Pulse oximetry in sickle cell disease

Abstract

Summary The place of pulse oximetry in monitoring arterial oxygen saturation in sickle cell disease has been evaluated. In four admissions of patients with sickle cell anaemia with varying degrees of arterial haemoglobin oxygen desaturation, pulse oximetry was compared with a simultaneous assessment of oxygen saturation by arterial blood gas measurement and oxygen dissociation curve (ODC) analysis. Close agreement was found between the oxygen saturation measured by pulse oximetry and that calculated from the measured arterial partial pressure of oxygen (PaO2) with reference to the patient's own ODC. Calculation of oxygen saturation by the blood gas analyser assuming a normal ODC was erroneous. Pulse oximetry is an accurate and effective non‐invasive method for monitoring the arterial oxygen saturation in sickle cell disease.

Severity of Obstructive Sleep Apnea in Children With Sickle Cell Disease

“…As a result, in anemic patients with higher met-Hb and carboxy-Hb due to hemolysis, pulse oxymetry will show a higher oxygen saturation value than blood oxymetry. 35 Weston Smith et al 36 showed that by adjusting the Hb oxygen saturation with the patient's oxygen dissociation curve and PaO 2 , more accurate readings can be achieved by pulse oxymetry. The oxygen desaturation curve in patients with homozygous sickle cell disease is shifted to the right so that small falls in arterial oxygen tension may produce large changes in SaO 2 .…”

“…The oxygen desaturation curve in patients with homozygous sickle cell disease is shifted to the right so that small falls in arterial oxygen tension may produce large changes in SaO 2 . 36 It is the latter, which is more directly related to the process of intracellular sickling. 11 Individuals with SCD may have oxyhemoglobin desaturation during the steady state, the causes of which are incompletely known.…”

Effect of erythrocytapheresis on arterial oxygen saturation and hemoglobin oxygen affinity in patients with sickle cell disease

“…Although there have been questions regarding the use of Tc-SO 2 in patients with SCD [9,10], Weston Smith et al [4] and Rackoff et al [1] have demonstrated the accuracy of Tc-SO 2 in patients with SCD, when the differences in patients' ODC were taken into account. Therefore, transcutaneous SaO 2 was considered to accurately reflect the true SaO 2 in this study.…”

“…Patients with SCD often have a lower arterial oxygen pressure (PaO 2 ) than normal subjects [1][2][3]. Since hemoglobin oxygen dissociation curves (ODC) in patients with SCD are shifted toward the right, a relatively small fall in PaO 2 usually results in a significant reduction in oxygen saturation [3,4]. This study was designed to examine the changes in arterial oxygen saturation (SaO 2 ), pulse rate, and P50 values (partial pressure of oxygen at which 50% of the hemoglobin is saturated with oxygen) that would occur after erythrocytapheresis in patients with sickle cell disease.…”

Low pulse oximeter-measured hemoglobin oxygen saturations with hemoglobin Cheverly

“…This contrasts with the accepted use of pulse oximetry for noninvasively monitoring patients with other hemoglobinopathies, such as sickle cell disease, where reasonably detailed studies have validated its usefulness to accurately assess hypoxemia [19,20]. Because of the dependence of pulse oximetry on hemoglobin absorptive spectra and the likelihood that amino-acid substitutions, particularly in the heme oxygen binding pocket, may alter the absorptive spectra, then hemoglobin analyses to assess for the presence of unstable hemoglobins should be an important part of the evaluation of a patient with an unexplained discordance in pulse oximetry and blood co-oximetry.…”