Artinis Medical Systems | version 06.

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Thank you for purchasing the PortaMon from Artinis Medical Systems B.V. The
PortaMon is a continuous wave Near Infrared Spectroscopy (NIRS) system. The
device measures online or offline changes in oxy-, and deoxyhemoglobin values
and the tissue saturation index (TSI).
Please read the entire manual thoroughly in order to get acquainted with the
principles and usage of the PortaMon.
Chapter 1 includes the safety information. Please read this chapter carefully.
Chapter 2 explains the basic principles of of the modified Lambert-Beer law.
Chapter 3 includes the theory of spatial resovled spectroscopy applied to calculate
the tissue saturation index (TSI). More literature about NIRS can be found on our
website and on the installation USB. The most up to date list is available on our
website: https://www.artinis.com/publications
PortaMon User Manual
Chapter 4 introduces the PortaMon and explains the equipment that is delivered
with the PortaMon device.
Chapter 5 explains how to measure with the PortaMon and how to perform an
online and an offline measurement. Additionally, instructions are given for
measurement issues.
Chapter 6 explains PortaSoft. PortaSoft is used to download the datafiles of the
offline measurements.
If you still have question after reading the manual, you can e-mail Artinis. Use the
e-mail address of your contact person or e-mail to askforinfo@artinis.com. For
recalibration or a service contract for your PortaMon, contact Artinis.
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Before operating the PortaMon, please read this manual carefully to
become familiar with the device. Additionally, for instructions on the
installation of OxySoft, please consult the OxySoft manual. If you have
any questions remaining after reading the manual, please contact
Artinis.
1 The user must always check the equipment prior to use and ensure it is
safe and proper to use.
2 The PortaMon may only be operated by people who have read the manual
thoroughly.
3 The PortaMon may only be used for research purposes: it cannot be used
for diagnostic purposes.
4 Besides the battery compartement, never open the PortaMon. Do not
unscrew parts of the PortaMon. No user-serviceable parts are inside the
PortaMon.
5 Explosion hazard: do not use the PortaMon in the presence of flammable
anesthetics or gases.
6 Disconnect the PortaMon during magnetic resonance imaging (MRI)
scanning. Using the PortaMon during MRI can inflict burns or adversely
affect the MRI image or the monitor’s accuracy. If it is necessary to use
PortaMon User Manual
oximetry equipement in a MRI environment, please contact Artinis
Medical Systems beforehand.
7 Use the PortaMon in an environemt with tempratures between 10 and 40
˚C. For special conditions (low temperature etc.) please contact Artinis for
further instructions.
8 The PortaMon is not waterproof. Protect the PortaMon from sweat and
moisture.
9 Be cautious when using the device for multiple hours. Excessive sweat,
stress and/or warmth can lead to skin irritation. Do not apply excessive
pressure on the skin with the probe attachment. Stop and remove the
probe if the participant experiences irritation.
10 Safety procedures are taken into cosideration during the development of
the hardware and firmware to prevent continious firing LEDs. if somehow
these procedures fail and the participant feels heat from the LEDs, remove
the sensor as soon as possible.
11 Do not apply excessive pressure on the sensor as this might inflict skin
complications.
1 Do not expose the PortaMon to rain or moisture.
2 Only replace the battery with VARTA model 56456701099-VAR. Use of
another battery may present a risk of fire or explosion. Replacement
batteries can be obtained at Artinis Medical Systems B.V.
3 Charge the batteries only with the supplied charger.
4 Handle the batteries carefully. Any damaged battery should be replaced
directly.
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5 Caution: The battery used in this device may present a fire or chemical Keep dry
burn hazard if mistreated. Do not disassemble, heat above 100°C (212°F)
or incinerate.

Do not wash

In case of problems, remove the battery and contact the manufacturer. No user- At the end of life, send back to
serviceable parts are inside the PortaMon. Service contracts are available from the manufacturer.
manufacturer.

Turn off the PortaMon and remove the battery. Clean the PortaMon by using a soft
cloth, moistened with a non-aggressive general purpose cleaner (e.g., alcohol). Do
not spill any liquid onto the instrument.
The PortaMon conforms with the European Regulations. The PortaMon is
intended for research purposes only. Consult the Declaration of Conformity for
more information about the regulatory compliance.
CE-mark

Symbol Explanation

Refer to instructions for use

Refer to instructions for use

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This chapter introduces the history of near infrared spectroscopy
(NIRS) as well as a basic background on how the technique is used. For
a brief introduction into NIRS principles, the first chapter of the ‘Near
Infrared Spectroscopy: Toy or Tool?’ thesis by dr. W.N.J.M. Colier is
included below. This part is not specific for the PortaMon.
During the second half of the 19th century, it was discovered that blood cells contain
a coloring substance of which the spectrum of light is influenced by various blood
gases [Hoppe, 1862]. Stokes discovered that this substance was the oxygen carrier
of the blood. This substance was later named hemoglobin by the German chemist
Felix Hoppe-Seyler. He found that when shaking a solution of hemoglobin with air,
this resulted in a spectral change. He called the component responsible for this
change "oxyhemoglobin". In 1876 Karl von Vierordt published the first study in which
spectroscopy was used to study hemoglobin in tissue. He identified the transition
of oxyhemoglobin to deoxyhemoglobin in the tissue of the finger after the arm was
PortaMon User Manual
fully occluded. This technique is still practiced today to study oxygenation in
muscles.
At the beginning of the 20th century, oximetry rapidly developed in Germany due
to the efforts of scientists such as Nicolai [1932], Kramer [1934], Matthes [1942] and
Gross. The latter two scientists mentioned, were the first to use light with a
wavelength in the near infrared region. In this part of the light spectrum, absorption
is independent of the oxygenation status of blood. This property allows
forcompensation of changes in blood volume, light scattering and tissue thickness
[Matthes et al., 1939]. However, this technique saw limited utility since the
instrumentation was still very bulky and difficult to use.
The first portable instrument that was able to accurately and automatically measure
hemoglobin saturation in tissue, was built and described by Millikan [1942]. He
named the instrument the "oximeter". The sensor weighed 30 grams, used two
wavelengths and could be slipped over the participant’s ear. To obtain arterial
saturation the ear was moderately heated, a method also used in later versions of
the oximeter. Millikan's instrument had an accuracy of 3 to 5% at the higher end of
the scale (~98% saturation) and an accuracy of 8% at the lower end of the scale
(~50% saturation).
The oximeter of Millikan was later improved by Wood and Geraci [1949]. Further
developments on reflection oximetry were done by Brinkman and Zijlstra [1950].
They developed the "Cyclops", a device which is able to measure oxygen
saturation on the forehead of a participant [Brinkman et al., 1950]. In the following
years, the use of oximetry became increasingly popular in clinical practices. The
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title of Zijlstra's thesis [1951]: "Fundamentals and applications of clinical oximetry",
indicated that they were far ahead of their time.
In the seventies, two important findings contributed to the development and clinical
applicability of oximetry. The first was by Aoyagi [1974], who found that the
variations in arterial blood volume could be used to obtain a signal dependent only
on arterial blood changes. With this knowledge, the arterial oxygen saturation of
the blood could be measured [Aoyagi et al. 1974, Nakajima et al. 1975]. This
technique was named pulse oximetry, and has been developed into a reliable and
widely used method [Kelleher 1989]. The second finding was by Jöbsis [1977], which
was the beginning of near infrared spectroscopy (NIRS).
In his article in Science, Jöbsis [1977] reported that biological tissue has a relatively
good transparency for light in the near infrared region (700-1300 nm). Therefore, it
is possible to transmit sufficient photons through organs for in situ monitoring. In
the near infrared region, hemoglobin, which can be divided into its main
components oxyhemoglobin (O2Hb) and deoxyhemoglobin (HHb), shows oxygen
dependent absorption. However, Jöbsis and his co-workers focused primarily on
the redox state of cytochrome a,a3 (Cyt.Ox.), the terminal enzyme of the
mitochondrial respiratory electron transport chain. Approximately 90% of the
intracellular oxygen consumption is catalyzed by this enzyme. It has been shown
that the absence of oxygen results in a complete reduction of Cyt.Ox. This
reduction can be monitored by measuring the change in absorption band of Cyt.Ox.
PortaMon User Manual
in the near infrared region of 770-880 nm [Chance, 1966]. Information gained from
the near infrared spectrum can therefore give insight into the oxygen availability at
the intracellular level. Combined with the information from the hemoglobin signal,
it is now possible to monitor both circulatory oxygen supply and intracellular oxygen
consumption of the tissue.
In the years following the first publication of Jöbsis, many studies were carried out
focusing on the assessment of Cyt.Ox. within the brains of animals and humans,
especially in the brains of neonates [Jöbsis 1979, Giannini et al., 1982, Keizer et al.,
1985, Proctor et al., 1985, Brazy et al. 1985, Brazy and Lewis 1986, Jöbsis-
VanderVliet et al., 1987, Brazy 1988, Jöbsis-VanderVliet et al., 1988]. Due to
technical improvements, NIRS became a more widespread used method at the end
of the eighties and into the nineties. However, as of now, most clinical studies are
still performed in the neonatal field [Brazy 1991, Edwards et al. 1991, Livera et al.
1991, Skov et al. 1991, Wickramasinghe et al. 1992, Skov et al. 1992, McCormick et
al. 1993, Bucher et al. 1993], of which some are performed by the Nijmegen group
[Liem et al. 1992, 1994, 1995]. A short history of the milestones reached in NIRS are
given in Table 1.
Table 1. The history of milestones reached in NIRS.
YEAR AUTHORS SUBJECT
1977 Jöbsis First publication on NIRS
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1982 Giannini et al. Cyt.Ox monitoring after perfluorcarcon exchange and λ the wavelength (nm) used. In this case, the Lambert-Beer law is given for a

