Dyshemoglobinemias and pulse oximetry: a therapeutic challenge.
Pulse oximetry normally provides a reliable indicator of arterial blood oxygen saturation. Individuals with a variant hemoglobin with low oxygen affinity would exhibit pulse oximetry values consistent with hypoxemia despite maintaining adequate oxygen delivery to tissues. We describe a patient we diagnosed with hemoglobin Rothschild and his mother. He presented with SpO2 81% on pulse oximetry and PaO2 on arterial blood gas of 47 mm Hg, while his mother had SpO2 87%. These values were significantly lower than physical examination suggested. A possible dyshemoglobinemia should be suspected when discordance exists between pulse oximetry readings and physical examination findings.
Hladik
Anne
A
Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA. ajhladik@texaschildrens.org
Lynshue
Kecha
K
D002648:Child; D002851:Chromatography, High Pressure Liquid; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D006455:Hemoglobins, Abnormal / Q000032:analysis*; D006801:Humans; D008297:Male; D008708:Methemoglobinemia / Q000097:blood* / Q000628:therapy*; D010092:Oximetry; D010100:Oxygen / Q000097:blood*
D006455:Hemoglobins, Abnormal; C024993:hemoglobin Rothschild; D010100:Oxygen