Non-invasive measurements of carboxyhemoglobin and methemoglobin in children with sickle cell disease

Jason B. Caboot, Abbas F. Jawad, Joseph M. McDonough, Cheryl Y. Bowdre, Raanan Arens, Carole L. Marcus, Thornton B A Mason, Kim Smith-Whitley, Kwaku Ohene-Frempong, Julian L. Allen

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Assessment of oxyhemoglobin saturation in patients with sickle cell disease (SCD) is vital for prompt recognition of hypoxemia. The accuracy of pulse oximeter measurements of blood oxygenation in SCD patients is variable, partially due to carboxyhemoglobin (COHb) and methemoglobin (MetHb), which decrease the oxygen content of blood. This study evaluated the accuracy and reliability of a non-invasive pulse co-oximeter in measuring COHb and MetHb percentages (SpCO and SpMet) in children with SCD. We hypothesized that measurements of COHb and MetHb by non-invasive pulse co-oximetry agree within acceptable clinical accuracy with those made by invasive whole blood co-oximetry. Fifty children with SCD-SS underwent pulse co-oximetry and blood co-oximetry while breathing room air. Non-invasive COHb and MetHb readings were compared to the corresponding blood measurements. The pulse co-oximeter bias was 0.1% for COHb and -0.22% for MetHb. The precision of the measured SpCO was ±2.1% within a COHb range of 0.4-6.1%, and the precision of the measured SpMet was ±0.33% within a MetHb range of 0.1-1.1%. Non-invasive pulse co-oximetry was useful in measuring COHb and MetHb levels in children with SCD. Although the non-invasive technique slightly overestimated the invasive COHb measurements and slightly underestimated the invasive MetHb measurements, there was close agreement between the two methods.

Original languageEnglish (US)
Pages (from-to)808-815
Number of pages8
JournalPediatric Pulmonology
Volume47
Issue number8
DOIs
StatePublished - Aug 2012

Fingerprint

Carboxyhemoglobin
Methemoglobin
Sickle Cell Anemia
Oximetry
Pulse
Oxyhemoglobins
Reading
Respiration
Air
Oxygen

Keywords

  • blood gas analysis
  • hemoglobins
  • oximetry
  • pediatrics
  • sickle cell anemia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Cite this

Caboot, J. B., Jawad, A. F., McDonough, J. M., Bowdre, C. Y., Arens, R., Marcus, C. L., ... Allen, J. L. (2012). Non-invasive measurements of carboxyhemoglobin and methemoglobin in children with sickle cell disease. Pediatric Pulmonology, 47(8), 808-815. https://doi.org/10.1002/ppul.22504

Non-invasive measurements of carboxyhemoglobin and methemoglobin in children with sickle cell disease. / Caboot, Jason B.; Jawad, Abbas F.; McDonough, Joseph M.; Bowdre, Cheryl Y.; Arens, Raanan; Marcus, Carole L.; Mason, Thornton B A; Smith-Whitley, Kim; Ohene-Frempong, Kwaku; Allen, Julian L.

In: Pediatric Pulmonology, Vol. 47, No. 8, 08.2012, p. 808-815.

Research output: Contribution to journalArticle

Caboot, JB, Jawad, AF, McDonough, JM, Bowdre, CY, Arens, R, Marcus, CL, Mason, TBA, Smith-Whitley, K, Ohene-Frempong, K & Allen, JL 2012, 'Non-invasive measurements of carboxyhemoglobin and methemoglobin in children with sickle cell disease', Pediatric Pulmonology, vol. 47, no. 8, pp. 808-815. https://doi.org/10.1002/ppul.22504
Caboot, Jason B. ; Jawad, Abbas F. ; McDonough, Joseph M. ; Bowdre, Cheryl Y. ; Arens, Raanan ; Marcus, Carole L. ; Mason, Thornton B A ; Smith-Whitley, Kim ; Ohene-Frempong, Kwaku ; Allen, Julian L. / Non-invasive measurements of carboxyhemoglobin and methemoglobin in children with sickle cell disease. In: Pediatric Pulmonology. 2012 ; Vol. 47, No. 8. pp. 808-815.
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abstract = "Assessment of oxyhemoglobin saturation in patients with sickle cell disease (SCD) is vital for prompt recognition of hypoxemia. The accuracy of pulse oximeter measurements of blood oxygenation in SCD patients is variable, partially due to carboxyhemoglobin (COHb) and methemoglobin (MetHb), which decrease the oxygen content of blood. This study evaluated the accuracy and reliability of a non-invasive pulse co-oximeter in measuring COHb and MetHb percentages (SpCO and SpMet) in children with SCD. We hypothesized that measurements of COHb and MetHb by non-invasive pulse co-oximetry agree within acceptable clinical accuracy with those made by invasive whole blood co-oximetry. Fifty children with SCD-SS underwent pulse co-oximetry and blood co-oximetry while breathing room air. Non-invasive COHb and MetHb readings were compared to the corresponding blood measurements. The pulse co-oximeter bias was 0.1{\%} for COHb and -0.22{\%} for MetHb. The precision of the measured SpCO was ±2.1{\%} within a COHb range of 0.4-6.1{\%}, and the precision of the measured SpMet was ±0.33{\%} within a MetHb range of 0.1-1.1{\%}. Non-invasive pulse co-oximetry was useful in measuring COHb and MetHb levels in children with SCD. Although the non-invasive technique slightly overestimated the invasive COHb measurements and slightly underestimated the invasive MetHb measurements, there was close agreement between the two methods.",
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