1985 Brazy et al. Neonatal brain monitoring system with a single component.

1986 Ferrari et al. Adult brain monitoring The Lambert-Beer law was intended for use in a clear, non-scattering medium.
When the law is applied to a scattering medium e.g., biological tissue, a
1986 Wyatt et al. Quantitation of cerebral oxygenation in newborn
dimensionless pathlength correction factor B must be incorporated. This factor,
1988 Delpy et al. Quantitation of optical pathlength sometimes called "Differential Pathlength Factor (DPF)", accounts for the increase
in optical pathlength due to scattering in the tissue. The modified Lambert-Beer law
1988 Edwards et al. Quantitation of cerebral blood flow
[Delpy et al., 1988] is given by:
1990 Wyatt et al. Quantitation of cerebral blood volume
O D =   c  L  B + O D R,
1991 de Blasi et al. Quantitation of oxygen consumption in muscle

where ODR,λ represents the oxygen independent light losses due to scattering in
the tissue. Assuming ODR,λ is constant during a measurement, we can convert an
optical density change into a concentration change:

The technique of NIRS relies on the Lambert-Beer law [Beer 1851], which is given
by:

I 
OD  = Log  0  =    c  L
 I

where ODλ is a dimensionless factor known as the optical density of the medium,

I0 stands for the incident radiation, I the transmitted radiation,

 the extinction
coefficient of the chromophore (mM-1•cm-1), c is the concentration (mM) of the
chromophore, L the distance (cm) between the light entry and the light exit point

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To define the algorithm used in NIRS systems, the spectral extinction coefficients
of the various chromophores are needed. Those first to extensively explore the
light absorbion spectra of hemoglobin were Hüfner [1900] and Horecker [1943].
More recently, van Assendelft [1970] investigated hemoglobin and its derivatives.
Due to the introduction of NIRS and pulse oximetry, several recent studies have
focused on the light absorbtion spectra of hemoglobin and cytochrome oxidase
with special attention to the near infrared spectral region [Rea et al., 1985, Harris et
al., 1988, Wray et al., 1988, Zijlstra et al., 1991, Crowe, 1994]. Interestingly, Harris
[1988] and Zijlstra [1991] determined absorption spectra of hemoglobin in both
fetuses and adults. This is of importance as pulse oximetry and NIRS are methods
used in fetal and neonatal applications (Figure 2.2).

Figure 2-1. A scattering medium with an incident and transmitted light ray. The chromophore is symbolized by
black dots. Light ray A is scattered, and therefore travels a distance which equals the pathlength correction factor
times the physical pathlength L. Light ray B is absorbed completely after being scattered.

This equation is valid for a medium with one chromophore. For mediums with
additional chromophores, we need to measure at least as many wavelengths as
there are chromophores present. This results in a set of linear equations. The
solution of this set leads to the algorithm used in most NIRS systems. In biological
tissue there are at least three oxygenation dependent chromophores present:
O2Hb, HHb and Cyt.Ox. The sum of O2Hb and HHb is a measure for the total blood
volume (tHb) in the tissue. If muscle tissue is investigated, there are two more
Figure 2-2. Extinction coefficients of adult oxy- and deoxyhemoglobin (O2Hb and HHb respectively), determined
chromophores present: oxy- and deoxymyoglobin (O2Mb and HMb). by Wray [1988] (solid lines) and Zijlstra [1991] ( and ▲ symbols), and cytochrome oxidase (Cyt.Ox, ● symbol),
also from Wray [1988].

Studies of Wickramasinghe et al. [1993] and Colier et al. [1992] showed that the
transition from fetal to adult hemoglobin had no significant influence on the

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quantitation of the hemoglobin data collected by NIRS. However, with the
quantitation of cytochrome oxidase in interventions where a transition from fetal to
adult hemoglobin takes place, e.g., during blood transfusion or extra corporeal
membrane oxygenation (ECMO), there has to be moved with caution. In these
situations, a small change in the algorithm can lead to unacceptable high errors in
the Cyt.Ox. signal. The change in Cyt.Ox. is highly correlated with changes in
hemoglobin [Skov et al. 1994]. Therefore, in general no attention is paid to Cyt.Ox.
in the literature anymore.
To distinguish between hemoglobin and myoglobin in muscle tissue, the spectra of
ligt applied needs to be sufficiently different. Unfortunately, this is not the case in
PortaMon User Manual
the visible part of the spectrum [Theorell et al. 1955, Yamazaki et al. 1964, Samejima
et al. 1964, Hardman et al. 1965]. Despite their only being one publication on the
near infreared part of the light spectrum [Thorniley et al. 1990], it has been shown
that that O2Mb is transparent to a different part of the near infrared region
compared to O2Hb. This finding however has not yet been confirmed.
Up until now there exists no consensus about which of the data sets for hemoglobin
and cytochrome oxidase come closest to reality. It can therefore be concluded that
the existence of several spectral data sets results in a non-uniform algorithm for
NIRS.
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Table 2. Values of the differential pathlength factor (DPF) for various types of tissue determined by either "time-of-flight" (TRS) or "frequency-resolved" (FRS) measurements. All DPF values are given as mean ± S.D. : post mortem
sample.

AUTHOR METHOD ORGAN/LIMB MALE/FEMALE WAVELENGTH (NM) DPF

Wyatt, 1990a TRS Baby Head () ? 783 4.39 ± 0.28

van der Zee, 1991 TRS Baby Head () M/F 783 3.85 ± 0.57

Benaron, 1990 FRS Infant Head M/F 754 3.78 ± 0.31

Benaron, 1990 FRS Infant Head M/F 816 3.71 ± 0.30

Duncan, 1995 FRS Infant Head M/F 807 4.99 ± 0.45

van der Zee, 1991 TRS Adult Head M/F 761 5.93 ± 0.42
Essenpreis, 1993 TRS Adult Head M/F 800 6.32 ± 0.46

Duncan, 1995 FRS Adult Head M/F 807 6.26 ± 0.88

Essenpreis, 1993 TRS Adult Calf M 800 5.84 ± 0.65
Essenpreis, 1993 TRS Adult Calf F 800 5.63 ± 0.62

van der Zee, 1991 TRS Adult Calf M 761 3.98 ± 0.46
van der Zee, 1991 TRS Adult Calf F 761 5.14 ± 0.43
Duncan, 1995 FRS Adult Calf M 807 4.94 ± 0.67

Duncan, 1995 FRS Adult Calf F 807 6.09 ± 0.93

Duncan, 1995 FRS Adult Forearm M 807 3.74 ± 0.57
Duncan, 1995 FRS Adult Forearm F 807 4.57 ± 0.74

van der Zee, 1991 TRS Adult Forearm M/F 761 3.59 ± 0.32
Ferrari, 1992 TRS Adult Forearm M/F 800 4.3 ± 0.2
Essenpreis, 1993 TRS Adult Forearm M/F 800 4.48 ± 0.41

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cumbersome, relatively expensive and insensitive compared to continuous wave

techniques. An overview of studies to DPF values is shown in Table 2.

