Methemoglobinemia as a Cause of Unexplained Hypoxia in Neurosurgical Patients: A Report of Two Cases
In methemoglobinemia, ferrous iron in the hemoglobin is oxidized to a ferric state. Hemoglobin in this state cannot carry oxygen resulting in hypoxemia, which manifests as low peripheral oxygen saturation (SpO2). Bedside co-oximetry can identify this condition. We present here two cases of methemogl...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical and Scientific Publishers Pvt. Ltd.
|
| Series: | Journal of Neuroanaesthesiology and Critical Care |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1776389 |
| _version_ | 1797220583393460224 |
|---|---|
| author | Sonia Bansal Bharath Srinivasaiah Vidya Sriram Vishal Baradwad Parthiban Giribabu Rajeeb K. Mishra |
| author_facet | Sonia Bansal Bharath Srinivasaiah Vidya Sriram Vishal Baradwad Parthiban Giribabu Rajeeb K. Mishra |
| author_sort | Sonia Bansal |
| collection | DOAJ |
| description | In methemoglobinemia, ferrous iron in the hemoglobin is oxidized to a ferric state. Hemoglobin in this state cannot carry oxygen resulting in hypoxemia, which manifests as low peripheral oxygen saturation (SpO2). Bedside co-oximetry can identify this condition. We present here two cases of methemoglobinemia. Our experience with the first case enabled swift diagnosis of the second case. This also enabled us to prepare ourselves better in the second case if worsening of hypoxemia had occurred. Therefore, we learn here that whenever there is low SpO2 with a normal partial pressure of oxygen, methemoglobinemia should be suspected and diagnosis should be confirmed using co-oximetry. |
| first_indexed | 2024-04-24T12:51:51Z |
| format | Article |
| id | doaj.art-24bee7e20b6243b58487a1ad01aff53f |
| institution | Directory Open Access Journal |
| issn | 2348-0548 2348-926X |
| language | English |
| last_indexed | 2024-04-24T12:51:51Z |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Journal of Neuroanaesthesiology and Critical Care |
| spelling | doaj.art-24bee7e20b6243b58487a1ad01aff53f2024-04-05T23:49:01ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Neuroanaesthesiology and Critical Care2348-05482348-926X10.1055/s-0043-1776389Methemoglobinemia as a Cause of Unexplained Hypoxia in Neurosurgical Patients: A Report of Two CasesSonia Bansal0Bharath Srinivasaiah1Vidya Sriram2Vishal Baradwad3Parthiban Giribabu4Rajeeb K. Mishra5https://orcid.org/0000-0003-4830-0347Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, IndiaDepartment of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, IndiaDepartment of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, IndiaDepartment of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, IndiaDepartment of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, IndiaDepartment of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, IndiaIn methemoglobinemia, ferrous iron in the hemoglobin is oxidized to a ferric state. Hemoglobin in this state cannot carry oxygen resulting in hypoxemia, which manifests as low peripheral oxygen saturation (SpO2). Bedside co-oximetry can identify this condition. We present here two cases of methemoglobinemia. Our experience with the first case enabled swift diagnosis of the second case. This also enabled us to prepare ourselves better in the second case if worsening of hypoxemia had occurred. Therefore, we learn here that whenever there is low SpO2 with a normal partial pressure of oxygen, methemoglobinemia should be suspected and diagnosis should be confirmed using co-oximetry.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1776389methemoglobinemiamethemoglobinhypoxiaco-oximetry |
| spellingShingle | Sonia Bansal Bharath Srinivasaiah Vidya Sriram Vishal Baradwad Parthiban Giribabu Rajeeb K. Mishra Methemoglobinemia as a Cause of Unexplained Hypoxia in Neurosurgical Patients: A Report of Two Cases Journal of Neuroanaesthesiology and Critical Care methemoglobinemia methemoglobin hypoxia co-oximetry |
| title | Methemoglobinemia as a Cause of Unexplained Hypoxia in Neurosurgical Patients: A Report of Two Cases |
| title_full | Methemoglobinemia as a Cause of Unexplained Hypoxia in Neurosurgical Patients: A Report of Two Cases |
| title_fullStr | Methemoglobinemia as a Cause of Unexplained Hypoxia in Neurosurgical Patients: A Report of Two Cases |
| title_full_unstemmed | Methemoglobinemia as a Cause of Unexplained Hypoxia in Neurosurgical Patients: A Report of Two Cases |
| title_short | Methemoglobinemia as a Cause of Unexplained Hypoxia in Neurosurgical Patients: A Report of Two Cases |
| title_sort | methemoglobinemia as a cause of unexplained hypoxia in neurosurgical patients a report of two cases |
| topic | methemoglobinemia methemoglobin hypoxia co-oximetry |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1776389 |
| work_keys_str_mv | AT soniabansal methemoglobinemiaasacauseofunexplainedhypoxiainneurosurgicalpatientsareportoftwocases AT bharathsrinivasaiah methemoglobinemiaasacauseofunexplainedhypoxiainneurosurgicalpatientsareportoftwocases AT vidyasriram methemoglobinemiaasacauseofunexplainedhypoxiainneurosurgicalpatientsareportoftwocases AT vishalbaradwad methemoglobinemiaasacauseofunexplainedhypoxiainneurosurgicalpatientsareportoftwocases AT parthibangiribabu methemoglobinemiaasacauseofunexplainedhypoxiainneurosurgicalpatientsareportoftwocases AT rajeebkmishra methemoglobinemiaasacauseofunexplainedhypoxiainneurosurgicalpatientsareportoftwocases |