Low pulse oximeter-measured hemoglobin oxygen saturations with hemoglobin Cheverly

Raymond Hohl, Alan R. Sherburne, James E. Feeley, Titus H.J. Huisman, C. Patrick Burns

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Unexpectedly low hemoglobin oxygen saturation as determined by pulse- oximeter analysis was observed in a patient who underwent an elective surgical procedure. Specific hemoglobin derivatives such as carboxyhemoglobin, methemoglobin, and reduced hemoglobin that have been described to lower pulse-oximetry determination of oxygenation were not detected. Absorbance spectra revealed the patient's hemoglobin to be different than that obtained from two normal volunteers. High-pressure liquid chromatographic analysis of the hemoglobin showed an unknown band that comprised 15% of the patient's hemoglobin. DNA sequence analysis showed a point mutation in the second nucleotide of the 45th codon of the β-globin chain. This mutation encodes for an abnormal β-chain (β-45 Phe→Ser) that has been described as hemoglobin Cheverly. Hemoglobin Cheverly is an unstable hemoglobin that has a similar mutation as the β-42 Phe-→Ser mutation seen in hemoglobin Hammersmith. Hemoglobin Hammersmith and another unstable hemoglobin, hemoglobin Koln, have previously been described to have unexpectedly low pulse-oximeter-determined oxyhemoglobin levels. That we find hemoglobin Cheverly to result in a similar phenomenon suggests that pulse- oximeter monitoring of oxygenation status may not be appropriate for the unstable hemoglobins. Low pulse-oximeter oxygenation determinations for these hemoglobins do not appear to predict clinical hypoxemia.

Original languageEnglish (US)
Pages (from-to)181-184
Number of pages4
JournalAmerican Journal of Hematology
Volume59
Issue number3
DOIs
StatePublished - Nov 1 1998

Fingerprint

Pulse
Hemoglobins
Oxygen
phenylalanylserine
Mutation
Elective Surgical Procedures
hemoglobin Cheverly
Carboxyhemoglobin
Methemoglobin
Oxyhemoglobins
Oximetry
Globins
DNA Sequence Analysis
Point Mutation
Codon
Healthy Volunteers
Nucleotides
High Pressure Liquid Chromatography

All Science Journal Classification (ASJC) codes

  • Hematology

Cite this

Hohl, Raymond ; Sherburne, Alan R. ; Feeley, James E. ; Huisman, Titus H.J. ; Burns, C. Patrick. / Low pulse oximeter-measured hemoglobin oxygen saturations with hemoglobin Cheverly. In: American Journal of Hematology. 1998 ; Vol. 59, No. 3. pp. 181-184.
@article{ec1dc5edc9da48dcb1165bc451431284,
title = "Low pulse oximeter-measured hemoglobin oxygen saturations with hemoglobin Cheverly",
abstract = "Unexpectedly low hemoglobin oxygen saturation as determined by pulse- oximeter analysis was observed in a patient who underwent an elective surgical procedure. Specific hemoglobin derivatives such as carboxyhemoglobin, methemoglobin, and reduced hemoglobin that have been described to lower pulse-oximetry determination of oxygenation were not detected. Absorbance spectra revealed the patient's hemoglobin to be different than that obtained from two normal volunteers. High-pressure liquid chromatographic analysis of the hemoglobin showed an unknown band that comprised 15{\%} of the patient's hemoglobin. DNA sequence analysis showed a point mutation in the second nucleotide of the 45th codon of the β-globin chain. This mutation encodes for an abnormal β-chain (β-45 Phe→Ser) that has been described as hemoglobin Cheverly. Hemoglobin Cheverly is an unstable hemoglobin that has a similar mutation as the β-42 Phe-→Ser mutation seen in hemoglobin Hammersmith. Hemoglobin Hammersmith and another unstable hemoglobin, hemoglobin Koln, have previously been described to have unexpectedly low pulse-oximeter-determined oxyhemoglobin levels. That we find hemoglobin Cheverly to result in a similar phenomenon suggests that pulse- oximeter monitoring of oxygenation status may not be appropriate for the unstable hemoglobins. Low pulse-oximeter oxygenation determinations for these hemoglobins do not appear to predict clinical hypoxemia.",
author = "Raymond Hohl and Sherburne, {Alan R.} and Feeley, {James E.} and Huisman, {Titus H.J.} and Burns, {C. Patrick}",
year = "1998",
month = "11",
day = "1",
doi = "10.1002/(SICI)1096-8652(199811)59:3<181::AID-AJH1>3.0.CO;2-I",
language = "English (US)",
volume = "59",
pages = "181--184",
journal = "American Journal of Hematology",
issn = "0361-8609",
publisher = "Wiley-Liss Inc.",
number = "3",

}

Low pulse oximeter-measured hemoglobin oxygen saturations with hemoglobin Cheverly. / Hohl, Raymond; Sherburne, Alan R.; Feeley, James E.; Huisman, Titus H.J.; Burns, C. Patrick.

