Methemoglobinemia: an unusual cause of postoperative cyanosis.
Methemoglobinemia, although rare, must be considered in surgical patients presenting with acute respiratory distress and cyanosis. We report two cases of methemoglobinemia in patients undergoing aortic reconstruction. The first patient developed methemoglobinemia while on a nitroglycerin infusion, and the second after receiving benzocaine spray before intubation. Both patients were treated with methylene blue and ascorbic acid, with resolution of their hypoxia and cyanosis. The pathophysiology, etiology, diagnosis, and treatment of methemoglobinemia are reviewed.
Anderson
Carryn M
CM
Division of Vascular Surgery, Department of Surgery, University of Texas Medical Branch, Boulevard, Galveston, TX 77555-0544, USA. gchunter@utmb.edu
Woodside
Kenneth J
KJ
Spencer
Todd A
TA
Hunter
Glenn C
GC
D000368:Aged; D000975:Antioxidants / Q000627:therapeutic use; D001205:Ascorbic Acid / Q000627:therapeutic use; D019917:Blood Vessel Prosthesis Implantation; D003490:Cyanosis / Q000209:etiology / Q000628:therapy*; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008708:Methemoglobinemia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008751:Methylene Blue / Q000627:therapeutic use; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome
D000975:Antioxidants; D004791:Enzyme Inhibitors; D001205:Ascorbic Acid; D008751:Methylene Blue