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Related Experiment Videos

Intraoperative decrease in pulse oximeter readings following injection of isosulfan blue.

R W Hoskin1, R Granger

  • 1Department of Anaesthesia, St Mary's Hospital, New Westminster, BC, Canada. rhoskin@home.com

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|February 24, 2001
PubMed
Summary
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Isosulfan blue dye used in sentinel lymph node mapping can cause falsely low pulse oximeter readings in breast cancer patients. Normal oxygenation can be confirmed with arterial blood gas analysis.

Area of Science:

  • Oncology
  • Surgical Pathology
  • Medical Devices

Background:

  • Sentinel lymph node biopsy is a common procedure for breast cancer staging.
  • Isosulfan blue dye is frequently used for lymphatic mapping during this procedure.
  • Potential interference of dyes with vital sign monitoring warrants investigation.

Observation:

  • A case report details an 83-year-old female patient undergoing sentinel node biopsy for breast carcinoma.
  • Following isosulfan blue injection, SpO2 readings dropped significantly, reaching 89-90%.
  • Pulse oximetry values normalized over six hours post-injection, despite normal arterial blood gas results.

Findings:

  • Isosulfan blue dye absorption into circulation can transiently decrease pulse oximeter readings.

Related Experiment Videos

  • The observed effect on SpO2 is variable in latency, magnitude, and duration.
  • Arterial blood gas analysis is crucial to confirm normal oxygenation and rule out other causes of desaturation.

    • Implications:

    • Clinicians should be aware of potential pulse oximetry interference following isosulfan blue injection.
    • Differential diagnosis of low SpO2 readings in patients undergoing lymphatic mapping is essential.
    • Co-oximetry can help rule out methemoglobinemia as a cause of decreased SpO2.