Elevated carboxyhemoglobin associated with sodium nitroprusside treatment.
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.
López-Herce
Jesús
J
Pediatric Critical Care Unit, Gregorio Marañón University Hospital, Dr. Castelo 47, 28009 Madrid, Spain. pielvi@ya.com
Borrego
Raúl
R
Bustinza
Amaya
A
Carrillo
Angel
A
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*
D014665:Vasodilator Agents; D009599:Nitroprusside; D002263:Carboxyhemoglobin