For the quantitation of the changes in absorption, not only the physical pathlength
(L) is needed, but also the DPF. The DPF can be assessed in multiple ways. The
most common method is by "time-of-flight" measurements [Delpy et al., 1988, Wyatt
et al., 1990a, Ferrari et al., 1992, van der Zee et al., 1992]. This method fires an ultra- By applying an arterial or a venous occlusion to a limb, it becomes possible to
short laser pulse into the tissue. Subsequently, the pulse is detected by an ultrafast assess various hemodynamic variables, such as limb blood flow and oxygen
camera. The time of flight t can then be converted into a travelled distance d using consumption of muscle tissue during rest or during exercise (Figure 2-3).
the formula:

c t
d =
n
When a venous occlusion is applied to the upper arm or leg by inflating a blood
where c is the velocity of light and n the refractive index of the tissue. Division of d pressure cuff to a pressure of approximately 50 mmHg, this results in (arterial) inflow
by L gives the DPF. Although the "time-of-flight" technique gives good results, the of blood but no outflow. The observed rise in blood volume equals the blood flow
equipment needed for it is expensive and bulky and therefore only available to a into the limb and can be measured with NIRS by monitoring the rise of the tHb
few dedicated research centers. signal after the occlusion (Figure 2-3). This method has been validated with strain
gauge plethysmography [de Blasi et al., 1994].
Another way of assessing the DPF is by making use of "frequency resolved"
systems [Benaron et al., 1990, Sevick et al., 1991, Duncan et al., 1995]. In this
technique, the intensity of the incident light is modulated at a frequency of 200-
300 MHz. A phase sensitive detector measures the envelope phase shift between
the incident and transmitted light. From the phase shift, the mean pathlength can
be obtained. A good set of pathlength data obtained with this technique for brain
and muscle tissue has been published by Duncan [1995]. This technique is still

