A case report of acquired methemoglobinemia rescued by veno-venous extracorporeal membrane oxygenation
| Autor: | You-Cian Lin, Robert Jeenchen Chen, Yu-Hsuan Lien |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
methemoglobinemia medicine.medical_treatment Exchange transfusion Return of spontaneous circulation Methemoglobinemia veno-venous extracorporeal membrane oxygenation Hypoxemia Diagnosis Differential Young Adult 03 medical and health sciences Extracorporeal Membrane Oxygenation 0302 clinical medicine medicine Extracorporeal membrane oxygenation Humans case report Clinical Case Report 030212 general & internal medicine Past medical history business.industry General Medicine Oxygenation medicine.disease Heart Arrest 030220 oncology & carcinogenesis Anesthesia Arterial blood medicine.symptom business Research Article |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 0025-7974 |
| Popis: | Rationale: Severe methemoglobinemia (Met-Hb) is rare. The delayed diagnosis and treatment often cause further damage. The management of cellular hypoxemia is challenging and the use of extra-corporeal membrane oxygenation (ECMO) has never been reported. Patient concerns: The young patient, healthy with unremarkable past medical history, was sent to emergency room with out-of-hospital circulatory arrest (OHCA) and severe generalized cyanosis. His family reported he ingested sodium nitrite accidentally. Diagnoses: After successful resuscitation and return of spontaneous circulation (ROSC), the paradoxically normal arterial blood gas (ABG) with the unusual brownish blood led to the suspicion of Met-Hb. The lab test confirmed it and showed a very high level of 80%. Interventions: Because of recovered and normal cardiac function, we placed veno-venous extracorporeal membrane oxygenation (VV-ECMO) for tissue hypoxemia in addition to exchange transfusion, vitamin C, and methylene blue. Outcomes: Met-Hb blood level dropped rapidly. After vigorous rehabilitation for weeks, the patient was able to be discharged home without major neurological sequela. Lessons: VV-ECMO can hyper-oxygenate the hypoxemic tissue regardless the etiology and minimize hypoxemia-reperfusion injury while awaiting the definite diagnosis and therapy. |
| Databáze: | OpenAIRE |
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