An Attempt on Methemoglobinemia: It’s Treatment and Relationship between Treatment and Cerebral Oximeter Value: Case Presentation  

作　　者：Ilknur S.Seker Onur Ozlu Yavuz Demiraran Gulbin Sezen Ertay Boran 

机构地区：[1]Department of Anesthesiology,University of Duzce,Faculty of Medicine,Duzce,Turkey

出　　处：《International Journal of Clinical Medicine》2015年第12期954-960,共7页临床医学国际期刊（英文）

摘　　要：Background: Our paper aimed to investigate whether there was a correlation among the pulse oximetry, cerebral oximetry (CO) and MetHb (methemoglobin) values of a patient with congenital methemoglobinemia who underwent a laparoscopic cholecystectomy operation. Case: The 35-year-old male patient with a weight of 70 kg, body massindex (BMI) of 21, American Society of Anesthesia status-2(ASA-2) category who was planned for laparoscopic cholecystectomy operation was identified to have been diagnosed with congenital methemoglobinemia as per his medical history was methemoglobin levels ranged between 12% and 20% according to the periodical measurements taken for the past 3 years. The patient received standard monitoring during anesthesia and device monitoring with a cerebral oximeter (Invos 5100C somatic/cerebral oximeter, Covidien) and a CO-oximetry (Rad ?87 “Rainbow”, Masimo Inc., Irvine, CA) device to continuously follow up his MetHb values was also added. During the intra-operative follow-up, the patient’s methemoglobin level rose to 16%, his peripheral oxygen saturation levels decreased to 86% and his cerebral oximetry values were identified to have also decreased;therefore, methylene blue (MB) was intravenously administered to the patient. The patient continued to be followed up in the post-operative period and he did not develop any complications. Discussion: Appropriate treatment and monitoring enabled the prevention of potential complications. We believe that monitoring with NIRS and MASIMO CO-oximetry device will enable physicians to perform a safe follow-up and treatment in the intraoperative and postoperative follow-up of methemoglobinemia patients.Background: Our paper aimed to investigate whether there was a correlation among the pulse oximetry, cerebral oximetry (CO) and MetHb (methemoglobin) values of a patient with congenital methemoglobinemia who underwent a laparoscopic cholecystectomy operation. Case: The 35-year-old male patient with a weight of 70 kg, body massindex (BMI) of 21, American Society of Anesthesia status-2(ASA-2) category who was planned for laparoscopic cholecystectomy operation was identified to have been diagnosed with congenital methemoglobinemia as per his medical history was methemoglobin levels ranged between 12% and 20% according to the periodical measurements taken for the past 3 years. The patient received standard monitoring during anesthesia and device monitoring with a cerebral oximeter (Invos 5100C somatic/cerebral oximeter, Covidien) and a CO-oximetry (Rad ?87 “Rainbow”, Masimo Inc., Irvine, CA) device to continuously follow up his MetHb values was also added. During the intra-operative follow-up, the patient’s methemoglobin level rose to 16%, his peripheral oxygen saturation levels decreased to 86% and his cerebral oximetry values were identified to have also decreased;therefore, methylene blue (MB) was intravenously administered to the patient. The patient continued to be followed up in the post-operative period and he did not develop any complications. Discussion: Appropriate treatment and monitoring enabled the prevention of potential complications. We believe that monitoring with NIRS and MASIMO CO-oximetry device will enable physicians to perform a safe follow-up and treatment in the intraoperative and postoperative follow-up of methemoglobinemia patients.

关 键 词：METHEMOGLOBINEMIA ANESTHESIOLOGY Cerebral Oximeter Pulse Oximeter 

分 类 号：R73[医药卫生—肿瘤]