Gutiérrez-Riverol K, Lozada RKG, Herrera JD, Avelar AC

Language: Spanish
References: 5
Page: 17-21
PDF size: 291.32 Kb.

ABSTRACT

Methemoglobinemia occasionally causes cyanosis particularly in congenital methemoglobinemia. Avoidance of exposure to oxidizing agents is important for patients with congenital methemoglobinemia because of their deficient enzymatic pathways and decreased oxygen-carrying capacity. Here, we present a pediatric patient with preoperatively undiagnosed congenital methemoglobinemia who underwent catheterization with probably diagnosis of pulmonar hypertension under general anesthesia. The pediatric patient was a 10-year-old who displayed a low pulse oximetry reading of 92% prior to induction of anesthesia. Methemoglobinemia was first suspected intraoperatively because of a mismatch of SpO₂ of finger pulse oximetry and SaO₂ of arterial blood, and was later confirmed by multiplewavelength CO-oximetry. The pathophysiology, etiology, clinical manifestations, anesthetic considerations, and treatment options of methemoglobinemia are discussed.

REFERENCES

1. Lin C-Y, Yang J-M, Chen C-T, Hsu Y-W, Huang C-J,Chen C-C, et al. Anesthetic management of a patient withcongenital methemoglobinemia. Acta Anaesthesiol Taiwan[Internet]. 2009;47(3):143-6. Disponible en: http://dx.doi.org/10.1016/s1875-4597(09)60042-4.

2. Herranz M, Clerigué N. Intoxicación en niños: Metahemoglobinemia.An Sist Sanit Navar [Internet].2003;26. Disponible en: http://dx.doi.org/10.4321/s1137-66272003000200013

3. Kus A, Berk D, Hosten T, Gurkan Y, Solak M, Teker K.The role of preoperative evaluation for congenital methemoglobinemia.Turk J Anesth Reanim. 2014;42(4):223-6.Disponible en: http://dx.doi.org/10.5152/tjar.2014.82335

4. Ludlow JT, Wilkerson RG, Nappe TM. Methemoglobinemia.[Updated 2022 Aug 29]. En: StatPearls [Internet].Treasure Island (FL): StatPearls Publishing; 2023 Jan.Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK537317/?report=classic

5. Quiñones Coneo KL, Carvajal del Castillo O, Bello GutiérrezP, Pulido Ovalle E, Caro Gutiérrez MD. Metahemoglobinemiasecundaria a aplicación de un anestésico tópico(EMLA). Rev Pediatr Aten Primaria [Internet]. 2021 Mar[citado 2023 Mayo 31];23(89):79-81. Epub 09-Mayo-2022.Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1139-76322021000100012&lng=es