Pseudohypoxemia

Pseudohypoxemia or spurious hypoxemia represents a low oxygen tension or saturation in an arterial blood sample that does not correspond with the actual levels in the body. […] A young patient with leukemia and extreme leukocytosis (hyperleukoctosis) who demonstrated pseudohypoxemia is described herein. Clinical experiments on the arterial blood sample from this patient revealed that the phenomenon of pseudohypoxemia was most likely caused by a rapid in vitro oxygen consumption by the excessively large number of immature leukemic cells.

Pseudohypoxaemia or spurious hypoxaemia is a recurrent problem faced on arterial blood gas analysis in patients with hyperleucocytosis leading to management dilemmas and unnecessary respiratory interventions. Various methods have been suggested to reduce the magnitude of this problem.

False readings of low oxygen content are rare but can be expected in specific clinical scenarios such as leukemia patients with marked leukocytosis who can develop "leukocyte larceny," a phenomenon of excess oxygen consumption by leukocytes. […] This case report presents a patient with marked leukocytosis from chronic myelogenous leukemia whose extubation was briefly delayed due to pseudohypoxemia on ABG measurements.