Wearable transcutaneous oxygen sensor for health monitoring

Abstract We present a wearable bandage-like photoluminescence (PL)-based transcutaneous oxygen (tcpO2) sensor consisting of a photoluminescent oxygen (O2)-sensing film, a polyvinylidene chloride (PVDC) film as an encapsulation layer, an indium tin oxide (ITO) thin-film heater, an array of micro-light-emitting diodes (μ-LED) as a light source, red cellophane paper as an optical filter, an organic photodiode (OPD) as a PL detector, and an optical isolation layer. All the components of the tcpO2 sensor were designed to be flexible and thus can be attached anywhere on the curved skin of the human body. The PVDC film with excellent O2 barrier properties and visible light transmittance was a significant additional component of the wearable sensor that improved the sensitivity of the photoluminescent O2-sensing film by minimizing the PL quenching effects of ambient atmospheric O2. Furthermore, the ITO thin-film heater increases the skin temperature, changing the structure of the stratum corneum and allowing O2 to more effectively diffuse from the skin toward the tcpO2 sensor. Therefore, the thin-film heater allows the accurate measurement of the tcpO2 variation from human skin to facilitate the determination of the severity of O2-deficiency related diseases in the tcpO2 range from 0 to 80 mmHg. The μ-LED array embedded into a polydimethylsiloxane (PDMS) film not only maintained its mechanical flexibility but also had stable light emission performance under ambient air conditions, allowing tcpO2 measurements over several cycles for as long as 60 min, which we could not previously achieve with ambient air-unstable flexible organic light-emitting diodes (f-OLEDs). The effects of the heat from the ITO thin-film heater and the skin color of the sensor user on the PL emitted by the sensing film and detected by the OPD were factored out from the tcpO2 measurements by defining two correction coefficients. The performance of the wearable tcpO2 sensor was tested using the leg elevation protocol to induce tcpO2 variation at the skin of the ankles of test volunteers. According to the experimental results, the sensing performance of our wearable bandage-like PL-based tcpO2 sensor proved to be superior to that of a commercially available tcpO2 sensor, as our wearable PL-based tcpO2 sensor demonstrated faster response times to tcpO2 variation and smaller measurement deviations between tcpO2 detection cycles.

[1]  Zhengchun Peng,et al.  A Highly Stretchable Transparent Self‐Powered Triboelectric Tactile Sensor with Metallized Nanofibers for Wearable Electronics , 2018, Advanced materials.

[2]  C. Kieda,et al.  Why is the partial oxygen pressure of human tissues a crucial parameter? Small molecules and hypoxia , 2011, Journal of cellular and molecular medicine.

[3]  G Mardirossian,et al.  Limitations of pulse oximetry. , 1992, Anesthesia progress.

[4]  A. Peitzman,et al.  Transcutaneous oxygen measurements in lower extremity ischemia: effects of position, oxygen inhalation, and arterial reconstruction. , 1988, Surgery.

[5]  P. Robless,et al.  Systematic review of antiplatelet therapy for the prevention of myocardial infarction, stroke or vascular death in patients with peripheral vascular disease , 2001, The British journal of surgery.

[6]  Otto S. Wolfbeis,et al.  Luminescent sensing and imaging of oxygen: Fierce competition to the Clark electrode , 2015, BioEssays : news and reviews in molecular, cellular and developmental biology.

[7]  Ruth Shinar,et al.  Structurally integrated organic light emitting device-based sensors for gas phase and dissolved oxygen. , 2006, Analytica chimica acta.

[8]  H. Nalwa,et al.  Flexible Graphene-Based Wearable Gas and Chemical Sensors. , 2017, ACS applied materials & interfaces.

[9]  O. Wolfbeis,et al.  Optical methods for sensing and imaging oxygen: materials, spectroscopies and applications. , 2014, Chemical Society reviews.

[10]  Jin-Woo Park,et al.  Wearable, Luminescent Oxygen Sensor for Transcutaneous Oxygen Monitoring. , 2018, ACS applied materials & interfaces.

[11]  K. Brismar,et al.  Transcutaneous oxygen tension and toe blood pressure as predictors for outcome of diabetic foot ulcers. , 1999, Diabetes care.

