| Intraoperative diagnosis of unsuspected methemoglobinemia due to low pulse oximetry values. | |
| | |
MedLine Citation:
|
PMID: 19617227 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Methemoglobinemia results from the oxidation of the iron in the hemoglobin molecule from the ferrous to the ferric state. Methemoglobinemia may result from congenital deficiencies of enzymes that normally convert methemoglobin (metHb) to hemoglobin, alterations in the hemoglobin molecule itself or, most commonly, from medications or toxins. As metHb cannot carry oxygen, clinical sequelae result when the concentration of metHb is high enough to compromise oxygen delivery to the tissues. With low levels, the patient may be asymptomatic or only symptomatic during periods of increased tissue oxygen demands such as exercise. With higher levels, symptoms may occur at rest. We describe an adolescent with acute leukemia who presented to the operating room for placement of a Broviac catheter for permanent central venous access. Given a persistently low oxygen saturation as measured by pulse oximetry (92% to 94%) with no response to changes in the inspired oxygen concentration and the lack of physical findings on auscultation to explain the low oxygen saturation, the diagnosis of metHb was entertained and confirmed by laboratory analysis. |
| | |
Authors:
|
Joseph D Tobias; Venkataraman Ramachandran |
Related Documents
:
|
17477717 - Near-infrared spectroscopic quantification of changes in the concentration of oxidized ... 10218377 - Long-term oxygen therapy: advances and perspectives in technical devices. 12566247 - Impaired oxygen-dependent reduction of hif-1alpha and -2alpha proteins in pre-eclamptic... 7146637 - Some aspects of the oxygen transport in patients with chronic obstructive lung diseases... 1756437 - Effect of prostaglandin inhibition by indomethacin on plasma active and inactive renin ... 1798317 - Caffeine ingestion during exercise to exhaustion in elite distance runners. revision. |
Publication Detail:
|
Type: Case Reports; Journal Article Date: 2009-07-17 |
Journal Detail:
|
Title: Journal of intensive care medicine Volume: 24 ISSN: 0885-0666 ISO Abbreviation: J Intensive Care Med Publication Date: 2009 Jul-Aug |
Date Detail:
|
Created Date: 2009-07-23 Completed Date: 2009-11-02 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8610344 Medline TA: J Intensive Care Med Country: United States |
Other Details:
|
Languages: eng Pagination: 273-7 Citation Subset: IM |
Affiliation:
|
Department of Anesthesiology, University of Missouri, Columbia, Missouri 65212, USA. Tobiasj@health.missouri.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Humans Leukemia, Myeloid, Acute / complications Male Methemoglobinemia / diagnosis* Oximetry* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Redox modification of ryanodine receptors underlies calcium alternans in a canine model of sudden ca...
Next Document: Analytic Reviews: High-Frequency Oscillatory Ventilation (HFOV) and Airway Pressure Release Ventilat...