Respiratory management of patients with myeloproliferative
disorders can be challenging, as illustrated in this
case. Pulse oximetry and standard laboratory ABG measurements
are not sufficient to make an accurate and early
diagnosis of pseudo-hypoxemia. The role of point-of-care
measurements for respiratory or metabolic assessment and
management should be considered the standard of care in
patients with myeloproliferative disorders such as hyperleukocytosis
or thrombocytosis.,
due to the intravenous iodine contrast. We report the case
of a patient with hyperleukocytosis secondary to myelofibrosis
who presented with altered mental status and pseudo-hypoxemia.
We discuss the differential diagnoses of
hypoxemia in this setting and the role of point-of-care
arterial blood gas (ABG) analysis in diagnosing pseudohypoxemia.