In: American Journal of Hematology, Vol. 59, No. 3, 01.11.1998, p. 181-184.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Low pulse oximeter-measured hemoglobin oxygen saturations with hemoglobin Cheverly

AU - Hohl, Raymond

AU - Sherburne, Alan R.

AU - Feeley, James E.

AU - Huisman, Titus H.J.

AU - Burns, C. Patrick

PY - 1998/11/1

Y1 - 1998/11/1

N2 - Unexpectedly low hemoglobin oxygen saturation as determined by pulse- oximeter analysis was observed in a patient who underwent an elective surgical procedure. Specific hemoglobin derivatives such as carboxyhemoglobin, methemoglobin, and reduced hemoglobin that have been described to lower pulse-oximetry determination of oxygenation were not detected. Absorbance spectra revealed the patient's hemoglobin to be different than that obtained from two normal volunteers. High-pressure liquid chromatographic analysis of the hemoglobin showed an unknown band that comprised 15% of the patient's hemoglobin. DNA sequence analysis showed a point mutation in the second nucleotide of the 45th codon of the β-globin chain. This mutation encodes for an abnormal β-chain (β-45 Phe→Ser) that has been described as hemoglobin Cheverly. Hemoglobin Cheverly is an unstable hemoglobin that has a similar mutation as the β-42 Phe-→Ser mutation seen in hemoglobin Hammersmith. Hemoglobin Hammersmith and another unstable hemoglobin, hemoglobin Koln, have previously been described to have unexpectedly low pulse-oximeter-determined oxyhemoglobin levels. That we find hemoglobin Cheverly to result in a similar phenomenon suggests that pulse- oximeter monitoring of oxygenation status may not be appropriate for the unstable hemoglobins. Low pulse-oximeter oxygenation determinations for these hemoglobins do not appear to predict clinical hypoxemia.

AB - Unexpectedly low hemoglobin oxygen saturation as determined by pulse- oximeter analysis was observed in a patient who underwent an elective surgical procedure. Specific hemoglobin derivatives such as carboxyhemoglobin, methemoglobin, and reduced hemoglobin that have been described to lower pulse-oximetry determination of oxygenation were not detected. Absorbance spectra revealed the patient's hemoglobin to be different than that obtained from two normal volunteers. High-pressure liquid chromatographic analysis of the hemoglobin showed an unknown band that comprised 15% of the patient's hemoglobin. DNA sequence analysis showed a point mutation in the second nucleotide of the 45th codon of the β-globin chain. This mutation encodes for an abnormal β-chain (β-45 Phe→Ser) that has been described as hemoglobin Cheverly. Hemoglobin Cheverly is an unstable hemoglobin that has a similar mutation as the β-42 Phe-→Ser mutation seen in hemoglobin Hammersmith. Hemoglobin Hammersmith and another unstable hemoglobin, hemoglobin Koln, have previously been described to have unexpectedly low pulse-oximeter-determined oxyhemoglobin levels. That we find hemoglobin Cheverly to result in a similar phenomenon suggests that pulse- oximeter monitoring of oxygenation status may not be appropriate for the unstable hemoglobins. Low pulse-oximeter oxygenation determinations for these hemoglobins do not appear to predict clinical hypoxemia.

UR - http://www.scopus.com/inward/record.url?scp=0031790831&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031790831&partnerID=8YFLogxK

U2 - 10.1002/(SICI)1096-8652(199811)59:3<181::AID-AJH1>3.0.CO;2-I

DO - 10.1002/(SICI)1096-8652(199811)59:3<181::AID-AJH1>3.0.CO;2-I

M3 - Article

C2 - 9798654

AN - SCOPUS:0031790831

VL - 59

SP - 181

EP - 184

JO - American Journal of Hematology

JF - American Journal of Hematology

SN - 0361-8609

IS - 3

ER -