Improving the management of patients with chronic cardiac and respiratory diseases by extending pulse-oximeter uses: the dynamic pulse-oximetry

Stefano Nardini; Ulisse Corbanese; Alberto Visconti; Jacopo Dalle Mule; Claudio M Sanguinetti; Fernando De Benedetto

doi:10.4081/mrm.2023.922

Improving the management of patients with chronic cardiac and respiratory diseases by extending pulse-oximeter uses: the dynamic pulse-oximetry

Multidiscip Respir Med. 2023 Dec 20;18(1):922. doi: 10.4081/mrm.2023.922. eCollection 2023 Jan 17.

Authors

Stefano Nardini¹, Ulisse Corbanese², Alberto Visconti³, Jacopo Dalle Mule⁴, Claudio M Sanguinetti⁵, Fernando De Benedetto⁶

Affiliations

¹ Scientific Committee, Italian Multidisciplinary Respiratory Society (SIPI), Milan.
² Retired - Chief of Department of Anaesthesia and Intensive Care, Hospital of Vittorio Veneto (TV).
³ ICT Engineer and Consultant, Italian Multidisciplinary Respiratory Society (SIPI), Milan.
⁴ Cardiologist, Blue Medical Center, Godega di Sant'Urbano (TV).
⁵ Chief Editor of Multidisciplinary Respiratory Medicine journal; Member of Steering Committee of Italian Multidisciplinary Respiratory Society (SIPI), Milan.
⁶ FISAR Foundation (Fondazione Salute Ambiente e Respiro), Chieti, Italy.

Abstract

Respiratory and cardio-vascular chronic diseases are among the most common noncommunicable diseases (NCDs) worldwide, accounting for a large portion of health-care costs in terms of mortality and disability. Their prevalence is expected to rise further in the coming years as the population ages. The current model of care for diagnosing and monitoring NCDs is out of date because it results in late medical interventions and/or an unfavourable cost-effectiveness balance based on reported symptoms and subsequent inpatient tests and treatments. Health projects and programs are being implemented in an attempt to move the time of an NCD's diagnosis, as well as its monitoring and follow up, out of hospital settings and as close to real life as possible, with the goal of benefiting both patients' quality of life and health system budgets. Following the SARS-CoV-2 pandemic, this implementation received additional impetus. Pulseoximeters (POs) are currently used in a variety of clinical settings, but they can also aid in the telemonitoring of certain patients. POs that can measure activities as well as pulse rate and oxygen saturation as proxies of cardio-vascular and respiratory function are now being introduced to the market. To obtain these data, the devices must be absolutely reliable, that is, accurate and precise, and capable of recording for a long enough period of time to allow for diagnosis. This paper is a review of current pulse-oximetry (POy) use, with the goal of investigating how its current use can be expanded to manage not only cardio-respiratory NCDs, but also acute emergencies with telemonitoring when hospitalization is not required but the patients' situation is debatable. Newly designed devices, both "consumer" and "professional," will be scrutinized, particularly those capable of continuously recording vital parameters on a 24-hour basis and coupling them with daily activities, a practice known as dynamic pulse-oximetry.

Keywords: cardio-vascular and respiratory NCDs; dynamic pulse-oximetry; pulse-oximeters; pulse-oximetry; telemonitoring.