Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Case Reports
Intraoperative decrease in pulse oximeter readings following injection of isosulfan blue.
Sentinel lymph node mapping, involving injection of isosulfan blue dye around a tumour, is beginning to be used in patients with carcinoma of the breast. Absorption of the dye into the circulation may interfere with pulse oximetry, causing falsely low readings. This report describes changes in pulse oximeter readings following injection of isosulfan blue for sentinel lymph node mapping in a patient with carcinoma of the breast. ⋯ Review of the literature reveals a small number of case reports of similar occurrences of low pulse oximeter readings following injection of isosulfan blue or patent blue dye for lymphatic mapping. Data from these reports and the case described here suggest that the latency, magnitude and duration of effect on pulse oximeter readings following injection of these dyes is highly variable. It is important to rule out other causes of low pulse oximeter readings when this effect occurs; normal oxygenation can be verified with arterial blood gas analysis. Co-oximetry can be done to rule out methemoglobinemia as a cause of decreased SpO2.
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This article will define standards, how they are developed and applied and how they impact on the day to day practice of clinicians. ⋯ Equipment and facility standards have helped improve patient safety over the past 20 yr. However, anesthesiologists need to encourage their governmental regulatory bodies to encourage manufacturer compliance with specific standards.