Potenziell letale Meth?moglobin?mie nach Ingestion von Alkylnitriten (?Poppers-

详细信息    查看全文

• 作者：G. Wellershoff (1)
  
• 关键词：Meth?moglobin?mie ; Alkylnitrite ; ?Poppers-/li> Methylenblau ; Pulsoximetrie ; Methemoglobinemia ; Alkyl nitrites ; “Poppers-/li> Antidote ; Pulse oxymetry
• 刊名：Notfall & Rettungsmedizin
• 出版年：2014
• 出版时间：March 2014
• 年：2014
• 卷：17
• 期：2
• 页码：137-140
• 全文大小：383 KB
• 参考文献：1. Barker SJ, Badal J (2008) The measurement of dyshemoglobins and total hemoglobin by pulse oximetry. Curr Opin Anaesthesiol 21:805-10 CrossRef
  2. Caudill L, Walbridge J, Kuhn G (1990) Methaemoglobinemia as a cause for coma. Ann Emerg Med 19:777-79 (Met-Hb 81,5-) CrossRef
  3. Cosby K, Partovi KS et al (2003) Nitrite reduction to nitric oxide by deoxyhemoglobin vasodilates the human circulation. Nat Med 9:1498-505 CrossRef
  4. Edwards RJ, Ujma J (1995) Extreme methaemoglobinaemia secondary to recreational use of amylnitrite. J Accid Emerg Med 12:138-42 CrossRef
  5. Faley B, Chase H (2012) A case of severe amyl nitrite induced methemoglobinemia managed with methylene blue. J Clinic Toxicol 2:127 CrossRef
  6. Fye B (1986) T Lauder Brunton and amyl nitrite: a Victorian vasodilator. Circulation 74:222-29 CrossRef
  7. Gamgee A (1868) On the actions of nitrites on the blood. Phil Trans Royal Soc London 158:589-25 CrossRef
  8. Haymond S, Cariappa R, Eby CS, Scott MG (2005) Laboratoy assessment of oxygenation in methemoglobinemia. Clin Chem 51:434-44 CrossRef
  9. Hurford WE, Kratz A (2004) Case 23-004: a 50-year-old woman with low oxygen saturation N Engl J Med 351:380-87
  10. Jensen FB (2001) Comparative analysis of autooxidation of haemoglobin. J Exp Biol 204:2029-033
  11. Keszler A, Piknova B, Schechter AN, Hogg N (2008) The reaction between nitrite and oxyhemoglobin. J Biol Chem 283:9615-622 CrossRef
  12. Lundberg JO, Weitzberg E, Gladwin MT (2008) The nitrate-nitrite-nitric oxide pathway in physiology and therapeutics. Nat Rev Drug Dicov 7:156-67 CrossRef
  13. Stambach T, Haire K, Soni N, Booth J (1997) Saturday night blue -a case of near fatal poisoning from the abuse of amyl nitrite. J Accid Emerg Med 14: 339-40 (Met-Hb: 83-)
  14. Steele CW, Spink WW (1933) Methylene blue in the treatment of poisonings associated with hemoglobinemia. NEJM 208:1152 CrossRef
  15. Wright RO, Lewander WJ, Woolf AD (1999) Methemoglobinemia: etiology, pharmacology, and clinical management. Ann Intern Med 34:646-56
  
• 作者单位：G. Wellershoff (1)
  
  1. Kardiologie und Konservative Intensivmedizin, Vivantes-Klinikum am Urban, Dieffenbachstra?e 1, 10967, Berlin, Deutschland
  
• ISSN：1436-0578

文摘

Background This case report presents a case of severe potentially fatal methemoglobinemia (Met-Hb 71.6-) after ingestion of alkyl nitrites (“poppers-. Objective The pathophysiology of methemoglobinemia, diagnostics and antidote therapy are discussed with reference to common pitfalls. Results Antidote therapy with toluidine blue was rapidly effective.