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Figure 2-3. An example of a NIRS tracing. In this case, two consecutive venous occlusions (V.O.) were applied
to the upper arm. The NIRS optodes were attached to the brachio-radialis muscle of the forearm. During V.O.
there is arterial inflow, but no venous outflow. This results in an increase of both oxy- and deoxyhemoglobin.
From the rise in the tHb signal the blood flow into the limb can be calculated.
The blood flow into a limb can be completely stopped by inflating a blood pressure
cuff to a pressure of more than 250 mmHg. It is then possible to calculate the local
oxygen consumption in rest [Cheatle et al., 1991, de Blasi et al., 1993] or during
(isometric) exercise [Colier et al., 1995] from the gradient of the subsequent
decrease of the O2Hb signal. After the pressure of the cuff is released, the tissue
PortaMon User Manual
will show a hyperemic reaction. The recovery time of the re-saturation observed
with NIRS can be used as a measure for, e.g., the vascularisation of the leg in
patients with peripheral vascular disease [McCully et al., 1994, Komiyama et al.,
1994].
By combining the NIRS data with arterial saturation (SaO2), measured for example
by pulse oximetry, it is possible to quantitate the absolute value of blood volume of
the examined tissue. This method was first described by Wyatt and colleagues
[1990b] for the quantitation of cerebral blood volume.
The effect of a small, gradual and transient change in SaO2 on the O2Hb
concentration is monitored. A decrease in SaO2 of approximately 10%, induced by
lowering the inspired oxygen concentration, is sufficient to calculate the blood
volume. Provided blood flow, volume and oxygen consumption remain constant
during the procedure, the tissue blood volume (TBV) in ml/100 g is given by:
 (O 2 Hb − HHb)
TBV =  c Hb  T  k
2  R  SaO 2
where cHb (mM) is the hemoglobin concentration of whole blood, ρT (g/cm3) the
specific density of the tissue, k a constant reflecting metric conversions and R is, in
case of cerebral tissue, the large-to-small vessel hematocrit ratio with a value of
0.69 [Lammertsma et al., 1984]. The difference between the O2Hb and HHb
concentration is taken to obtain a better signal-to-noise ratio. This difference is also
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called the hemoglobin difference signal (HbDiff). Using this method an absolute
change in arterial saturation is compared to a relative change in concentration of
O2Hb, which can then be quantified.
The principle of measuring organ blood flow with NIRS is based on the Fick
principle. This principle states that the accumulation of a tracer in an organ equals
the difference between the inflow (arterial concentration x flow) and outflow
(venous concentration x flow). If we measure within the transit time of the tracer
through the organ, the venous concentration will be zero. In NIRS the tracer used
is a bolus of O2Hb, which can be induced by suddenly increasing the inspired
oxygen concentration. The concentration of the bolus can be measured by
attaching a pulse oximetry probe onto the organ. The increase of O2Hb as
measured by NIRS represents the accumulation of the bolus into the organ. The
blood flow (BF, in ml●100g-1●min-1) through the organ is then given by the change
of O2Hb divided by the product of the arterial hemoglobin concentration (cHb, in
g●ml-1) times the integral of change in arterial saturation (SaO2, in %) :
K  (O2Hb)
BF = t Chem 1851; 84: 37-52.
cHb  10 − 2   (SaO2)dt
0
K is constant representing the molecular weight of hemoglobin, the tissue density
and a metric conversion factor. This methodology has first been described by
PortaMon User Manual
Edwards and colleagues [1988] for the determination of cerebral blood flow in
newborns, and afterwards by others who made a comparison with the 133Xe
clearance method [Skov et al., 1991, Bucher et al., 1993]. These studies found an
acceptable correlation between the two methods in newborns. Elwell and
colleagues [1992, 1993] have used it to determine the cerebral blood flow in adults.
However, this methodology also comes with its disadvantages. Firstly, a certain
degree of hypoxia with subsequent hyperoxia is needed to induce the O2Hb bolus.
Secondly, a reliable beat-to-beat pulse oximeter is needed for the measurements,
which is generally difficult to comeby. Lastly, an adequate lung function is
necessary.
For more literature about NIRS, see our website.
Assendelft van, OW. Spectrophotometry of Haemoglobin Derivatives. Springfield, IL. CC Thomas 1970;
355–359,
Aoyagi T, Kishi M, Yamaguchi K, Watanabe S. Improvement of the earpiece oximeter. In: Abstracts of the
Japanese Society of Medical Electronics and Biological Engineering 1974; 90-91.
Beer A. Versuch der Absorptions-Verhältnisse des Cordierites für rothes Licht zu bestimmen. Ann Physik
Benaron DA, Gwiazdowski, Kurth CD, Steven J, Delvoria-Papadopoulos, Chance B. Optical pathlength
of 754nm and 816nm light emitted into the head of infants. IEEE Eng Med Biol Soc 1990; 12: 1117-1119.
Brazy JE, Lewis DV, Mitnick MH, Jöbsis-VanderVliet FF. Noninvasive monitoring of cerebral oxygenation
in preterm infants: preliminary observations. Pediatrics 1985; 75: 217-225.
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Brazy JE, Lewis DV. Changes in cerebral blood volume and cytochrome aa3 during hypertensive peaks
in preterm infants. J Pediatr 1986; 108 983-987.
Brazy JE. Cerebral oxygen monitoring with near infrared spectroscopy: clinical application to neonates.
J Clin Monit 1991; 7: 325-334.
Brazy JE. Effect of crying on cerebral blood volume and cytochrome aa3. J Pediatr 1988; 112: 457-461.
Brinkman R, Zijlstra WG, Koopmans RK. A method for continuous observation of percentage oxygen
saturation in patients. Acta Chir Neerl 1950; 1: 333-344.
Bucher HU, Edwards AD, Lipp AE, Duc G. Comparison between near infrared spectroscopy and 133Xenon
clearance for estimation of cerebral blood flow in critically ill preterm infants. Ped Res 1993; 33: 56-60.
Chance B. In: The Biochemistry of Copper (Peisach G, Aisen P, Blumberg WE, eds.) pp: 293-301.
Academic Press, New York. 1966.
Cheatle TR, Potter LA, Cope M, Delpy D, Coleridge Smith PD, Scurr JH. Near-infrared spectroscopy in
peripheral vascular disease. Br J Surg 1991; 78: 405-408.
Colier WNJM, Liem D, Oeseburg B. The effect of fetal hemoglobin on the algorithm used in near infrared
spectroscopy. In: Proc Int Soc Oxygen Transport to Tissue, P76, 1992.
Cope M. The application of Near Infrared Spectroscopy to non-invasive monitoring of cerebreal
oxygenation in the newborn infant. PhD-Thesis of the University of London, Department of Medical
Physics and Bioengineering, UK, 1991.
Crowe J. Absorption spectra of cytochrome oxidase. In: Newsletter Concerted Action NIRS & I, 1994; 3:
3-4.
De Blasi RA, Cope M, Elwell C, Safoue F, Ferrari M. Noninvasive measurement of human forearm oxygen
consumption by near infrared spectroscopy. Eur J Appl Physiol 1993; 67: 20-25.
De Blasi RA, Ferrari M, Natali A, Conti G, Mega A, Gasparetto A. Noninvasive measurement of forearm
blood flow and oxygen consumption by near infrared spectroscopy. J Appl Physiol 1994; 76: 1388-1393.
PortaMon User Manual
Delpy DT, Cope M, Zee P van der, Arridge S, Wray S, Wyatt J. Estimation of optical pathlength through
tissue from direct time of flight measurements. Phys Med Biol 1988; 33: 1433-1442.
Duncan A, Meek JH, Clemence M, Elwell CE, Tyszczuk L, Cope M, Delpy DT. Optical pathlength
measurements on adult head, calf and forearm and the head of the newborn infant using phase resolved
optical spectroscopy. Phys Med Biol 1995; 40: 295-304.
Edwards AD, Brown C, Cope M, Wyatt JS, McCormick DC, Roth SC, Delpy DT, Reynolds EOR.
Quantification of concentration changes in neonatal human cerebral oxidized cytochrome oxidase. J
Appl Physiol 1991; 71: 1907-1913.
Edwards AD, Wyatt JS, Richardson CE, Delpy DT, Cope M, Reynolds EOR. Cotside measurement of
cerebral blood flow in ill newborn infants by near-infrared spectroscopy (NIRS). Lancet 1988; 2: 770-771.
Elwell CE, Cope M, Edwards AD, Wyatt JS, Reynolds EOR. Measurement of cerebral blood flow in adult
humans using near infrared spectroscopy - methodology and possible errors. Adv Exp Med Biol 1992;
317: 325-245.
Elwell CE, Owen-Reece H, Cope M, Wyatt JS, Edwards AD, Delpy DT, Reynolds EOR. Measurement of
adult cerebral haemodynamics using near infrared spectroscopy. Acta Neurochir 1993; 59(Suppl): 74-
80.
Essenpreis M, Elwell CE, Cope M, van der Zee P, Arridge SR, Delpy DT. Spectral dependence of
temporal point spread functions in human tissues. Appl Optics 1993; 32: 418-425.
Ferrari M, Wei Q, Carraresi L, De Blasi RA, Zaccanti G. Time-resolved spectroscopy of human forearm. J
Photochem Photobiol 1992; 16: 141-153.
Giannini I, Ferrari M, Carpi A, Fasella P. Rat brain monitoring by near infrared spectroscopy: an
assessment of possible clinical significance. Physiol Chem Phys 1982; 14: 295-305.
Hardman KD, Eylar EH, Ray DK, Banaszak LJ, Gurd FRN. Isolation of sperm whale myoglobin by low
temperature fractionation with ethanol and metallic ions. J Biol Chem 1966; 241: 432-442.
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Harris AP, Sendak MJ, Donham RT, Thomas M, Duncan D. Absorption characteristics of human fetal Liem KD, Hopman JCW, Kollée LAA , Oeseburg B. Effects of repeated indomethacin administration on
haemoglobin at wavelengths used in pulse oximetry. J Clin Monit 1988; 4: 175-177. cerebral oxygenation and haemodynamics in preterm infants: combined near infrared spec-
trophotometry and Doppler ultrasound study. Eur J Pediatr 1994; 153: 504-509.
Horecker BL. The absorption spectra of haemoglobin and its derivatives in the visible and near-infrared
regions. J Biol Chem 1943; 148: 173-183. Liem KD, Hopman JCW, Oeseburg B, de Haan AFJ, Festen C, Kollee LAA. Cerebral oxygenation and
hemodynamics during induction of extracorpereal membrane oxygenation as investigated by near
Hüfner G. Ueber die gleichzeitige quantitative Bestimmung zweier Farbstoffe im Blute mit Hilfe des
infrares spectroscopy. Pediatrics 1995. (in press).
Spectrophotometers. Arch Anat Physiol 1900; Physiol Abt 39.
Liem KD, Oeseburg B and Hopman JCW. Method for the fixation of optrodes in near infrared
Jöbsis FF. Noninvasive , infrared monitoring of cerebral and myocardial oxygen suffiency and circulatory
spectrophotometry. Med Biol Eng Comput 1992; 30:120-121.
parameters. Science 1977; 198: 1264-1267.
Livera LN, Spencer SA Thorniley MS, Wickramasinghe YABD, Rolfe P. Effect of hypoxaemia and
Jöbsis FF. Oxidative metabolic effects of cerebral hypoxia. Adv Neurol 1979; 26: 299-318.
bradycardia on neonatal cerebral haemodynamics. Arch Dis Child 1991; 66: 376-380.
Jöbsis-VanderVliet FF, Fox E, Sugioka K. Monitoring of cerebral oxygenation and cytochrome aa3 redox
Matthes K, Gross F. Fortlaufende Registrierung der Lichtabsorption der Farbe des Blutes in zwei
state. In: Advances in Oxygen Monitoring (Tremper KK, Barker J, eds.) pp: 209-230. Little, Brown and
verschiedenen Spektralbezirken. Arch Exp Pathol Pharmacol 1939; 191: 369-380.
Company, Boston 1987.
Matthes K. Untersuchungen über den Verlauf der Oxyhämoglobinreduktion in der menschlichen Haut.
Jöbsis-VanderVliet FF, Piantadosi CA, Sylvia AL, Lucas SK, Keizer HH. Near-infrared monitoring of
Pflügers Arch 1942; 246: 70-91.
cerebral oxygen sufficiency. I: Spectra of cytochrome c oxidase. Neurol Res 1988; 10: 7-17.
McCormick DC, Edwards AD, Brown GC, Wyatt JS, Potter A, Cope M, Delpy DT, Reynolds EOR. Effect of
Keizer HH, Jöbsis-VanderVliet FF, Lucas SS, Piantadosi CA, Sylvia AL. The near infrared (NIR) absorption
indomethacine on cerebral oxidized cytochrome oxidase in preterm infants. Ped Res 1993; 33: 603-608.
band of cytochrome aa3 in purified enzyme, isolated mitochondria and in intact brain in situ. Adv Exp
Med Biol 1985; 191: 823-832. McCully KK, Halber C, Posner JD. Exercise-induced changes in oxygen saturation in the calf muscles of
elderly subjects with peripheral vascular disease. J Gerontol 1994; 49: B128-B134.
Kelleher JF. Pulse oximetry. J Clin Monit 1989; 5: 37-62.
Millikan GA. The oximeter, an instrument for measuring continuously the oxygen saturation of arterial
Komiyama T, Shigematsu H, Yasuhara H, Muto T. An objective assessment of intermittent cladication by
blood in man. Rev Sci Instrum 1942; 13: 434-444.
near infrared spectroscopy. Eur J Vasc Surg 1994; 8: 294-296.
Nakajima S, Hirai Y, Takase H, Kuse, Aoyagi T, Kishi M, Yamaguchi K. Performances of new pulse wave
Kramer K. Fortlaufende Registrierung der Sauerstoffsättigung im Blute an uneröffneten Blutgefässen.
earpiece oximeter. Resp Circ 1975; 23: 41-45.
Klin Wochenschr 1934; 13: 379-380.
Nicolai L. Fortgesetzte Untersuchungen über den Verlauf der Oxyhämoglobinreduktion in der
Lammertsma AA, Brooks DJ, Beaney RP, Turton DR, Kensett MJ, Heather JD, Marshall J, Jones T. In vivo
menslichen Hut. Arch Ges Physiol 1931; 230: 328-245.
measurement of regional cerebral haematocrit using positron emission tomography. J Cereb Blood Flow
Metab 1984; 4: 317-322.

