Honoring Dr. Takuo Aoyagi – the inventor of the pulse oximeter

Dr. Aoyagi’s legacy was recognized with posthumous Honorary Membership of the American Society of Anesthesiologists (ASA).

“It is hard to express the scale of transformation in patient care that resulted from Dr. Takuo Aoyagi’s invention of the pulse oximeter. Effective safety monitoring is an essential part of patient care. Pulse oximeters gave us a way to monitor, with a simple finger probe, the oxygenation of people’s blood. That rapidly made them indispensable and lifesaving across healthcare – from the operating room and intensive care, to the identification of childhood pneumonia, to the triage of COVID-19 patients. They have become so universal, we can all too easily forget that this transformation in patient care happened in our lifetime – because of Dr. Aoyagi.” Dr. Atul Gawande, Lifebox Co-Founder and Chair.

The pulse oximeter is a medical device which clips onto a finger and displays the level of oxygen in the blood and produces a variable pitch auditory signal with each heartbeat. For surgical teams, this invention allowed them to “see” whether a patient was getting enough oxygen to survive when under anesthesia. Anesthesia providers often refer to their oximeter as their “eyes and ears”. When the WHO Surgical Safety Checklist was introduced in 2008, the only piece of equipment included on the Checklist was a pulse oximeter – a testament to the international recognition of the undisputed critical role Dr. Aoyagi’s invention has played in improving surgical safety. In high-income countries such as Japan and the United States, pulse oximeters have been the bedrock of anesthetic care for decades. Unfortunately, due to price and adaptability constraints, pulse oximeters are still lacking from many operating rooms in low- and middle-income countries. In 2011, it was estimated that 77,000 operating rooms around the world still lacked this essential piece of medical equipment. Lifebox was founded to close the “oximetry gap” by equipping operating rooms with pulse oximeters – globalizing Dr. Aoyagi’s invention. Lifebox developed a pulse oximeter specifically designed for use in low-resource settings – with robust construction and rechargeable batteries that stay on even when the power fails. To date, more than 30,000 Lifebox pulse oximeters have been distributed throughout 116 countries for vital patient monitoring.  The distribution is accompanied by oximetry and anesthesia safety training, recognizing that for many of the recipients this is their first patient monitoring technology.Dr. Aoyagi lived to see his invention become one of the most crucial tools in fighting the COVID-19 pandemic. Pulse oximeters enable healthcare providers to assess the oxygen saturation of COVID-19 patients – helping them to decide who is well enough to be sent home, who needs to be given oxygen, or who needs to go to an ICU.  In low-income countries that often lack intensive care resources, the early identification of COVID-19 patients is essential for the best outcomes. Read about the role of pulse oximetry in COVID-19 here. Throughout the pandemic, Lifebox has pivoted its activities to support healthcare workers to provide safe surgical, anesthesia, and COVID-19 care. The mainstay of this response has been the distribution of pulse oximeters to frontline healthcare providers. Read more about Lifebox’s COVID-19 response here. In his article on Dr. Aoyagi and his legacy, Lifebox Board Member Dr. Alexander Hannenberg writes:

“Recognizing the oversized contribution of anesthesia-related mortality to preventable surgical deaths, the first priority for Lifebox was improving anesthesia safety by disseminating oximetry and related training. Since its creation in 2011, Lifebox has distributed more than 26,000 oximeters specifically designed for use in austere settings in 116 countries. As we understand the value of oximetry beyond the operating room, the oximetry gap estimated in 2010 for operating rooms alone grows. For example, the value of oximetry for diagnosis and triage of respiratory insufficiency in COVID19 led Lifebox to rapidly deploy 6,500 oximeters in 43 low-resource countries. The work done by Lifebox and its partners is dramatically amplifying Aoyagi’s impact.”

There is still much work to be done in the global access to pulse oximetry. Lifebox is working to expand beyond operating room use, working to make pulse oximetry available for the full perioperative process – from pre- to post-op – in intensive and neonatal intensive care units, and in the transfer of patients to a higher level of care.Lifebox celebrates the life of Dr. Aoyagi with every pulse oximeter distributed to a healthcare provider. We cannot think of a more lasting legacy to Dr. Aoyagi’s work than the millions of pulse oximeters in use across the world keeping patients safe.Dr. Aoyagi’s Honorary Membership was awarded by ASA President, Dr. Beverly Philip, and accepted by Nihon Kohden America CEO Eiichi Tanaka. Dr. Aoyagi worked for Nihon Kohden throughout his careerSupport Lifebox’s work with a donation today.