| Unexpectedly low pulse oximetry measurements associated with variant hemoglobins: a systematic review. | |
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MedLine Citation:
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PMID: 20890907 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Pulse oximetry estimates arterial blood oxygen saturation based on light absorbance of oxy- and deoxy-hemoglobin at 660 and 940 nm wavelengths. Patients with unexpectedly low SpO₂ often undergo cardio-pulmonary testing to ascertain the cause of their hypoxemia. However, in a subset of patients, a variant hemoglobin is responsible for low SpO₂ measurements. The extent of this problem is unclear. We performed a systematic literature review for reports of low SpO₂ associated with variant hemoglobins. We also reviewed unpublished cases from an academic hemoglobin diagnostic reference laboratory. Twenty-five publications and four unpublished cases were identified, representing 45 patients with low SpO₂ and confirmed variant hemoglobin. Fifty-seven family members of patients had confirmed or suspected variant hemoglobin. Three low oxygen affinity variant hemoglobins had concordantly low SpO₂ and SaO₂. Eleven variant hemoglobins were associated with unexpectedly low SpO₂ measurements but normal SaO₂. Hemoglobin light absorbance testing was reported in three cases, all of which showed abnormal absorption spectra between 600 and 900 nm. Seven other variant hemoglobins had decreased SpO₂, with unreported or uncertain SaO₂. Twenty-one variant hemoglobins were found to be associated with low SpO₂. Most variant hemoglobins were associated with spuriously low SpO₂. Abnormal absorption spectra explain the discrepancy between SpO₂ and SaO(2) for some variants. The differential diagnosis of possible variant hemoglobin ought to be considered in asymptomatic patients found to have unexpectedly low SpO₂. The correct diagnosis will help to spare patients from unnecessary investigations and anxiety. |
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Authors:
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Madeleine Verhovsek; Matthew P A Henderson; Gerard Cox; Hong-yuan Luo; Martin H Steinberg; David H K Chui |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Review |
Journal Detail:
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Title: American journal of hematology Volume: 85 ISSN: 1096-8652 ISO Abbreviation: Am. J. Hematol. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-26 Completed Date: 2010-12-10 Revised Date: 2011-09-01 |
Medline Journal Info:
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Nlm Unique ID: 7610369 Medline TA: Am J Hematol Country: United States |
Other Details:
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Languages: eng Pagination: 882-5 Citation Subset: IM |
Copyright Information:
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© 2010 Wiley-Liss, Inc. |
Affiliation:
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Section of Hematology and Oncology, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA. verhovm@mcmaster.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Diagnosis, Differential Genetic Variation* Hemoglobinopathies / diagnosis Hemoglobins / genetics*, physiology Humans Oximetry / statistics & numerical data* |
| Grant Support | |
ID/Acronym/Agency:
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R01 DK63088/DK/NIDDK NIH HHS; RR-08084/RR/NCRR NIH HHS; U54 HL070871/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobins |
| Comments/Corrections | |
Corrected and Republished In:
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Am J Hematol. 2011 Aug;86(8):722-5
[PMID:
21879495
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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