17

Patterson MS, Chance B, Wilson BC. Time resolved reflectance and transmittance for the non-invasive
measurement of tissue optical properties. Applied optic 1989; 28: 2331-2336
Proctor HJ, Cairns C, Fillipo D, Jöbsis-VanderVliet FF. Near infrared spectrophotometry: potential role
during increased intracranial pressure. Adv Exp Med Biol 1985; 191: 863-871.
Rea PA, Crowe J, Wickramasinghe Y, Rolfe P. Non-invasive optical methods for the study of cerebral
metabolism in the human newborn; a technique for the future? J Med Eng Technol 1985; 9: 160-166.
Samejima T, Yang JT. Optical Rotary dispersion of sperm-whale myoglobin and its derivatives. J Mol Biol
1964; 8: 863-871.
Sevick EM, Chance B, Leigh J, Nioka S, Maris M. Quantitation of time- and frequency-resolved optical
spectra for the determination of tissue oxygenation. Anal Biochem 1991; 195: 330-351.
Skov L, Greissen G. Apparent cerebral cytochrome aa3 reduction during cardiopulmonary bypass in
hypoxaemic children with congenital heart disease. A critical analysis of in vivo near-infrared
spectrophotometric data. Physiol Meas 1994. 15: 447-457.
Skov L, Pryds O, Greissen G. Estimating cerebral blood flow in newborn infants: comparison of near
infrared spectroscopy and 133Xe clearance. Ped Res 1991; 30: 570-573.
Skov L, Rydling J, Pryds O, Greissen G. Changes in cerebral oxygenation and cerebral blood volume
during endotracheal suctioning in ventilated neonates. Acta Pediatr 1992; 81: 389-393.
Theorell H, Åkeson Å. Reversible splitting of a homogeneous horse myoglobin. Ann Acad Scient
Fennicæ 1955; 60: 303-312.
Thorniley MS, Houston R, Wickramasinghe YA, Rolfe P. Application of near-infrared spectroscopy for the
assessment of the oxygenation level of myoglobin and haemoglobin in cardiac muscle in vivo. Biochem
Soc Trans. 1990; 18: 1195-1196.
Vierordt K. Die quantitative Spektralanalyse in ihrer anwendung auf Physiologie, Chemie und
Technologie. Tubingen: H. Laup p'sche Buchhandlung. 1876.
PortaMon User Manual
Wickramasinghe YABD, Livera LN, Spencer SA, Rolfe P, Thorniley MS. Plethysmographic validation of
near infrared spectroscopic monitoring of cerebral blood volume. Arch Dis Childhood 1992; 67: 407-411.
Wickramasinghe YABD, Palmer KS, Houston R, Spencer SA, Rolfe P, Thorniley MS, Oeseburg B, Colier
WNJM. Effects of fetal haemoglobin on the determination of neonatal cerebral oxygenation by near-
infrared spectroscopy. Pediatr Res 1993; 34: 15-17.
Wood E, Geraci JE. Photoelectric determination of arterial oxygen saturation in man. J Lab Clin Med
1949; 34: 387-401.
Wray S, Cope M, Delpy DT, Wyatt JS, Reynolds EOR. Characterisation of the near infrared absorption
spectra of cytochrome aa3 and haemoglobin for the non-invasive monitoring of cerebral oxygenation.
Biochim Biophys Acta 1988; 933: 184-192.
Wyatt JS, Cope M, Delpy DT, Zee van der P, Arridge S, Edwards AD, Reynolds EOR. Measurement of
optical pathlength for cerebral near infrared spectroscopy in newborn infants. Dev Neurosci 1990a; 12:
140-144.
Wyatt JS, Cope M, Delpy DT, Richardson CE, Edwards AD, Wray S, Reynolds EOR. Quantitation of
cerebral blood volume in newborn human infants by near infrared spectroscopy. J Appl Physiol 1990b;
68: 1086-1091.
Yamazaki I, Yokota K, Shikama K. Preparation of crystalline oxymyoglobin from horse heart. J Biol Chem
1964; 239: 4151-4153.
Zee van der P, Cope M, Arridge SR, Essenpreis M, Potter LA, Edwards AD, Wyatt JS, McCormick DC,
Roth SC, Reynolds EOR, Delpy DT. Experimentally measured optical pathlengths for the adult head, calf
and forearm and the head of the newborn infant as a function of inter optode spacing. Adv Exp Med Biol
1992. 316: 143-153.
Zijlstra WG, Buursma A, Meeuwsen-van der Roest WP. Absorption spectra of human fetal and adult
oxyhemoglobin de-oxyhemoglobin, carboxyhemoglobin and methemoglobin. Clin Chem 1991; 37: 1633-
1638.
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 PortaMon User Manual

Zijlstra WG. Fundamentals and applications of clinical oxymetry. PhD-Thesis University of Groningen,
The Netherlands.

19

This chapter will guide you in setting up a measurement for the tissue
saturation index (TSI) in OxySoft.
The modified Lambert-Beer (MLB) law can only be used for the calculation of
relative concentration changes of oxygenated and deoxygenated hemoglobin.
Absolute concentrations can be obtained by using spatial resolved spectroscopy
(SRS). In SRS, the intensity of the light reflected from the transmitter is measured as
a function of the distance from the transmitter. The shape of this function is related
to the absorption coefficient (μa) of the tissue, from which the absolute hemoglobin
concentrations [µM] and the tissue saturation index [%] can be calculated.
PortaMon User Manual
Figure 3-1. Schematic view of a TSI measurement. Light through tissue with three transmitters, ρ, μa, μs and
absorbers.
The propagation of photons in a highly scattering medium (e.g., tissue), can be
approximated by the photon diffusion theory [Patterson et al., 1989]. The intensity
of the light detected by a receiver, is a function of the source-detector distance and
the absorption and scattering coefficient of the tissue. The slope of the measured
light attenuation versus source-detector distance (δOD/δd) can be determined
using at least two transmitters (see Figure 3-1). From the slope, the absorption
coefficient can be calculated. The two main assumptions in this theory are that the
measurement is performed on homogeneous tissue, and that the wavelength
dependent scattering coefficient of the tissue is constant during the measurement.
The most significant absorbers in tissue that determine the absorption coefficient
are oxyhemoglobin, deoxyhemoglobin and water. The amount of water in tissue is
assumed constant and its value can be set in OxySoft. The correction for absorption
due to water is based on the formula below:
µa (λ) = εO2Hb (λ) cO2Hb + εHHb (λ) cHHb
Where cO2Hb and cHHb are the absolute concentrations of water,
oxyhemoglobin and deoxyhemoglobin respectively. εO2HB (λ) and εHHB (λ) are the
extinction coefficients of water, oxyhemoglobin and deoxyhemoglobin for the
specified wavelenghts. Using two different wavelengths, enables you to calculate
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 PortaMon User Manual

oxygenated and deoxygenated hemoglobin. The tissue saturation index is an

estimate of the oxygen saturation of the tissue (StO2) and is defined as:

cO2Hb cO2Hb
TSI [%] = x 100% = x 100% The parameters in Table 4 are needed in a TSI measurement, and can be set in
ctHb cO2Hb+ cHHB

OxySoft in the optode template tab in the measurement properties screen:

The scattering coefficient needs to be known for the calculation of TSI. The reduced
scattering coefficient µs is related to the distance that the photons travel before Table 4: Parameters used in the optode template in OxySoft.

being scattered. In tissue, µs is found to scale linearly with the applied wavelength. PARAMETER DESCRIPTION
The scattering coefficient is defined as µs = k (1-hλ) and has been quantified for
the average distance between transmitters and the detector
various kinds of tissue by several research groups. The values of k and h found by d –
in the optode holder
Matcher and colleagues (1997) are given in Table 3. In OxySoft, the scattering
coefficient is approximated as being constant over time and the values of k and h delta d – the distance between two subsequent transmitters
can be set.
these constants determine the scattering coefficient µs = k
Table 3: Example of scattering coefficients for three tissue types (Matcher et al., 1997). –
and (1-hλ). Predefined values as well as user-defined values can

TISSUE TYPE [MM-1] [NM-1] be used.

Forearm 1.1
Note that the TSI is not dependent of DPF, but the DPF is needed in the calculation
Head 1.45
of the concentration changes, so always fill in this value in OxySoft.
Calf 1.63

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 PortaMon User Manual

A one-channel TSI measurement can be performed by using a minimal of two

transmitters in combination with one detector. A three-channel measurement
provides you with an additional value: the TSI Fit factor. The TSI Fit factor
determines how well the measurement values fit the theory and is a measure for
the quality of your TSI measurement. The measurement quality and the TSI Fit factor
can be increased by covering the optodes during data acquisition and by placing
the optode on homogeneous tissue (e.g., no moles). A TSI Fit factor of 100% means
a perfect fit and TSI Fit factor of >99% will give good TSI measurement. Due to
physiological changes during exercise, this value may change during the
measurement. To set up a measurement with a TSI fit factor, use an optode
template with ‘TSI fit factor’ in its name (e.g., ‘PortaMon TSI fit factor’).

