一氧化碳血红蛋白形成作为重度急性呼吸窘迫综合征吸入一氧化氮治疗的意外副作用。
Carboxyhemoglobin formation as an unexpected side effect of inhaled nitric oxide therapy in severe acute respiratory distress syndrome.
作者信息
Rusca Marco, Oddo Mauro, Schaller Marie-Denise, Liaudet Lucas
机构信息
Division of Critical Care, Department of Internal Medicine, University Hospital, Lausanne, Switzerland.
出版信息
Crit Care Med. 2004 Dec;32(12):2537-9. doi: 10.1097/01.ccm.0000148012.80245.fc.
OBJECTIVE
To report an unexpected cause of carboxyhemoglobinemia associated with inhaled nitric oxide therapy in severe acute respiratory distress syndrome.
DESIGN
Case report.
SETTING
Medical critical care unit at Lausanne University Hospital.
PATIENT
One female patient with acute respiratory distress syndrome treated with inhaled nitric oxide, who developed a simultaneous increase in blood methemoglobin and carboxyhemoglobin.
CONCLUSIONS
Potential pathophysiologic mechanisms linking acute respiratory distress syndrome, inhaled nitric oxide, methemoglobin, and carboxyhemoglobin are discussed. Since carboxyhemoglobin has a negative influence on oxygen-carrying capacity, this effect may potentially offset the beneficial influence (if any) of inhaled nitric oxide on arterial PO2. This observation does not support the use of inhaled nitric oxide in the treatment of acute respiratory distress syndrome.
目的
报告在严重急性呼吸窘迫综合征中与吸入一氧化氮治疗相关的一氧化碳血红蛋白血症的意外病因。
设计
病例报告。
地点
洛桑大学医院的医疗重症监护病房。
患者
一名接受吸入一氧化氮治疗的急性呼吸窘迫综合征女性患者，其血液中高铁血红蛋白和一氧化碳血红蛋白同时升高。
结论
讨论了将急性呼吸窘迫综合征、吸入一氧化氮、高铁血红蛋白和一氧化碳血红蛋白联系起来的潜在病理生理机制。由于一氧化碳血红蛋白对氧携带能力有负面影响，这种效应可能会抵消吸入一氧化氮对动脉血氧分压的有益影响（如果有的话）。该观察结果不支持在急性呼吸窘迫综合征治疗中使用吸入一氧化氮。
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