[12]  Kevin K. Tremper,et al.  Transcutaneous PO2 measurement , 1984, Canadian Anaesthetists' Society journal.

[13]  E. Roussakis,et al.  Oxygen-Sensing Methods in Biomedicine from the Macroscale to the Microscale. , 2015, Angewandte Chemie.

[14]  Tse Nga Ng,et al.  Temperature-Dependent Detectivity of Near-Infrared Organic Bulk Heterojunction Photodiodes. , 2017, ACS applied materials & interfaces.

[15]  J. Scurr,et al.  Effect of leg elevation on the skin microcirculation in chronic venous insufficiency. , 1994, Journal of vascular surgery.

[16]  Andreas Tünnermann,et al.  Highly sensitive on-chip fluorescence sensor with integrated fully solution processed organic light sources and detectors , 2017 .

[17]  T. Miyata,et al.  Diabetic nephropathy: a disorder of oxygen metabolism? , 2010, Nature Reviews Nephrology.

[18]  B. F. V. Duzee Thermal Analysis Of Human Stratum Corneum , 1975 .

[19]  W. Abbott,et al.  Utility of transcutaneous oxygen tension measurements in peripheral arterial occlusive disease. , 1984, Journal of vascular surgery.

[20]  J. Bacharach,et al.  Predictive value of transcutaneous oxygen pressure and amputation success by use of supine and elevation measurements. , 1992, Journal of vascular surgery.

[21]  E. Jung,et al.  Evaluation of hyperbaric oxygen therapy for free flaps using planar optical oxygen sensors. Preliminary results. , 2011, Clinical hemorheology and microcirculation.

[22]  J C Yuen,et al.  Monitoring Free Flaps Using the Laser Doppler Flowmeter: Five‐Year Experience , 2000, Plastic and reconstructive surgery.

[23]  F A Matsen,et al.  Transcutaneous oxygen tension measurements on limbs of diabetic and nondiabetic patients with peripheral vascular disease. , 1984, Surgery.

[24]  Ichiro Okura,et al.  Photoluminescent determination of oxygen using metalloporphyrin-polymer sensing systems , 1998 .

[25]  P. von Wichert,et al.  Transcutaneous Measurement of Oxygen and Carbon Dioxide Tension (TcPO2 and TcPCO 2) during Treadmill Exercise in Patients with Arterial Occlusive Disease (AOD)—Stages I and II , 1990, Angiology.

[26]  M. Krimmel,et al.  Monitoring in microvascular tissue transfer by measurement of oxygen partial pressure: four years experience with 125 microsurgical transplants. , 2013, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[27]  K. S. Miller,et al.  Oxygen and aroma barrier properties of edible films: A review , 1997 .

[28]  Malte C. Gather,et al.  Impact of temperature on the efficiency of organic light emitting diodes , 2015 .

[29]  Ajay K. Pandey,et al.  Organic Photodiodes: The Future of Full Color Detection and Image Sensing , 2016, Advanced materials.

[30]  Changduk Lim,et al.  Luminescent oxygen-sensing films with improved sensitivity based on light scattering by TiO2 particles , 2017 .

[31]  H. Nalwa,et al.  Flexible Molybdenum Disulfide (MoS2) Atomic Layers for Wearable Electronics and Optoelectronics. , 2019, ACS applied materials & interfaces.

[32]  Shinsuke Akita,et al.  Regional Oxygen Saturation Index: A Novel Criterion for Free Flap Assessment Using Tissue Oximetry , 2016, Plastic and reconstructive surgery.

[33]  F L Golbranson,et al.  Transcutaneous PO2 measurements in health and peripheral arterial occlusive disease. , 1982, Surgery.

[34]  M. Holl,et al.  Direct measurement of oxygen consumption rates from attached and unattached cells in a reversibly sealed, diffusionally isolated sample chamber. , 2010, Advances in bioscience and biotechnology.

[35]  Jin Woo Park,et al.  Heat evolution and dissipation in organic light-emitting diodes on flexible polymer substrates , 2016 .

[36]  Debju Ghosh Structurally integrated luminescence based oxygen sensors with Organic LED/ oxygen sensitive dye and PECVD grown thin film photodetectors , 2008 .

