185:(CO) or other non-respiratory hypoxic symptoms, most current CO-oximeters will detect the relative levels of each hemoglobin fraction (oxyhemoglobin and dyshemoglobins) and likely the oxyhemoglobin saturation. For any system making these measurements it is critical that the device clearly distinguish between Oxygen Saturation' and Fractional Oxyhemoglobin" . The issue here is the careless use of saturation vs. fractional oxyhemoglobin, which both measure the same entity -oxyhemoglobin- but the oxygen saturation uses as its base only the hemoglobin available for binding, while the fractional oxyhemoglobin uses the total hemoglobin in the sample as its base. In normal subjects the values are nearly identical-thus leading to terminologic and possibly clinical confusion. A simple oximeter measuring only oxygen derivatives, may report a normal saturation or even a hyperoxic state if oxygen gas has been administered when in fact there is serious compromise of oxygen carrying ability of the hemoglobin present.
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which measures hemoglobin bound to molecular oxygen—O2Hb—or hemoglobin capable of binding to molecular oxygen—HHb. Simpler oximeters may report oxygen saturation alone, i.e. the ratio of oxyhemoglobin to total 'bindable' hemoglobin (i.e. oxyhemoglobin + deoxyhemoglobin-HHb). CO-oximetry is useful in
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processed in a specific device designed to be able to measure proportions of multiple components of several hemoglobin moieties using multi-wavelength spectrophotometry and complex, but straightforward internal computations. While these units still are in wide use, blood gas analyzers with integral
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specimen, including oxygen-carrying hemoglobin (O2Hb), non-oxygen-carrying but normal hemoglobin (HHb) (formerly, but incorrectly, referred to as 'reduced' hemoglobin), as well as the dyshemoglobins such as carboxyhemoglobin (COHb) and methemoglobin (MetHb). The use of 'CO' rather than 'Co' or 'co'
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CO-oximetry modules have also been developed and successfully marketed by several manufacturers. More recently, some 'pulse' or more precisely 'peripheral' oximeters have made it possible to estimate carboxyhemoglobin with non-invasive technology similar to a simple
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Simultaneous measurement of total hemoglobin and its derivatives in blood using CO-oximeters: Analytical principles; Their application in selecting analytical wavelengths and reference methods; A comparison of the results of the choices
148:, and deoxyhemoglobin (formerly called 'reduced' hemoglobin), and thus determine the oxyhemoglobin saturation (the percentage of oxygenated hemoglobin compared to the total amount of available
169:. In contrast, the use of a standard or simple pulse oximeter is not effective in the diagnosis of CO poisoning as patients who have carbon monoxide poisoning may have a normal
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CO-oximetric measurement of oxyhemoglobin, deoxyhemoglobin, and dyshemoglobins in blood: Effects of analytical wavelength and reference method selection.
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Comparison and assessment of blood gas related quantities including base excess, the gas exchange indices and temperature corrected pH/
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A CO-oximeter measures the absorption of light passing through blood from few as two or three wavelengths of light to several dozens of
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mplications of Fetal
Hemoglobin : Measurement of oxygen saturation, fractional oxyhemoglobin, carboxyhemoglobin and methemoglobin.
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The case for standardized terminology: Oxygen "saturation" values can trick the unwary and lead to clinical misjudgement
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CLSI, C46-A2- Blood Gas and pH Analysis and
Related Measurements; Approved Guideline—Second Edition, Wayne, PA, 2010
160:-metHb, other hemoglobin moieties and 'background' light-absorbing species. Traditionally, measurement is made from
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Definition, significance and measurement of quantities pertaining to the oxygen carrying properties of human blood.
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152:(Hb)). Measurement of greater numbers of wavelengths enables the instrument to distinguish between these and
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216:"Spectrophotometric measurement of carboxyhemoglobin and methemoglobin in blood"
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Hemoglobin F and measurement of oxygen saturation and fractional oxyhemoglobin
317:"Reliability of new pulse CO-oximeter in victims of carbon monoxide poisoning"
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is more appropriate since this designation represents a device that measures
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433:, Data processing in CO-oximeters that Use overdetermined systems (Reply).
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268:"Evaluation of methods used to estimate inhaled dose of carbon monoxide"
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CLSI document C25A, can provide in-depth information and references.
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Coulange M, Barthelemy A, Hug F, Thierry AL, De Haro L (2008).
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Rodkey FL, Hill TA, Pitts LL, Robertson RF (August 1979).
111:(CO) bound to hemoglobin, as distinguished from simple
479:Brunnelle JA, Degtiarov AM, Moran RF, Race LA,
420:Brunelle JA, Degtiarov AM, Moran RF, Race LA,
266:Rees PJ, Chilvers C, Clark TJ (January 1980).
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369:"Carboxyhaemoglobinaemia and pulse oximetry"
335:. Archived from the original on 2011-06-25
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66:Learn how and when to remove this message
29:This article includes a list of general
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367:Vegfors M, Lennmarken C (May 1991).
321:Undersea & Hyperbaric Medicine
35:it lacks sufficient corresponding
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409:Zijlstra WJ, Maas AHJ, Moran RF.
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373:British Journal of Anaesthesia
94:is a device that measures the
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428:56: (Suppl) 224, 47–69, 1996.
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181:When a patient presents with
173:reading on a pulse oximeter.
465:56:(Suppl) 224, 89-106 1996.
167:(peripheral) pulse oximeter
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144:, in order to distinguish
533:Medical testing equipment
463:Scand J Clin Lab Invest ,
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183:carbon monoxide poisoning
426:Scand J Clin Lab Invest,
116:defining the causes for
496:, April–May 8–9, 1995.
494:Crit Care International
486:. 1:2, 161 - 164, 1995.
415:Scand J Clin Lab Invest
154:carboxyhemoglobin,-COHb
50:more precise citations.
507:, 21:5, 805–807, 1993.
195:Breath carbon monoxide
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431:Brunelle JA, Moran RF
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441:Degen BR, Moran RF,
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512:, Lab Consultant:
476:7:3, 162–164, 1994.
438:43:1, 189–191, 1997
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220:Clinical Chemistry
98:carrying state of
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126:oxygen deficiency
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527:Categories
499:Moran RF,
468:Moran R,
436:Clin Chem,
339:2009-07-17
252:2009-07-17
201:References
150:hemoglobin
122:or hypoxia
100:hemoglobin
31:references
136:Mechanism
118:hypoxemia
510:Moran RF
333:18500075
189:See also
113:oximetry
56:May 2013
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