Acquired methemoglobinemia in a third trimester puerpera and her premature infant with sodium nitrite poisoning:A case report  

作　　者：Dong-Sheng Fei Yang Gao Xue-Jiao Bao Yu-Jia Tang Yi-Lu Lin Jia-Xi Xu Jia-Ning Zhang Bo-Wen Liu Kai Kang 

机构地区：[1]Department of Critical Care Medicine,The First Affiliated Hospital of Harbin Medical University,Harbin 150001,Heilongjiang Province,China [2]Department of Critical Care Medicine,The Sixth Affiliated Hospital of Harbin Medical University,Harbin 150027,Heilongjiang Province,China

出　　处：《World Journal of Clinical Cases》2024年第22期5151-5158,共8页世界临床病例杂志

基　　金：Supported by the National Natural Science Foundation of China,No.82372172;the Key Research and Development Plan Project of Heilongjiang Province,No.GA23C007;the Heilongjiang Province Postdoctoral Start-up Fund,No.LBH-Q20037;the Research Project of Heilongjiang Provincial Health Commission,No.20231717010461;the Special Fund for Clinical Research of Wu Jie-ping Medical Foundation,No.320.6750.2022-02-16;the Scientific Research Innovation Fund of the First Affiliated Hospital of Harbin Medical University,No.2021M08.

摘　　要：BACKGROUND The common cause of sodium nitrite poisoning has shifted from previous accidental intoxication by exposure or ingestion of contaminated water and food to recent alarming intentional intoxication as an employed method of suicide/exit.The subsequent formation of methemoglobin(MetHb)restricts oxygen transport and utilization in the body,resulting in functional hypoxia at the tissue level.In clinical practice,a mismatch of cyanotic appearance and oxygen partial pressure usually contributes to the identification of methemoglobinemia.Prompt recognition of characteristic mismatch and accurate diagnosis of sodium nitrite poisoning are prerequisites for the implementation of standardized systemic interventions.CASE SUMMARY A pregnant woman was admitted to the Department of Critical Care Medicine at the First Affiliated Hospital of Harbin Medical University due to consciousness disorders and drowsiness 2 h before admission.Subsequently,she developed vomiting and cyanotic skin.The woman underwent orotracheal intubation,invasive mechanical ventilation(IMV),and correction of internal environment disturbance in the ICU.Her premature infant was born with a higher-than-normal MetHb level of 3.3%,and received detoxification with methylene blue and vitamin C,supplemental vitamin K1,an infusion of fresh frozen plasma,as well as respiratory support via orotracheal intubation and IMV.On day 3 after admission,the puerpera regained consciousness,evacuated the IMV,and resumed enteral nutrition.She was then transferred to the maternity ward 24 h later.On day 7 after admission,the woman recovered and was discharged without any sequelae.CONCLUSION MetHb can cross through the placental barrier.Level of MetHb both reflects severity of the sodium nitrite poisoning and serves as feedback on therapeutic effectiveness.

关 键 词：Sodium nitrite poisoning METHEMOGLOBINEMIA METHEMOGLOBIN Third trimester puerpera Premature infant Placental barrier Methylene blue Case report 

分 类 号：R595[医药卫生—内科学]