scholarly journals Rare Case of Methemoglobinemia Complicating Pregnancy

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
S. Verma ◽  
P. Sachdeva ◽  
G. Gandhi
Keyword(s):  
High Risk ◽  
Oxygen Saturation ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Operation Theatre ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Emergency Cesarean ◽  
Arterial Blood Gas Analysis ◽  
High Risk Case

A patient at 38 weeks of gestation when taken for emergency cesarean section had her oxygen saturation of 66 to 70% (by saturation probe on monitor) in operation theatre. She was otherwise asymptomatic but her oxygen saturation was persistently low on the monitors. Her arterial blood gas analysis showed all parameters to be normal. Her electrocardiography was normal. Her surgery was imperative but due to her reduced oxygen saturation she became a high-risk case. In presence of senior consultants of anesthesia and gynecology and under high-risk consent she had an uneventful cesarean delivery. Physician and cardiologist opinions were sought thereafter. The outcomes and the results of our efforts to find the etiology of her reduced saturation on monitors despite being clinically asymptomatic lead to the disclosure of this rare hemoglobinopathy. Mother and baby had uneventful course after delivery and were discharged well.

scholarly journals Acrocyanosis - An uncommon event at post anaesthesia recovery room- A case report

2014 ◽  
Vol 26 (1) ◽  
pp. 58-60
Author(s):  
Md Azmal Hossain ◽  
Mosammat Maksuhuda Begum
Keyword(s):  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Cold Environment ◽  
Blood Gas ◽  
Operation Theatre ◽  
Left Ureter ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Short Period

A healthy patient of aged 26 years underwent left ureter-lithotomy and cystostomy under general anesthesia. In post-operative ward, both extremities were cold & nailed were cyanosed. This cyanosis persisted for as long as 8-10 hours. No abnormality was detected in arterial blood gas analysis. This is not a simple peripheral cyanosis induced by cold environment of operation theatre, as warming usually reverses the phenomenon within a short period. But in this case, peripheral cyanosis persisted for as long as 8-10 hours. Therefore, this is a case of acrocyanosis. DOI: http://dx.doi.org/10.3329/jbsa.v26i1.19819 Journal of Bangladesh Society of Anaesthesiologists 2013; 26(1): 58-60

scholarly journals Sleep-disordered breathing in patients with COPD and mild hypoxemia: prevalence and predictive variables

2017 ◽  
Vol 43 (3) ◽  
pp. 176-182 ◽  
Author(s):  
José Laerte Rodrigues Silva Júnior ◽  
Marcus Barreto Conde ◽  
Krislainy de Sousa Corrêa ◽  
Helena Rabahi ◽  
Arthur Alves Rocha ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Sleep Disordered Breathing ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Nocturnal Hypoxemia ◽  
Arterial Blood Gas Analysis ◽  
Disordered Breathing

ABSTRACT Objective: To infer the prevalence and variables predictive of isolated nocturnal hypoxemia and obstructive sleep apnea (OSA) in patients with COPD and mild hypoxemia. Methods: This was a cross-sectional study involving clinically stable COPD outpatients with mild hypoxemia (oxygen saturation = 90-94%) at a clinical center specializing in respiratory diseases, located in the city of Goiânia, Brazil. The patients underwent clinical evaluation, spirometry, polysomnography, echocardiography, arterial blood gas analysis, six-minute walk test assessment, and chest X-ray. Results: The sample included 64 patients with COPD and mild hypoxemia; 39 (61%) were diagnosed with sleep-disordered breathing (OSA, in 14; and isolated nocturnal hypoxemia, in 25). Correlation analysis showed that PaO2 correlated moderately with mean sleep oxygen saturation (r = 0.45; p = 0.0002), mean rapid eye movement (REM) sleep oxygen saturation (r = 0.43; p = 0.001), and mean non-REM sleep oxygen saturation (r = 0.42; p = 0.001). A cut-off point of PaO2 ≤ 70 mmHg in the arterial blood gas analysis was significantly associated with sleep-disordered breathing (OR = 4.59; 95% CI: 1.54-13.67; p = 0.01). The model showed that, for identifying sleep-disordered breathing, the cut-off point had a specificity of 73.9% (95% CI: 51.6-89.8%), a sensitivity of 63.4% (95% CI: 46.9-77.9%), a positive predictive value of 81.3% (95% CI: 67.7-90.0%), and a negative predictive value of 53.1% (95% CI: 41.4-64.4%), with an area under the ROC curve of 0.69 (95% CI: 0.57-0.80), correctly classifying the observations in 67.2% of the cases. Conclusions: In our sample of patients with COPD and mild hypoxemia, the prevalence of sleep-disordered breathing was high (61%), suggesting that such patients would benefit from sleep studies.

scholarly journals A Novel Hemoglobin, Bonn, Causes Falsely Decreased Oxygen Saturation Measurements in Pulse Oximetry

2008 ◽  
Vol 54 (3) ◽  
pp. 594-596 ◽  
Author(s):  
Berndt Zur ◽  
Andreas Hornung ◽  
Johannes Breuer ◽  
Ulrike Doll ◽  
Christine Bernhardt ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Pulse Oximetry ◽  
Globin Gene ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Low Oxygen ◽  
Hemoglobin Variant ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis

Abstract Background: A 4-year-old boy and his father exhibited low oxygen saturation measured transcutaneously by pulse oximetry, a finding that could not be confirmed by arterial blood gas analysis. Both patients exhibited slight hemolysis in their blood, and the boy had a microcytic anemia. There was no evidence of hypoxemia or methemoglobinemia. Despite the normal results from the arterial blood gas analysis, a right-to-left-shunt was assumed in the boy until a cardiology examination excluded this diagnosis. Sleep apnea syndrome was suspected in the father and treated with nocturnal positive pressure respiration based on the low oxygen saturation values obtained with pulse oximetry. Only after consultation with our laboratory was a hemoglobin variant suspected and investigated. Methods: We performed hemoglobin protein analysis by HPLC, electrophoretic separation, and spectrophotometry and DNA sequence analysis of the α-globin gene. Results: Both HPLC chromatographic separation and alkaline electrophoresis revealed a unique hemoglobin peak. In both patients, α-globin gene sequencing revealed a mutation resulting in a histidine-to–aspartatic acid substitution at position α87. The low oxygen saturation measurement by pulse oximetry was due to hemoglobin Bonn oxyhemoglobin having an absorption peak at 668 nm, near the 660 nm measured by pulse oximeters. Conclusion: Hemoglobin Bonn is a novel hemoglobin variant of the proximal α-globin that results in falsely low oxygen saturation measurements with pulse oximetry.

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