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Because newborns are known to wiggle and move around, using a pulse oximeter that is motion tolerant is also important.

Smartphones and tablets could become medical monitors

Do you have a smartphone in your pocket or purse? If so, you may be carrying the future of mobile medical monitoring technology.

According to a special article in the October issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS), smartphones and tablet computers have an emerging role as mobile medical monitoring devices. They may also help extend the use of pulse oximetry for monitoring blood oxygen levels in developing countries around the world, according to the article by Dr J. Mark Ansermino of University of British Columbia, Vancouver. He writes, "The widespread adoption of mobile devices, even in low-resource settings, promises to make vital signs monitoring available anywhere and at low cost."

Today's mobile devices "have the computing capability, display, and battery power to become powerful medical devices that measure vital signs and provide intelligent interpretation or immediate transmission of information," according to Dr Ansermino. He notes that of the nearly six billion mobile phone users worldwide, two-thirds live in developing countries and remote areas.

In particular, mobile devices could increase access to pulse oximetry: the familiar "finger clip" device used to monitor blood oxygen levels (arterial oxygen saturation) during anesthesia and surgery, as well as other medical procedures. In developed countries, pulse oximetry has become so widely used that it has been called the "fifth vital sign" — added to body temperature, pulse rate, blood pressure, and respiratory rate.

But pulse oximetry is still not routinely available in many areas, because of the costs of purchasing, using, and maintaining the monitoring equipment. In those places, cell phones or tablet computers as monitors could provide an effective and economical approach to increasing the availability of blood oxygen measurement.

"The inherent computing power of these devices, and their everyday availability, offer the opportunity to create a stand-alone device that can be used in the home by patients—yet which can also communicate with clinicians in real time,"

Dr Ansermino writes. He notes that previously owned smartphones and tablets could be "repurposed" for use as monitoring devices in developing countries.

Some technologies for mobile pulse oximetry are already in use; commercial modules that can communicate with mobile devices are now in clinical trials. An app that converts the iPhone into a device capable of monitoring pulse oximetry and other vital signs is also available, though not approved for medical use. While the technology still needs to be refined, these types of applications "deliver the promise of pulse oximetry combined with supportive diagnostic and treatment applications into every medical setting and every home," writes Dr Ansermino.

For example, mobile monitoring could be an important tool in reducing deaths from pneumonia in children — still a common event in many resource-poor countries. If mobile pulse oximeters were more widely available, declining blood oxygen levels could be detected more promptly, thus allowing faster intervention.

Mobile pulse oximetry could also improve the ability to identify women at risk of developing pre-eclampsia —a life-threatening complication of pregnancy and delivery.

In addition, modern smartphones and tablets also have the computing power to perform sophisticated analyses of the photophlethysmographic (PPG) data produced by pulse oximeters, potentially providing additional useful information. They could also be used to improve contact with health care providers, as an information resource to guide care, and as an educational tool for patients and health care providers.

"The widespread availability of pulse oximetry on mobile devices will realize the potential of pulse oximetry as both a monitoring and diagnostic tool in a wide range of clinical settings," Dr Ansermino concludes. With continued development of mobile monitoring technology, he foresees a day when "Oxygen saturation will truly become recognized as one of the vital signs."

Abstract
Much more than a telephone, today’s mobile device has become an integral part of the way we interface with the world. Mobile devices have the computing capability, display, and battery power to become powerful medical devices that measure vital signs and provide intelligent interpretation or immediate transmission of information. The widespread adoption of mobile devices, even in low-resource settings, promises to make vital signs monitoring available anywhere and at low cost. This readily available computing power will also extend the utility of vital signs monitoring to new clinical indications, especially with the use of additional processing and integration of information. This review will focus on the universal promotion of pulse oximetry and advanced processing of plethysmography to assess variables such as respiratory rate, capillary refill time, and fluid responsiveness, and how these measurements may assist with perioperative monitoring, diagnosis, and management of pneumonia in children and preeclampsia in pregnancy when combined with mobile devices.

About Anesthesia & Analgesia
Anesthesia & Analgesia was founded in 1922 and was issued bi-monthly until 1980, when it became a monthly publication. A&A is the leading journal for anesthesia clinicians and researchers and includes more than 500 articles annually in all areas related to anesthesia and analgesia, such as cardiovascular anesthesiology, patient safety, anesthetic pharmacology, and pain management. The journal is published on behalf of the IARS by Lippincott Williams & Wilkins (LWW), a division of Wolters Kluwer Health.

About the IARS
The International Anesthesia Research Society is a nonpolitical, not-for-profit medical society founded in 1922 to advance and support scientific research and education related to anesthesia, and to improve patient care through basic research. The IARS contributes nearly $1 million annually to fund anesthesia research; provides a forum for anesthesiology leaders to share information and ideas; maintains a worldwide membership of more than 15,000 physicians, physician residents, and others with doctoral degrees, as well as health professionals in anesthesia related practice; sponsors the SmartTots initiative in partnership with the FDA; and publishes the monthly journal Anesthesia & Analgesia in print and online.

About Wolters Kluwer Health
Wolters Kluwer Health is a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Serving more than 150 countries and territories worldwide, Wolters Kluwer Health's customers include professionals, institutions and students in medicine, nursing, allied health and pharmacy. Major brands include Health Language®, Lexicomp®, Lippincott Williams & Wilkins, Medicom®, Medknow, Pharmacy OneSource®, ProVation® Medical and UpToDate®.

Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company. Wolters Kluwer had 2012 annual revenues of €3.6 billion ($4.6 billion), employs approximately 19,000 people worldwide, and maintains operations in over 40 countries across Europe, North America, Asia Pacific, and Latin America. Follow our official Twitter handle: @WKHealth.

Original press releas: http://www.eurekalert.org/pub_releases/2013-09/ru-msa091013.php