Korean J Anesthesiol.
2006 Jun;50(6):723-726. 10.4097/kjae.2006.50.6.723.
Anesthetic Implication of Hemoglobin-M: A case report
- Affiliations
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- 1Department of Anesthesiology and Pain Management, Asan Medicine Center, Seoul, Korea.
- 2Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan, Korea. inyoung_huh@unh.ulsan.kr
- KMID: 1862252
- DOI: http://doi.org/10.4097/kjae.2006.50.6.723
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.
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