This case study examines a patient undergoing an elective procedure who had a past medical history of Hemoglobin Louisville and presented with baseline oxygen saturation levels (SpO2) in the 80s as measured by noninvasive pulse oximetry. It presents the anesthetic provided, a brief review of physiology, and a discussion pertaining to this particular genetic mutation. Understanding the physiological implications of these types of hemoglobinopathies and their anesthetic management is key to managing patients' care throughout the perioperative period. With new hemoglobin variants continuing to emerge, reviewing some of the rare hemoglobinopathies is prudent to support the anesthesia community in their assessment and care of patients who present with unexpectedly low SPO2.
Keywords: Hemoglobin Bucuresti; Hemoglobin Louisville; hemoglobin-oxygen affinity; hemoglobinopathies; hypoxia.
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