Figure 3-2. Screenshot of tab Optode Template in measurement properties where all parameters can be set.

The TSI is generally 60-80% in muscle tissue at normal conditions. Note that the
Table 5 gives an overview of the difference in theory of the MLB law and the theory
TSI theory will only be valid under certain conditions. When the calculated TSI
of SRS. Note that a TSI measurement will also provide you with the relative
percentage is negative or larger than 100, it is truncated to [0,100]. In that case, the
concentrations calculated by the MLB theory, as one TSI channel forms 2 or 3
measurement does not fit into the mathematical model.
regular channels. Therefore, the DPF should also be set for TSI measurements. A
TSI channel combination of 1 Rx and 2 Tx does not have the TSI Fit Factor option.

Table 5: Overview of the Modified Lambert-Beer Law and the spatial resolved spectroscopy theory.

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 PortaMon User Manual

THEORY: MODIFIED LAMBERT-BEER (MLB) SPATIAL RESOLVED SPECTROSCOPY (SRS)*

Optodes: Combination of 1 Rx and 1 Tx Combination of 1 Rx and 2 Tx** or 1 Rx and 3 Tx

Measures: Hemoglobin concentration changes TSI, TSI Fit Factor and absolute hemoglobin concentrations

Parameters: Known: , and d , , d and Δd

Assumed: DPF ( and )

Channel selection for plotting: Select circle: Select square:

Example: Rx1 – Tx1 Example: Rx1 – Tx1, Tx2, Tx3

23

This chapter introduces the PortaMon and explains all the equipment
which is delivered with the PortaMon device. Please first follow the
installation procedures as described in in the OxySoft manual.
The PortaMon is a portable continuous wave NIRS system, which emits light at two
wavelengths. The device is developed to measure concentration changes of
oxyhemoglobin and deoxyhemoglobin with near infrared light. Based on the
configuration of three transmitters and one receiver, the PortaMon system is able
to calculate the the tissue saturation index (TSI) (Chapter 3). The device has been
calibrated prior to delivery. For recalibration of the device, contact Artinis Medical
Systems. The components of the PortaMon are explained in Figure 4-1 and Figure
4-2.
1. Top lid
2. Display diodes
3. LEDs
4. Receiver
5. Left button (on/off)
PortaMon User Manual
6. Bluetooth display diode
7. On/off and Bluetooth display diodes
8. Right button(start/stop offline acquisition)
9. Power bar
Keep the surface of the receiver and light sources clean. The device is not
waterproof. It is possible to seal the PortaMon with a thin transparent plastic to
protect it from moisture (sweat) or for hygienic purposes. Since measurements are
based on relative light intensities, any homogeneous material (light absorber) can
be placed in between tissue and the receiver and/or the light sources. This means
that, for example, the instrument can be kept in a thin plastic bag during
measurements. In this way, the light loss for all three channels should be the same.
If this is not the case, the relative offsets will change and the device needs to be
re-calibrated.
The wavelengths are approximately 760 nm and 850 nm. The exact wavelengths
are visible in the software. The PortaMon can measure with a sampling frequency
of 1, 2, 5 or 10 Hz. The internal flash memory can store 1 GB of data, which equals
about 50 hours at a 10 Hz sample rate. The device weighs 84 grams including the
battery. The dimensions are 84x42x17 mm (LWH).
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 PortaMon User Manual

After inserting the battery (paragraph 4.2.4), the device will automatically power on
within a few seconds. If the battery is inserted but the device is off, press the left
button [5] for a couple of seconds to turn on the device. If the device is not powering
on, check the placement of the battery or replace it with a fully charged battery.
The on/off display diode [7] will turn on.

The device will automatically turn itself off after 5 minutes if it is not measuring and
not connected to Bluetooth. It will also power down when the battery level is too
Figure 4-1. PortaMon – top.
low to perform a measurement. The device can be powered off when there is no
Bluetooth connection by pressing the left button [5] for a couple of seconds. If the
battery is removed without powering off the PortaMon, settings such as the date
and time might become incorrect.

The front display contains blue and green diodes. The most left diode [7] is blue
and indicates a Bluetooth connection. The second most left diode [7] is green and
indicates the power mode. A continuous green light indicates that the device is
powered on; a blinking green light indicates that the device is recording data.

The diode bar [9] indicates the battery strength. All lit diodes indicate a fully charged
battery, while no lit diodes indicate an empty battery. During ongoing recording the
Figure 4-2. PortaMon – bottom. diode bar is turned off to save battery power.

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 PortaMon User Manual

The distance between the receiver and transmitters is called the source-detector
distance or the inter-optode distance. The first transmitter is at 30 mm, the second
The display contains two buttons, a left and a right button. The left button [5] is used
is at 35 mm and the third at 40 mm distance from the receiver. The separator
to turn the device on/off and to generate events during offline measurements. To
distance of the transmitters is 5 mm. A transmitter and receiver together form a
turn the device on or off, it should be pressed once for a couple of seconds. The
channel.
events can only be made during offline recordings (paragraph 5.2). Press the button
shortly to generate an event. During the experiment, be careful when pressing the The optode configuration which is used during the measurement has to be
button. Do this only during an unimportant part of the experiment, since it is possible specified in OxySoft in the measurement properties as an optode template (see
that the PortaMon will move when pressing the button. Good fixation of the the OxySoft manual). Optode templates define the used optode combinations
PortaMon will reduce this problem. made by transmitter and receiver optodes. The optode templates are essential to
create the correct graphs, to calculate the concentrations and TSI. Choose the
Note for PortaMon devices with an ID below 209: the right button generates an
template ‘PortaMon TSI’ or ‘PortaMon TSI fit factor’ in OxySoft for the right
event.
parameters.
The right button [8] is used for on-board DAQ and the battery/signal strength
indication. A short button press (~1 second) is used to toggle between indicating
battery signal strength (green diodes) and received signal strength (yellow diodes)
[9]. A long button press (more than a second) is used to start/stop offline recording.
The PortaMon is packed in a sturdy yellow Peli case (

Figure 4-3), which is ideal for fieldwork. The picture below gives an overview and
The PortaMon contains three transmitters (Tx). The transmitters or light sources, are example of the case and its contents. All items are numbered and described in the
LEDs of which each transmit two wavelengths (± 760 nm and ±850 nm). If the list below.
PortaMon is placed on the skin, the light transmits through the skin, scatters back,
1. Straps and black cloth for bright ambient light situations
and is received by the receiver (Rx). The receiver is a high sensitivity PIN diode with
2. Battery charger power cord
ambient light protection. The light sources fire one by one; consequently, the
3. OxySoft license key (USB dongle protected)
system can distinguish the light sources. This principle is called the time-
sequenced principle. Transmitters and receivers are also called optodes. 4. PortaMon

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 PortaMon User Manual

5. USB Bluetooth dongle

6. Battery charger Straps and tape are delivered to attach the PortaMon to a participant. The best
7. Two Li-Polymer batteries material to apply depends on the application, e.g., how tight the PortaMon should
The USB stick with OxySoft software is usually in the opening of the lower right be attached to the skin. Some examples of fixation are shown in Figure 4-4. Cover
corner. the PortaMon with a plastic wrap (household plastic, saran wrap, cling film, glad
wrap) before fixation to protect it from sweat.

Make sure the receiver and the LEDs are completely attached to the skin.

Make sure you use a dark cloth to cover at least 6-10 cm of tissue around the
detector, especially when you perform experiments in bright sunlight. We can
provide different solution to attach the PortaMon firmly to the skin.

a. b.
1 2 3 45 6 7

Figure 4-3. Yellow Peli case with the PortaMon.

