WORKING PRICIPAL

Pulse oximeters measure oxygen saturation. Before we learn how pulse

oximeters work, we need to understand what oxygen saturation is. We all
know we need oxygen for life. Oxygen enters the lungs and then is passed on
into blood. The blood carries oxygen to the various organs in our body. The
primary way oxygen is held in our blood is through hemoglobin. The
hemoglobin deficient of oxygen is called deoxygenated hemoglobin (deoxy
Hb). The hemoglobin rich in oxygen is called oxygenated hemoglobin (oxy Hb).
Oxygen saturation refers to the percentage of the total available hemoglobin
that carries oxygen

Pulse oximetry is based on principle that oxy Hb and deoxy Hb differentially

absorb red and near-infrared (IR) light. It is fortuitous that oxy Hb and deoxy
Hb have significant differences in absorption at red and near-Infra Red light
because these two wavelengths penetrate the tissues well whereas blue,
green, yellow, and far-Infra Red light are significantly absorbed by non-vascular
tissues and water. oxy Hb absorbs greater amounts of IR light and lower
amounts of red light than does HHb
This is consistent with experience – well-oxygenated blood with its higher
concentrations of oxy Hb appears significantly more red to the eye because it
scatters more red light than deoxy Hb.

Light is emitted from LED sources which go through the pulse oximeter probe
and reach the light detector sensor.

If a finger is placed between the LED light source and the light detector sensor,
the light will then have to pass through the finger to reach the light detector.
Part of the light will be absorbed by the non-vascular tissues, oxy Hb and the
portion not absorbed by above then eaches the light sensor.

PHYSICAL PROPERTY No 1 : Amount of light absorbed is directly

proportional to the concentration of light absorbing substance
Hemoglobin absorbs light. The amount of light absorbed is directly
proportional to the concentration of Hb in the blood. In the diagram below, the
blood vessels have same diameter. However, one blood vessel has a low HHb
concentration compared to the other blood vessel which has a high Hb
concentration. Every single Hb absorbs some amount of the light, so more the
Hb per/area, more is the light is absorbed. This property is described in a law
called Beer’s Law.
Beer’s Law: Amount of light absorbed is directly proportional to the
concentration of the light absorbing substance
By measuring how much light reaches the light senor, the oximeter knows how
much light has been absorbed by hb. More the Hb concentration in the finger ,
more is the light absorbed.

oxy Hb absorbs more infrared light than red light & deoxy Hb absorbs
more red light than infrared light
the pulse oximeters also makes use of a vital property to calculate oxygen
saturation. That is, oxy Hb and deoxy Hb absorb light of different wavelengths
in a specific way.
Before we go ahead, we need to remember what is wavelength? The distance
between two consecutive tips of the waves is equal to the wavelength. The pulse
oximeter uses the property that oxy Hb and deoxy Hb absorb light of different
wavelengths in a particular way. This property can be demonstrated
experimentaly as described now. We can first show how oxy Hb absorbs light
of different wavelengths in a particular way. We use a unique light source
through which we can adjust the wavelength of the light that it emit. This light
source passes light of different wavelengths through oxy Hemoglobin. The
sensor notes how much light, at each wavelength, has been absorbed.
A graph for the absorbance of oxy Hb at different wavelengths will be as
shown.
It shows that oxy Hemoglobin doesn’t absorb the same amount of light at
different wavelengths.
Again notice, how like oxyhemoglobin, Deoxy Hhemoglobin absorbs a
different amount of light at different wavelengths.

Let us see the absorbance graph of oxyhemoglobin and the absorbance graph of
deoxyhemoglobin together in a single graph with a common axis to compare
them. Notice how each of them absorbs light of different wavelengths
differently.
The pulse oximeter makes use of the two lights to analyze hemoglobin
concentration levels. One is a red light, which has a wavelength of 650
nanometers. The other is infrared light, which has a wavelength of 950
nanometers. ( the infrared light is shown in light blue. In reality, however,
infrared light is invisible to the human eye.)
 Oxy Hemoblobin absorbs more IR light than red light
 Deoxy hemoglobin absorbs more red light than IR light
The pulse oximeter calculates the oxygen saturation by comparing amount of
red light absorbed to IR light is absorbed by the blood. Depending on the
concentration of oxy Hemoglobin and deoxy Hemoglobin present, the ratio of
the amount of red light absorbed is compared to the amount of IR light
absorbed changes.

For example, at 100 % saturation level, the absorbance ratio will be identical to
that seen with the oxy Hemoglobin absorbance curve given above.
At 0 % saturation, there is only deoxy Hemoglobin. The absorbance ratio will
therefore be identical as that seen with the deoxy Hemoglobin absorbance
curve that we saw earlier.Now look at when the patient has an oxygen
saturation of 75 percent. The blood has both , oxy Hb and deoxy Hb. The
absorbance pattern is then somewhere in between the oxy Hemoglobin curve
and deoxy Hemoglobin curve ( shown in grey). The ratio of absorbed red light
 and IR light is different and using this information, the oximeter is able to
calculate the oxygen saturation as 75 percent

Pulse oximeters measure pulsatile blood

In a finger, blood in arteries is not the only thing that absorb light. Skin and other
tissues also absorb some part of the light. This poses a major problem , because the
pulse oximeter should only analyse arterial blood while ignoring the absorbance of
the light by any other surrounding tissues.let us take an example. One is a fat finger
and the other is a thin finger. The tissues in the thin finger absorbs only a little bit of
extra light, while the fatter finger absorbs much more light compared to thin finger.
However, the oximeter has no way to measure if the finger is thin or fat there is a
solution to the problem.

Luckily, arterial blood is the only thing that is pulsating in the finger. Everything else
in is non-pulsating. Any changing absorbance must be due to arterial blood. On the
other hand, the pulse oximeter knows that any absorbance constant with time must
be because of skin and other nonarterial tissues. So the signal reaching the pulse
oximeter is a combination of the changing absorbance because of arterial blood and
the non-changing absorbance because of other tissues.

Oximetry Applications
Oximetry is used to assess arterial blood oxygenation for many diverse patient
groups with suspected cardiopulmonary disorders or in normals during intense
exercise or exposure to low level of oxygen.
In Heart and Lung Disease
Patients with heart and lung disease experience episodes of arterial hypoxemia with
a therapeutic goal to maintain arterial oxygenation above 90% SpO2
During Exercise
Another area for oximetry uses is in ongoing monitoring of patients admitted for
rehabilitation. Pulse oximetry is used to assess baseline shifts and changes
impacting exercise performance and the ongoing disease process.