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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/22069

Title: Failing blood gas measurement due to methemoglobin forming hemoglobin variants: a case report and review of the literature
Authors: Schiemsky, Toon
Penders, Joris
Kieffer, Davy
Issue Date: 2016
Citation: ACTA CLINICA BELGICA, 71(3), p. 167-170
Abstract: Introduction: We present a case of an arterial blood gas sample analysis from a 33-year old woman where no oximetry results could be obtained using the Radiometer ABL800 FLEX device. Clinical history of this patient learned that she was carrier of a methemoglobin forming hemoglobin variant type Hyde Park (HbM Hyde Park) and raised the question whether or not this variant could be the cause of the errors obtained during analysis. Materials and methods: A literature search was performed, focusing on methemoglobin forming hemoglobin variants and their influence on oxygenation measurements. An overview of the currently described methemoglobin forming hemoglobin variants is also included. Results and discussion: In the presence of dyshemoglobins such as methemoglobin, techniques used to obtain parameters that reflect the patient oxygenation status, such as pulse oximetry and CO-oximetry can be influenced. In these cases, CO-oximetry is the preferred technique because it can compensate for this, in contrast to pulse oximetry. In case of the presence of methemoglobin originating from a hemoglobin variant, it is possible that COoximetry data cannot be calculated because the absorbance spectrum of this methemoglobin can differ from regular methemoglobin. Moreover, pulse oximetry devices are actually prone to erroneous results since pulse oximetry data will be calculated in these cases, but unreliable and should be avoided. Conclusion: Methemoglobin forming hemoglobin variants are rare genetic mutations. However, they can possibly interfere with the calculation of CO-oximetry values. In these cases, pulse oximetry data should be avoided because they could lead to incorrect medical decisions.
Notes: [Schiemsky, Toon; Kieffer, Davy] Univ Hosp Leuven, Lab Med, B-3000 Leuven, Belgium. [Penders, Joris] Hasselt Univ, Sch Life Sci, Biomed Res Inst, Diepenbeek, Belgium. [Penders, Joris] Transnat Univ Limburg, Diepenbeek, Belgium. [Penders, Joris] Ziekenhuis Oost Limburg, Lab Med, Genk, Belgium. [Kieffer, Davy] KU Leuven Univ Leuven, Dept Microbiol & Immunol, Leuven, Belgium.
URI: http://hdl.handle.net/1942/22069
DOI: 10.1080/17843286.2016.1148299
ISI #: 000378349600008
ISSN: 1784-3286
Category: A1
Type: Journal Contribution
Validation: ecoom, 2017
Appears in Collections: Research publications

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