New indications for peripheral pulse wave

Event start date
Event start time
12.00
Place

Finn-Medi 5, auditorium, address: Biokatu 12.

Jarkko Harju

Doctoral defence of Lic.Med. Jarkko Harju

New indications for peripheral pulse wave

The field of science of the dissertation is Anaesthesiology and Intensive Care Medicine.

The opponent is docent Anne Vakkuri (University of Helsinki). Professor Arvi Yli-Hankala acts as the custos.

The language of the dissertation defence is Finnish.

How could the peripheral pulse wave be utilised better in the monitoring of a patient?

The wrist or finger as a point where to measure vital functions is a tempting modern alternative. The development of mobile and battery technology has enabled the development of small portable devices, but there is still very little reliable information about their operation, error sources and suitability for patient monitoring. The pulse wave measured from the finger can also be used for estimating the strength of the pain stimulus during surgery and, through that, for directing the dosage of pain medication for anaesthetised patients. The dissertation study of the anaesthesiology and intensive care specialist Jarkko Harju deals with new ways to make use of the pulse wave measured from the protruding parts of the body. The dissertation consists of four separate parts and a summary section where the operation and reliability of different kinds of devices that measure from the periphery are discussed.

A device that is capable of the remote monitoring of a patient and that is continuously-operating, easy to use, affordable, light and portable could be extremely useful in many monitoring wards or generally in the monitoring of the condition of a patient who is in hospital. In the study, the operation of the bracelet that is being developed was examined with surgery patients. The device can measure tissue oxygenation, the pulse, the respiratory rate and the blood pressure through nearly continuous measurement. Even though the device had worked with healthy test subjects, its performance still proved insufficient for reliable patient measurement.

The benefit of the measurement of depth of sleep and the pain stimulus was investigated in an extensive international multisite study (494 patients). By using meters in directing the dosage of pain medication and anaesthetic during anaesthesia, the patient’s reawakening and recovery could be speeded up without deterioration in the circumstances during surgery or the condition of the patient.

For small children, significant detriment is caused by excessive administration of analgesics during surgery. An excessive dosage may lead to incidents of apnoea, even hours after the operation. There is no meter yet that is suitable for these very youngest patients. In the study, the pain index SPI (Surgical Pleth Index) was also found to work with children under the age of two, even with small children, but the meter would need a separate scale in order to be usable.

The dissertation brings together the challenges and reliability of peripheral measurement with patients.

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The dissertation is published in the publication series of Acta Universitatis Tamperensis; 2408, Tampere University Press, Tampere 2018. The dissertation is also published in the e-series Acta Electronica Universitatis Tamperensis; 1918, Tampere University Press 2018.

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