27

c. d.
Figure 4-4 Fixation of the PortaMon. Caution: the PortaMon should be protected from sweat before fixation. (a)
The best way to fixate the PortaMon is with tape. (b) Fixation with elastic straps. (c) Fixation with tape strips. (d)
PortaMon covered with a black cover.
The RocKey license key enables OxySoft to run. Plug the license key in a USB port
of the computer before starting OxySoft to enable the functions. The license key
looks similar to a red USB stick, however, it cannot be opened or used to store any
data files.
If OxySoft gives an error with the license key plugged in the USB port of the
computer, the driver of the license key should be updated. Please consult the
OxySoft manual for additional information.
PortaMon User Manual
The USB Bluetooth dongle is needed to connect the PortaMon via Bluetooth with
a good connection. Connect the USB Bluetooth dongle by plugging it in a USB port.
See paragraph 5.3.1 or the OxySoft manual for additional information about
Bluetooth.
To insert a battery, open the top lid of the PortaMon by sliding it gently to the
backside of the PortaMon. The battery has to be placed such that the metal plates
of the battery make contact with the metal pins of the PortaMon. Once the battery
is inserted, slide the top lid back in position. The PortaMon will turn on in a couple
of seconds.
If the battery is (almost) empty, it can be removed and replaced. Always power off
the device before removing the battery, otherwise data can be lost. You can
deduce the battery strength by looking at the diode bar on the PortaMon display
(paragraph 4.1.1).
The battery can be removed permanently to preserve battery power. Before
starting an offline measurement, connect the PortaMon with a computer to make
sure the settings are correct and to synchronize the date and time with that of the
computer.
Charge the batteries with the delivered charger [6]. You can connect the charger
via the supplied cord with a power socket. This initiates blinking of the yellow light
on the charger. Insert the battery into the charger. The yellow light turns orange,
28
 PortaMon User Manual

which means the battery is charging. The battery is a lithium Polymer (1100 mAh)
and can run 7 to 10 hours in normal environment.

Dispose of the used battery promptly. Keep away from children.

29

This chapter explains how to perform an experiment with one or more
PortaMon device(s). The measurement can be performed online in
OxySoft with a Bluetooth connection to the computer, or offline. Offline
recordings are stored in the internal memory of the PortaMon and are
downloaded with PortaSoft and analyzed in OxySoft. If the PortaMon
is within Bluetooth range, it is preferred to run it with OxySoft (online).
Online measurements are performed with OxySoft. First, make sure that OxySoft is
installed (see OxySoft manual), the calibration file is in the device folder
(C:\Users\Public\Documents\Artinis Medical Systems BV\common\device) and the
battery is charged. When using multiple PortaMon devices, please be aware of light
interference if the systems are placed in proximity of each other. This can be
checked by turning off the light sources of the PortaMon in OxySoft, and checking
the DAQ values in the DAQ value view. For more information on any OxySoft
functions, including the DAQ value view, please consult the OxySoft manual).
1 Turn on the PortaMon.
2 Connect the PortaMon to the computer via Bluetooth.
PortaMon User Manual
3 Plug in the OxySoft license key.
4 Start OxySoft.
5 Create (a project and) a measurement in OxySoft and connect to the
PortaMon.
6 Choose the optode template and set the DPF, D(mm), delta d(mm), h and
k and the appropriate sample rate.
7 Attach the PortaMon to the participant (paragraph 4.2.1). Remove hair if
necessary.
8 Make sure the PortaMon is covered to prevent influence from any
environmental light. We advise to use a black cloth to cover the tissue and
device over an area of at least 6 cm around the receiver for optimal
measurments.
9 Start the data acquisition. If multiple systems are used, check for
interference.
10 Let the PortaMon run (LEDs are firing) for at least 2 minutes before you
start the experiment. If you stop in between, run it again for 2 minutes
before you start the experiment.
11 Make sure you are displaying graphs, traces and indicators and have
predefined events or anything else that you will need during the
measurement.
12 Never start your experiment before you have good signal quality for all
channels. You can check the received light in the DAQ values.
1 Start measurement.
2 Indicate the start of the experiment with an event (OxySoft manual), this is
adviced due to two reasons. 1: to have a clear indication of the start of the
experiment, 2: to ensure the data is being recorded.
30

3 Inspect the DAQ values to ensure data quality.
4 Inspect the device status in the DAQ status view.
5 Insert events during the experiment if needed.
6 End the data acquisition after performing the experiment.
The DAQ value view in OxySoft is crucial for checking your data quality. In this
window, you can adjust the power level of the transmitters. Set them to “Standard”
when measuring. Set them to “Off” when checking for interference of other devices
or environmental light. Make sure the PortaMon is securely fixated on the skin and
covered with a black cloth. This will lead to the DAQ values only displaying the
received environmental light or light from other systems. If this is higher than 30
light counts, there is interference.
To get an optimal signal, try to remove (dark) hair. In some cases, the light of one
transmitter is completely absorbed. This will disturb calculation of the TSI. If it is not
possible to increase the amount of received light of this transmitter, it is possible to
use the TSI calculation based solely on the first and second optode combination,
with the optode template “PortaMon TSI”. Make sure that the distance (d(Nom)) and
the slope (d(Slope)) in the measurement properties is correct. Check if you can see
the heartbeat in the signals; this indicates a good quality signal.
PortaMon User Manual
Offline measurements are prepared with PortaSoft (chapter 6). If the PortaMon is
within Bluetooth range of a computer during the measurement, it is recommended
to do an online measurement instead. To do an offline measurement, make sure
OxySoft is installed (see OxySoft manual) and the battery is charged (paragraph
4.1.1). It is advised to use fully charged batteries.
It is not possible to check the quality of the data during an offline measurement,
therefore it is recommended to perform an online trial measurement beforehand.
During the trial measurements, it is important to keep the same paradigm and
positioning as will be used during the offline measurements. Note that a darker skin
or dark hair can lead to lower signal strength (paragraph 5.2.3).
1. Power on the PortaMon (paragraph 4.1.1).
2. Connect the PortaMon to the computer via Bluetooth.
3. Start PortaSoft (chapter 6).
4. Make a connection.
5. Erase the memory if necessary (paragraph 6.2.3).
6. Select the sample rate.
7. Close PortaSoft.
8. Attach the PortaMon to the participant (paragraph 4.2.1). Remove hairs if
necessary.
9. Make sure the PortaMon is covered to prevent influence from any
environmental light. We advise to use a black cloth to cover the tissue and
device over an area of at least 6 cm around the receiver.
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 PortaMon User Manual

8. Analyze the data.

1. Start the offline data acquisition by pressing the right button of the
PortaMon for 5-10 seconds (paragraph 4.1.2), you will notice that the power
light [7] starts blinking. Let it run (LEDs are firing) for at least 2 minutes
before you start the experiment. If you stop in between, run it again for 2
minutes before you start the experiment.
2. Check the signal strength by pressing the right button for 1 second
(paragraph 4.1.2).
3. Start the experiment. It is possible to indicate the start of the experiment
with an event. Insert an event by pressing the left button for 1 second,
resulting in a blue light for 1 second of the Bluetooth display diode
(paragraph 4.1.2).
4. Insert events during the experiment (paragraph 4.1.2).
The internal flash memory can store 1 GB of data, which equals about 50 hours of
recordings at a 10 Hz sample rate. If there are unexpected spikes in the
downloaded data, or if you do not get any data files from downloading, try to
download the data again or contact Artinis. Data samples might have been lost
during transfer to your computer, for example due to other interfering software.
The signal strength is important during the experiment. Check the signal strength
before the start of the experiment. The signal strength can be depicted as the
number of diodes which are on in the diodebar (paragraph 4.1.1).

5. End the data acquisition after the experiment by pressing the right button If the diode bar is empty, that means the receiver receives no light and, most likely,
for 5-10 seconds (paragraph 4.1.2).
the tissue is absorbing all light. When this happens, try to remove (dark) hair and
If you want to analyze the data afterwards or if the memory is full, follow the steps ensure the fixation of the PortaMon on the skin.
below. You can start a new recording without downloading the data.
During an offline experiment, the signal strength can be checked. However, be
1. Connect the PortaMon to the computer via Bluetooth. careful when pressing the button to check. Do this only during an unimportant part
of the experiment, since it is possible that the PortaMon will move when pressing
2. Start PortaSoft (chapter 6).
the button. Good fixation of the PortaMon will reduce this problem.
3. Make a connection.
4. Download the recorded data (paragraph 6.2.2).
5. Erase the memory if necessary (paragraph 6.2.3).
6. Close PortaSoft.
7. Open the data in OxySoft using the function “Create offline
measurement”.