[37]  D. Smith,et al.  Predictors of Transcutaneous Oxygen Tension in the Lower Limbs of Diabetic Subjects , 1996, Diabetic medicine : a journal of the British Diabetic Association.

[38]  W. Shoemaker,et al.  Use of a Transcutaneous PO2 Regional Perfusion Index to Quantify Tissue Perfusion in Peripheral Vascular Disease , 1983, Annals of surgery.

[39]  G. Valentini,et al.  Transcutaneous oxygen pressure in systemic sclerosis: evaluation at different sensor temperatures and relationship to skin perfusion , 2004, Archives of Dermatological Research.

[40]  J. Severinghaus,et al.  Dark Skin Decreases the Accuracy of Pulse Oximeters at Low Oxygen Saturation: The Effects of Oximeter Probe Type and Gender , 2007, Anesthesia and analgesia.

[41]  A. Pouchelon,et al.  Energy of adhesion of polydimethylsiloxane networks / glass and polycarbonate assemblies , 1998 .

[42]  Changduk Lim,et al.  Highly flexible and solution-processed organic photodiodes and their application to optical luminescent oxygen sensors , 2019, Organic Electronics.

[43]  V. Schlosser,et al.  Determination of amputation level in ischemic legs by means of transcutaneous oxygen pressure measurement. , 1984, International surgery.

[44]  K. Yamashita,et al.  Effects of the electrode temperature of a new monitor, TCM4, on the measurement of transcutaneous oxygen and carbon dioxide tension , 2006, Journal of Anesthesia.

[45]  Frederick Albert Matsen IV,et al.  Transcutaneous oxygen tension measurement in peripheral vascular disease. , 1980, Surgery, gynecology & obstetrics.

[46]  Unyong Jeong,et al.  Highly flexible transparent thin film heaters based on silver nanowires and aluminum zinc oxides , 2015 .

[47]  M. Weiner Concepts of "tissue PO2" in relation to O2 delivery. , 1994, Artificial cells, blood substitutes, and immobilization biotechnology.

[48]  D. Slaaf,et al.  Can transcutaneous oximetry detect nutritive perfusion disturbances in patients with lower limb ischemia? , 1995, Microvascular research.

[49]  D. Lübbers,et al.  Quantitative continuous measurement of partial oxygen pressure on the skin of adults and new-born babies , 2004, Pflügers Archiv.

[50]  Wolfgang Trettnak,et al.  Miniaturized luminescence lifetime-based oxygen sensor instrumentation utilizing a phase modulation technique , 1996 .

[51]  G. Semenza Oxygen sensing, homeostasis, and disease. , 2011, The New England journal of medicine.

[52]  Damijan Miklavčič,et al.  Parameters of Postocclusive Reactive Hyperemia Measured by Near Infrared Spectroscopy in Patients with Peripheral Vascular Disease and in Healthy Volunteers , 2001, Annals of Biomedical Engineering.

[53]  Dual luminophore polystyrene microspheres for pressure-sensitive luminescent imaging , 2006 .

[54]  Y. Liao,et al.  360° omnidirectional, printable and transparent photodetectors for flexible optoelectronics , 2018, npj Flexible Electronics.

[55]  P. Jolinat,et al.  Degradation in organic light-emitting diodes , 1998 .

[56]  K. Tremper,et al.  Transcutaneous oxygen tension: A physiological variable for monitoring oxygenation , 1985, Journal of Clinical Monitoring.

[57]  A. Singhal A review of oxygen therapy in ischemic stroke , 2007, Neurological research.

[58]  D. Smith,et al.  Paradoxical Transcutaneous Oxygen Response to Cutaneous Warming on the Plantar Foot Surface: A Caution for Interpretation of Plantar Foot TcPO2 Measurements , 1995, Foot & ankle international.

[59]  T. Tsuboi,et al.  Optical characteristics of PtOEP and Ir(ppy)3 triplet-exciton materials for organic electroluminescence devices , 2003 .

[60]  Benjamin A. DeGraff,et al.  Photophysics and photochemistry of oxygen sensors based on luminescent transition-metal complexes , 1991 .