Monte Carlo simulation of the effect of melanin concentration on light-tissue interactions for transmittance pulse oximetry measurement.

Significance: Questions about the accuracy of pulse oximeters in measuring arterial oxygen saturation ( ) in individuals with darker skin pigmentation have resurfaced since the COVID-19 pandemic. This requires investigation to improve patient safety, clinical decision making, and research.

Aim: We aim to use computational modeling to identify the potential causes of inaccuracy in measurement in individuals with dark skin and suggest practical solutions to minimize bias.

Monte Carlo simulation of the effect of melanin concentration on light-tissue interactions in transmittance and reflectance finger photoplethysmography.

Photoplethysmography (PPG) uses light to detect volumetric changes in blood, and is integrated into many healthcare devices to monitor various physiological measurements. However, an unresolved limitation of PPG is the effect of skin pigmentation on the signal and its impact on PPG based applications such as pulse oximetry. Hence, an in-silico model of the human finger was developed using the Monte Carlo (MC) technique to simulate light interactions with different melanin concentrations in a human finger, as it is the primary determinant of skin pigmentation.

A review of the effect of skin pigmentation on pulse oximeter accuracy.

. Pulse oximetry is a non-invasive optical technique used to measure arterial oxygen saturation (SpO) in a variety of clinical settings and scenarios. Despite being one the most significant technological advances in health monitoring over the last few decades, there have been reports on its various limitations.

Monte Carlo Simulation of the Effect of Human Skin Melanin in Light-Tissue Interactions.

Recent reports have highlighted the potential challenges skin pigmentation can have in the accurate estimation of arterial oxygen saturation when using a pulse oximeter. Pulse oximeters work on the principle of photoplethysmography (PPG), an optical technique used for the assessment of volumetric changes in vascular tissue. The primary aim of this research is to investigate the effect of melanin on tissue when utilising the technique of PPG.

Inaccuracy of pulse oximetry with dark skin pigmentation: clinical implications and need for improvement.

Recent reports highlight potential inaccuracies of pulse oximetry in patients with various degrees of skin pigmentation. We summarise the literature, provide an overview of potential clinical implications, and provide insights into how pulse oximetry could be improved to mitigate against such potential shortcomings.