Anesthetic Implication of Hemoglobin-M: A case report.
10.4097/kjae.2006.50.6.723
- Author:
In Young HUH
1
;
Kyu Taek CHOI
;
Moo Young CHEON
;
Pyung Hwan PARK
Author Information
1. Department of Anesthesiology and Pain Management, Asan Medicine Center, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
cyanosis;
hemoglobin-M;
methemoglobin
- MeSH:
Absorption;
Blood Gas Analysis;
Child;
Cyanosis;
Heart Diseases;
Hemoglobin M;
Hemoglobinopathies;
Hemoglobins, Abnormal;
Humans;
Lung Diseases;
Methemoglobin;
Methemoglobinemia;
Oximetry;
Oxygen;
Sulfhemoglobinemia
- From:Korean Journal of Anesthesiology
2006;50(6):723-726
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Cyanosis in children is most often caused by pulmonary disease, or cyanotic heart disease but is rarely caused by hematological problems such as methemoglobinemia and sulfhemoglobinemia. Abnormal hemoglobins with a reduced oxygen affinity are an exceptionally uncommon cause of cyanosis in children. Hemoglobin-M (Hb-M) is rapidly auto-oxidized into the met-form resulting in the loss of its O2-binding ability. This hemoglobinopathy is inherited in an autosomal dominant pattern and is characterized by marked cyanosis. Hb-M affects the anesthetic management because of the anomalous absorption spectrum of Hb-M in standard pulse oximetry. Sufficient O2 delivery should be maintained by keeping a high FiO2 and intermittently checking the O2 delivery state using arterial blood gas analysis. We reported our experience of the anesthetic management of a patient with hemoglobin M.
