| Anesthetic Implication of Hemoglobin-M: A case report. |
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In Young Huh, Kyu Taek Choi, Moo Young Cheon, Pyung Hwan Park |
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 |
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| Abstract |
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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. |
| Key Words:
cyanosis; hemoglobin-M; methemoglobin |
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