficient?
Shelley KH, Barker SJ. Disclosures, What Is Necessary and Sufficient? Anesthesia & Analgesia 2016, 122: 307-308. PMID: 26797547, DOI: 10.1213/ane.0000000000000742.Commentaries, Editorials and Letters
2014
Photoplethysmography
Alian AA, Shelley KH. Photoplethysmography. Best Practice & Research Clinical Anaesthesiology 2014, 28: 395-406. PMID: 25480769, DOI: 10.1016/j.bpa.2014.08.006.Peer-Reviewed Original ResearchImpact of lower body negative pressure induced hypovolemia on peripheral venous pressure waveform parameters in healthy volunteers
Alian AA, Galante NJ, Stachenfeld NS, Silverman DG, Shelley KH. Impact of lower body negative pressure induced hypovolemia on peripheral venous pressure waveform parameters in healthy volunteers. Physiological Measurement 2014, 35: 1509-1520. PMID: 24901895, DOI: 10.1088/0967-3334/35/7/1509.Peer-Reviewed Original ResearchConceptsLower body negative pressureBlood pressureBody negative pressureCardiac modulationHeart ratePulse pressurePVP waveformsProgressive lower body negative pressureArterial systolic blood pressureFinger arterial blood pressurePeripheral venous pressure waveformsMmHg lower body negative pressureMean blood pressureDiastolic blood pressureSystolic blood pressureArterial blood pressureArterial BP valuesPressure waveformSignificant reductionMild hypovolemiaVenous pressureHemodynamic changesIntravenous siteRespiratory modulationBP valuesAnalysis of plethysmographic waveform changes induced by beach chair positioning under general anesthesia
Zhu R, Atteya G, Shelley KH, Silverman DG, Alian AA. Analysis of plethysmographic waveform changes induced by beach chair positioning under general anesthesia. Journal Of Clinical Monitoring And Computing 2014, 28: 591-596. PMID: 24420341, DOI: 10.1007/s10877-014-9555-9.Peer-Reviewed Original ResearchConceptsBeach chair positioningVasoactive drugsBlood pressureShoulder surgeryNoninvasive hemodynamic parametersPostoperative cerebral ischemiaMean arterial pressureTidal carbon dioxideBeach chair positionIntermittent blood pressureChair positionWilcoxon signed-rank testPosition surgeryArterial pressureCerebral ischemiaGeneral anesthesiaSigned-rank testHemodynamic parametersRare caseDevastating outcomesHeart rateRespiratory frequencyPatientsSurgeryAmplitude density
2013
Is pulse oximetry an essential tool or just another distraction? The role of the pulse oximeter in modern anesthesia care
Shah A, Shelley KH. Is pulse oximetry an essential tool or just another distraction? The role of the pulse oximeter in modern anesthesia care. Journal Of Clinical Monitoring And Computing 2013, 27: 235-242. PMID: 23314807, DOI: 10.1007/s10877-013-9428-7.Peer-Reviewed Original ResearchConceptsPulse oximetryOutcome studiesAnesthesia carePulse oximeterStandard of careAnesthetic agentsClinical careClinical monitoringPatient careFirst operationCardiovascular monitoringOximetryAvailable evidenceAnesthesiologistsCareOutcomes researchAmerican SocietyFurther studiesPatientsOximeterPatient monitoringRare eventUnambiguous roleNoninvasive cardiovascular monitoringVast majority
2012
Modulation of finger photoplethysmographic traces during forced respiration: Venous blood in motion?
