Isosulfan Blue Affects Pulse Oximetry

Abstract

After peritumoral administration of IB, 50 mg, a significant interference with Spo2 will occur.

Blue dyes, blue people: the systemic effects of blue dyes when administered via different routes

“…Of these dyes, Patent Blue has long been used to color lymphatic vessels before lymphangiography. More recently, it has found its way into the OR for use in identifying and visualizing sentinel lymph nodes, which are biopsied in the search for metastases [2,[4][5][6][7][8][9][10][11][12][13]. In lymphangiography, Patent Blue V (occasionally referred to as Sulphan Blue) is injected subcutaneously so it can enter the lymphatic vessels, which then become visible through the skin, and it can be injected with a radiological contrast agent.…”

“…Patent Blue, like all the blue dyes-including indigo carmine and methylene blue-alter the light absorbance characteristics of plasma and should, therefore, create oximetry artifacts [11][12][13]. It is well known that dyes such as methylene blue, indigo carmine, and indocyanine green, when given IV, can cause erroneous pulse oximetry readings [1,19,20], as was the case with methylene blue in Patient 1.…”

Anaphylaxis to isosulfan blue dye during sentinel lymph node biopsy

“…It is classified as an inert physiological dye, which has no known pharmacological action. Approximately 15% of IB is excreted in urine over a 24-hour period, and the remainder is presumed to be excreted via the biliary route [5].…”

“…Numerous cases of unexplained decreases in measured oxygen saturation by pulse oximetry have been reported after injection of 1% IB dye [1,5]. It is thought that this effect is due to the interfering absorptive spectroscopy between IB dye and the wavelength used to measure hemoglobin saturation.…”

Murine photoplethysmography for in vivo estimation of vascular gold nanoshell concentration

“…Only recently have there been more advances in the algorithms used in pulse oximetry accounting for whole blood optical properties. medical procedures such as hepatic studies, 8 renal studies, sentinel node detection in patients with cancer, [9][10][11] and cardiac output and volume measurements. 12 These dyes, including methylene blue, indigo carmine ͑IDG͒, indocyanine green ͑ICG͒, and patent blue, cause changes in the extinction spectrum of blood.…”