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Korean J Anesthesiol > Volume 50(6); 2006 > Article
Korean Journal of Anesthesiology 2006;50(6):723-726.
DOI: https://doi.org/10.4097/kjae.2006.50.6.723   
Anesthetic Implication of Hemoglobin-M: A case report.
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
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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