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, a...

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Bibliographic Details
Published in:Journal of vascular surgery 2004-03, Vol.39 (3), p.686-690
Main Authors: Anderson, Carryn M, Woodside, Kenneth J, Spencer, Todd A, Hunter, Glenn C
Format: Article
Language:English
Subjects:
Aged
Antioxidants - therapeutic use
Ascorbic Acid - therapeutic use
Biological and medical sciences
Blood Vessel Prosthesis Implantation
Cyanosis - etiology
Cyanosis - therapy
Enzyme Inhibitors - therapeutic use
Female
Humans
Medical sciences
Methemoglobinemia - diagnosis
Methemoglobinemia - etiology
Methemoglobinemia - physiopathology
Methemoglobinemia - therapy
Methylene Blue - therapeutic use
Middle Aged
Postoperative Complications
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Treatment Outcome
Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
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Summary: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.
ISSN:0741-5214
1097-6809
DOI:10.1016/j.jvs.2003.08.023