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TECHNOLOGY, COMPUTING, AND SIMULATION

Different Responses of Ear and Finger Pulse Oximeter Wave Form to Cold Pressor Test

Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut

Address correspondence and reprint requests to Kirk H. Shelley, MD, PhD, Department of Anesthesiology, Yale University School of Medicine, 333 Cedar St., TMP-3, P.O. Box 208051, New Haven, CT 06520-8051. Address e-mail to kirk.shelley{at}yale.edu

The cold pressor test is often used to assess vasoconstrictive responses because it simulates the vasoconstrictive challenges commonly encountered in the clinical setting. With IRB approval, 12 healthy volunteers, aged 25–50 yr, underwent baseline plethysmographic monitoring on the finger and ear. The contralateral hand was immersed in ice water for 30 s to elicit a systemic vasoconstrictive response while the recordings were continued. The changes in plethysmographic amplitude for the first 30 s of ice water immersion (period of maximum response) of the finger and ear were compared .The data indicate a significant disparity between the finger and the ear signals in response to the cold stimulus. The average finger plethysmographic amplitude measurement decreased by 48% ± 19%. In contrast, no significant change was seen in the ear plethysmographic amplitude measurement, which decreased by 2% ± 10%. We conclude that the ear is relatively immune to the vasoconstrictive effects. These findings suggest that the comparison of the ear and finger pulse oximeter wave forms might be used as a real-time monitor of sympathetic tone and that the ear plethysmography may be a suitable monitor of the systemic circulation.

Implications: We performed a cold pressor test while baseline pulse oximeter monitoring was performed on the finger and ear. The ear was immune to the vasoconstrictive effect of the cold pressor test, suggesting that it may be a more suitable monitor of systemic circulation.

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