Phillips J, Belhaj A, Shafqat K, Langford R, Shelley K, Kyriacou P. Modulation of finger photoplethysmographic traces during forced respiration: Venous blood in motion? Annual International Conference Of The IEEE Engineering In Medicine And Biology Society (EMBC) 2012, 2012: 3644-3647. PMID: 23366717, DOI: 10.1109/embc.2012.6346756.Peer-Reviewed Original ResearchConceptsVenous oxygen saturationOxygen saturationBlood volumeNegative airway pressureAirway pressureVenous bloodArterial saturationRespiratory modulationHealthy volunteersRespiratory frequencyTissue bedsPilot studyResultant modulationArteryModulationFingerBloodPhotoplethysmographic signalsVolunteersAutonomic control mechanism of maximal lower body negative pressure application
Selvaraj N, Shelley K, Silverman D, Stachenfeld N, Chon K. Autonomic control mechanism of maximal lower body negative pressure application. Annual International Conference Of The IEEE Engineering In Medicine And Biology Society (EMBC) 2012, 2012: 3120-3123. PMID: 23366586, DOI: 10.1109/embc.2012.6346625.Peer-Reviewed Original ResearchConceptsLower body negative pressureDiastolic blood pressureHeart rate variabilityBlood pressure variabilityAutonomic control mechanismsPulse pressureSevere hemorrhageTermination of LBNPLower body negative pressure applicationMaximal lower body negative pressureSystolic blood pressure variabilityRoot mean square successive differenceBody negative pressureConscious human subjectsNegative pressure applicationMean square successive differenceSquare successive differenceHigh-frequency powerLBNP applicationSympathetic reflexesAutonomic reflexesSympathetic activityBaroreflex sensitivityBlood pressureLBNP toleranceUsing Time-Frequency Analysis of the Photoplethysmographic Waveform to Detect the Withdrawal of 900 mL of Blood
Scully CG, Selvaraj N, Romberg FW, Wardhan R, Ryan J, Florian JP, Silverman DG, Shelley KH, Chon KH. Using Time-Frequency Analysis of the Photoplethysmographic Waveform to Detect the Withdrawal of 900 mL of Blood. Anesthesia & Analgesia 2012, 115: 74-81. PMID: 22543068, DOI: 10.1213/ane.0b013e318256486c.Peer-Reviewed Original ResearchMeSH KeywordsAdultBlood PressureBlood Pressure DeterminationBlood Transfusion, AutologousBlood VolumeBlood Volume DeterminationCluster AnalysisConnecticutElectrocardiographyHeart RateHumansHypovolemiaInfrared RaysMalePhotoplethysmographyPredictive Value of TestsRespiratory MechanicsSensitivity and SpecificitySignal Processing, Computer-AssistedTime FactorsConceptsML of bloodArterial blood pressureBlood lossBlood pressureHeart rateHeart rate frequencyBlood withdrawalML blood lossMean percent decreaseBlood volume lossHeart rate componentSignificant changesPhotoplethysmographic waveformSpontaneous breathingTrauma settingCuff measurementsPPG waveformBlood reinfusionHealthy volunteersStandard electrocardiogramBloodEarly detectionEar PPG signalsBaselineConfidence intervalsRespiratory Physiology and the Impact of Different Modes of Ventilation on the Photoplethysmographic Waveform
Alian AA, Shelley KH. Respiratory Physiology and the Impact of Different Modes of Ventilation on the Photoplethysmographic Waveform. Sensors 2012, 12: 2236-2254. PMID: 22438762, PMCID: PMC3304164, DOI: 10.3390/s120202236.Peer-Reviewed Original Research
2010
Measuring venous oxygenation using the photoplethysmograph waveform
Walton ZD, Kyriacou PA, Silverman DG, Shelley KH. Measuring venous oxygenation using the photoplethysmograph waveform. Journal Of Clinical Monitoring And Computing 2010, 24: 295-303. PMID: 20644985, DOI: 10.1007/s10877-010-9248-y.Peer-Reviewed Original ResearchConceptsVenous saturationVenous systemRegional venous oxygen saturationPeripheral venous waveformCardiac surgery patientsVenous oxygen saturationPeripheral venous systemPhotoplethysmograph waveformsWilcoxon signed-rank testVenous waveformSurgery patientsAtrial contractionSigned-rank testVenous bloodVenous oxygenationOxygen saturationGold standardPPG characteristicsHigh complianceBonferroni correctionSignificant differencesPPG analysisBloodPPG waveformPatients