Document Detail


Hyperoxia in lethal methemoglobinemia: effects on oxygen transport, tissue oxygenation, and survival in pigs.
MedLine Citation:
PMID:  16003066     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Treatment of severe methemoglobinemia includes the avoidance of methemoglobin-inducing drugs, the application of methylene blue, and the administration of supplementary oxygen. However, the efficacy of the latter on oxygen transport, tissue oxygenation, and survival in the treatment of extreme methemoglobinemia is ambiguous. The objective was to assess whether using hyperoxic ventilation as the sole therapeutic intervention (i.e., ventilation with pure oxygen, Fio2 1.0) improves the short-term (6-hr) survival rate during otherwise lethal methemoglobinemia. DESIGN: Prospective, randomized, controlled study. SETTING: Experimental animal laboratory of a university hospital. SUBJECTS: Fourteen anesthetized, mechanically ventilated pigs. INTERVENTIONS: After induction of profound methemoglobinemia (60 +/- 2%) by the injection of 15 mg/kg 4-dimethylaminophenol, artificial ventilation either was continued with room air (G 0.21, n = 7) or was changed over to hyperoxic ventilation (G 1.0, n = 7). A constant level of methemoglobinemia was maintained by continuous infusion of 4-dimethylaminophenol throughout a 6-hr follow-up period. MEASUREMENTS AND MAIN RESULTS: All animals died within the 6-hr follow-up period, but survival time was prolonged in animals ventilated with pure oxygen (G 0.21, 105 +/- 30 mins; G 1.0, 210 +/- 64 mins, p < .05). No differences were encountered between G 0.21 and G 1.0 with respect to the investigated variables of macrohemodynamics, oxygen transport, and tissue oxygenation. CONCLUSIONS: Hyperoxic ventilation has negligible effects on oxygen transport and tissue oxygenation during lethal methemoglobinemia; nevertheless, survival was increased without severe adverse reactions provoked by hyperoxic ventilation.
Authors:
Jens Meier; Andreas Pape; Patrick Lauscher; Bernhard Zwissler; Oliver Habler
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  33     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-08     Completed Date:  2005-08-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1582-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Intensive Care Medicine, and Pain Control, Johann Wolfgang Goethe-University Frankfurt am Main, Frankfurt, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aminophenols
Animals
Biological Transport
Blood Gas Analysis
Female
Hyperoxia*
Male
Methemoglobinemia / chemically induced,  mortality*,  therapy*
Oxygen / adverse effects,  metabolism*,  pharmacokinetics
Oxygen Consumption
Oxygen Inhalation Therapy*
Prospective Studies
Random Allocation
Respiration, Artificial
Swine
Tissue Survival
Chemical
Reg. No./Substance:
0/Aminophenols; 619-60-3/4-dimethylaminophenol; 7782-44-7/Oxygen
Comments/Corrections
Comment In:
Crit Care Med. 2005 Jul;33(7):1662-3   [PMID:  16003089 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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