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If you have any Bluetooth problems at connection or during a measurement, please
make sure that:
- The Bluetooth dongle is inserted in the laptop
- The Bluetooth dongle is installed correctly (in general this happens
automatically)
- The PortaMon is added in the window Bluetooth & other devices of
your settings on your computer
- The internal Bluetooth of your laptop is disabled
- No other Bluetooth software is installed on your laptop
A poor Bluetooth signal can also be caused by interference.
- Walls or metal between the PortaMon and Bluetooth receivers strongly
reduce Bluetooth signal quality
- A strong wifi network can interfere with Bluetooth
- Bluetooth cannot reach through water (PortaMon should be sealed
before underwater use, contact us for more information)
- The distance between the PortaMon and Bluetooth dongle does not
exceed the range. There are two types of antenna that can be used:
one for a range of 70 meters and one for 150 meters.
Tips for troubleshooting whenever you have Bluetooth connection issues:
- Restart the PortaMon
- Restart OxySoft
- Remove and add the PortaMon at Bluetooth devices of your computer
PortaMon User Manual
- Restart your laptop
- Decrease the distance between the PortaMon and the Bluetooth
receiver
If this does not solve your Bluetooth connection issues, please contact us at
askforinfo@artinis.com.
If the recording can not start or if it stops during an online measurement, please
make sure that:
- The PortaMon is on and the battery is not empty
- There is a Bluetooth connection
- The measurement is opened for data acquisition
- The PortaMon is selected as measurement device in OxySoft
If the recording can not start or stops during an offline measurement, please make
sure that:
- The PortaMon is on and the battery is not empty
- The memory is not full
If no changes are visible in the DAQ values or if the traces are flat, zero or gone,
there can be several reasons causing this.
If this is observed during online measurements, please make sure that:
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 PortaMon User Manual

- The PortaMon is on and the battery is not empty - You filled in the correct inter-optode distance, DPF, d, h and k.
- There is a Bluetooth connection - You selected the correct optode template
- The experimental setup is correct - You set a correct graph scale/zoom or auto scale
- The PortaMon is well attached: all LEDs and receivers have skin - You select Bias all traces in measurement before the start of your
contact experiment to get better offsets
- Enough light is received. You can check the DAQ values. - You select no filter
- The trace properties are set correctly. Select the correct graph, - The calibration file is in the correct folder
channel or traces. Make sure you select no filter and remove any cyclic (C:\Users\Public\Documents\Artinis Medical Systems
operator BV\common\device)
- If data is visible, but not as expected, take a few steps back and check - The coefficient tables are correct
the experimental setup
If this is observed during analyzing an offline measurement, please make sure that:

- The PortaMon was on and the battery was not empty.

- The experimental setup was correct.
- The PortaMon was well attached: all LEDs and receiver had skin
contact.
- Enough light was received. You checked the signal strength with the
front diodes (paragraph 4.1.1)
- The trace properties are correct.
- If data is visible, but not as expected, take a few steps back and check
the experimental setup.
If you are analyzing data, make sure that:

- You selected a data file with data. You can check the file information
in OxySoft

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 PortaMon User Manual

This chapter describes how PortaSoft works. PortaSoft is necessary to

download the datafiles of offline measurements.

Double-click the PortaSoft3 icon on your computer. Make sure that the Bluetooth
Figure 6-2: Searching for the connection with the PortaMon
USB dongle is in the computer. Click Scan for devices to make PortaSoft search for
the PortaMon device. The window shown in Figure 6-2 will open. Select your device
and click Connect.

Figure 6-3: Connecting with the PortaMon

Figure 6-1: Opening screen of PortaSoft

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 PortaMon User Manual

Figure 6-5: Failed connection with the PortaMon device

To disconnect the PortaMon, close the PortaSoft application.

The window in Figure 6-1 is the main menu with the options for preparing an offline
measurement (paragraph 6.2.1), erasing the memory (paragraph 6.2.3) and
Figure 6-4: Connected PortaMon device
downloading recorded data (paragraph 6.2.2)
If the connection succeeds, the following window will come up (Figure 6-4). The
window shows which PortaMon is connected (ID 1117, in this example). PortaSoft can
warn you about the battery level. To prepare the settings of an offline recording, connect the PortaMon with
PortaSoft. Select the sample rate of your offline recording by clicking on the scroll
If the connection fails, the window as shown in Figure 6-5 will come up. Check the
down menu of the fourth box (Figure 6-4), you can choose 1, 2, 5 or 10 Hz for the
things mentioned by the text. Restart PortaSoft before trying to connect again.
PortaMon device. After choosing the appropriate sampling frequency click Set.

It is not necessary to prepare each offline measurement again. If an offline

measurement is started without preparation in PortaSoft, it will use the same
settings as for the previous recording. However, after replacing the battery or

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 PortaMon User Manual

making a connection in OxySoft, connect again with PortaSoft for time

synchronization. The time is automatically synchronized with the computer when
connecting with PortaSoft.

Download the recorded data by clicking Download, the second button on the
menu. Select the output directory to store the data. You cannot store files in the C-
root (C:/). Enter a base filename for the downloaded datafiles and click OK.
PortaSoft is now dowloading all the offline recordings stored on the PortaMon. The
progress of the downloading time is shown with the green bar (Figure 6-6). The
data is saved as an *.oxy3 file. These files can be opened in OxySoft for analysis.
For more information regarding opening of the datafiles, consult the OxySoft
Figure 6-7: Overview of the downloaded files
manual.
After finishing downloading an overview of the datafiles is given (Figure 6-7).
Whenever two or more recordings were stored on the PortaMon, the filenames +
the number of the recording will be the title of the new filename: [Filename01.oxy3],
[Filename02.oxy3] etc. After erasing the memory (paragraph 6.2.3), the numbering
will restart.

The number of samples and start time of the measurement is shown in the
download summary. The start time is only correct if the PortaMon was synchronized
with the computer during the time of the measurement.

Figure 6-6: Downloading offline recording of the PortaMon system

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 PortaMon User Manual

Click Erase memory, the third box in the menu, to erase the memory of the
PortaMon (Figure 6-8).

Figure 6-8: Erase the memory of the PortaMon

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 PortaMon User Manual

7
In the event that any Artinis Medical Systems product becomes defective in material
or workmanship during the warranty period, Artinis Medical Systems B.V. will
determine whether the product defect is covered under warranty. Artinis Medical
Systems B.V., at its sole discretion, may replace or repair the unit determined to be
The warranty of Artinis Medical Systems products perseids to one year from the
under warranty. The labor and material costs associated with the repair of the
date of delivery, with the exception of optical fibers. Optical fibers are fully excluded
product may be covered by Artinis Medical Systems if the product is determined to
from warranty. These warranties do not cover product abuse, modification, failure
be under warranty. You must receive pre-approval from Artinis Medical Systems for
to adhere to product instructions, improper operations and/or misuse. Artinis
the labor and material costs prior to repair or replacement of warranty products.
Medical Systems B.V. is not responsible for damage arising from failure to follow
Artinis Medical Systems must be contacted either online or by telephone to obtain
instructions relating to the product’s intended use. Artinis Medical Systems B.V. is
a Return Material Authorization (RMA) number. Performance of any repair or
not responsible for injury or loss caused by or associated with the installation and/or
replacement on products under warranty does not renew or extend the warranty
use of equipment in any manner other than in strict conformance with the
period. For repairs of products obtained through a reseller or distributor, the
instructions set in this manual. Artinis Medical Systems B.V. does not warrant
reseller or distributor should be contacted for warranty.
damages or defects as a result of unauthorized changes to one of the items or
shipping damage (other than original shipment from Artinis Medical Systems). The
warranty is voided if the serial number of the product is defaced, modified or
missing. Software Products are covered specifically for defective media or manuals
only, and are provided as is. The acquired software license cannot be transferred
back to Artinis Medical Systems B.V. under any circumstances. Artinis Medical
Systems B.V. does not warrant that third-party software or hardware will function
You can return a product for repair that is not covered by warranty only if you have
error-free when used in conjunction with its products.
received a preapproved RMA number from Artinis Medical Systems B.V. Labor
Devices developed by Artinis Medical Systems are not intended to cure, treat, costs and freight charges associated with non-warranty repair will be the sole
mitigate or prevent any disease. responsibility of the customer. For any product that is repaired outside of the

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 PortaMon User Manual

warranty period, extra costs for labor and materials specific to the needed repair
will be charged by Artinis Medical Systems B.V. Repaired products out of warranty
receive an extended half year warranty, exclussively for the repaired parts. The
warranty becomes effective the day the item is received after repair. For repairs of
products obtained via a reseller or distributor, the reseller or distributor should be
contacted for warranty.

You are notified if, after examining and testing a returned product, Artinis Medical
Systems concludes that the product is not defective. The product is returned to you
and you would be responsible for the freight charges associated with the return.

40