title: Elevated carboxyhemoglobin associated with sodium nitroprusside treatment.
abstract: OBJECTIVE
  To report four cases of carboxyhemoglobinemia associated with high doses of sodium nitroprusside after cardiac transplant in children.
  
  
  METHODS
  Four children in the pediatric care unit of a university hospital aged 6 months-4 years. Carboxyhemoglonemia developed at levels of 5.5-7.7% in patients receiving high doses of sodium nitroprusside (7-16 microg/kg per minute and no other medication that could caused elevated carboxyhemoglobin). One patient died, and three recovered with no sequelae after discontinuation of sodium nitroprusside.
  
  
  CONCLUSIONS
  High doses of sodium nitroprusside can induce carboxyhemoglobinemia in children after heart transplant, probably by inducing hemeoxygenase, with no other secondary effects.
authors.affiliation: Pediatric Critical Care Unit, Gregorio Marañón University Hospital, Dr. Castelo 47, 28009 Madrid, Spain. pielvi@ya.com
authors.forename: Jesús
authors.initials: J
authors.lastname: López-Herce
authors.forename: Raúl
authors.initials: R
authors.lastname: Borrego
authors.forename: Amaya
authors.initials: A
authors.lastname: Bustinza
authors.forename: Angel
authors.initials: A
authors.lastname: Carrillo
mesh_terms: D002263:Carboxyhemoglobin; D002675:Child, Preschool; D017809:Fatal Outcome; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D007223:Infant; D008297:Male; D008508:Medication Errors; D009599:Nitroprusside / Q000009:adverse effects*; D011183:Postoperative Complications; D014665:Vasodilator Agents / Q000009:adverse effects*
chemical_list: D014665:Vasodilator Agents; D009599:Nitroprusside; D002263:Carboxyhemoglobin