Document Detail

Seeking optimal relation between oxygen saturation and hemoglobin concentration in adults with cyanosis from congenital heart disease.
MedLine Citation:
PMID:  21295176     Owner:  NLM     Status:  MEDLINE    
In patients with cyanosis from congenital heart disease, erythropoiesis is governed by many factors that can alter the expected relation between the oxygen saturation (O(2sat)) and hemoglobin concentration. We sought to define the relation between the O(2sat) and hemoglobin in such patients and to predict an ideal hemoglobin concentration for a given O(2sat). Adults with congenital heart defects and cyanosis were studied prospectively using blood tests and exercise testing. Nonoptimal hemoglobin was defined as any evidence of inadequate erythropoiesis (i.e., iron, folate, or vitamin B(12) deficiency, increased erythropoietin, reticulocytosis, or a right-shifted oxygen-hemoglobin curve). For patients without these factors, a linear regression equation of hemoglobin versus O(2sat) was used to predict the optimal hemoglobin for all patients. Of the 65 patients studied, 21 met all the prestudy criteria for an optimal hemoglobin. For all patients, no correlation was found between O(2sat) and hemoglobin (r = -0.22). However, a strong linear correlation was found for those meeting the criteria for optimal hemoglobin (r = -0.865, p <0.001). The optimal hemoglobin regression equation was as follows: predicted hemoglobin = 57.5 - (0.444 × O(2sat)). A negative correlation was found between the hemoglobin difference (predicted minus measured) and exercise duration on cardiopulmonary exercise testing (r = -0.396, p = 0.005) and the 6-minute walk distance (r = -0.468, p <0.001). In conclusion, a strong relation between O(2sat) and hemoglobin concentration can be shown in stable cyanotic patients and used to predict an optimal hemoglobin. This relation might be useful in defining functional anemia in this group.
Craig S Broberg; Ananda R Jayaweera; Gerhard P Diller; Sanjay K Prasad; Swee Lay Thein; Bridget E Bax; John Burman; Michael A Gatzoulis
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  107     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-07     Completed Date:  2011-04-08     Revised Date:  2011-10-11    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  595-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
Adult Congenital Heart Disease Program, Oregon Health and Sciences University, Portland, USA.
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MeSH Terms
Cyanosis / blood*,  congenital
Exercise Test
Heart Defects, Congenital / blood*,  physiopathology
Hemoglobins / metabolism*
Middle Aged
Oxygen / blood*
Oxygen Consumption
Predictive Value of Tests
Prospective Studies
Reference Values
Sensitivity and Specificity
Grant Support
//British Heart Foundation
Reg. No./Substance:
0/Hemoglobins; 7782-44-7/Oxygen
Comment In:
Am J Cardiol. 2011 Sep 15;108(6):899-902; author reply 902   [PMID:  21884880 ]

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