经食管超声心动图检查前给予局部麻醉剂引起的中毒性高铁血红蛋白血症。

Toxic methemoglobinemia caused by topical anesthetic given before transesophageal echocardiography.

作者信息

Marcovitz P A, Williamson B D, Armstrong W F

机构信息

Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor.

出版信息

J Am Soc Echocardiogr. 1991 Nov-Dec;4(6):615-8. doi: 10.1016/s0894-7317(14)80221-6.

DOI:10.1016/s0894-7317(14)80221-6

PMID:1760183

Abstract

Transesophageal echocardiography was performed on a patient with critical aortic stenosis and severe three-vessel coronary artery disease. Immediately after the procedure the patient experienced marked cyanosis (oxygen saturation of 53%) secondary to methemoglobinemia (methemoglobin saturation of 45%). Toxic methemoglobinemia was thought to be caused by topical anesthetic. He responded dramatically to treatment with intravenous methylene blue. Toxic methemoglobinemia should be suspected in unexplained cyanosis occurring after transesophageal echocardiography and other endoscopic procedures during which potentially causative agents have been used.

摘要

对一名患有严重主动脉瓣狭窄和严重三支冠状动脉疾病的患者进行了经食管超声心动图检查。术后患者立即出现明显的紫绀（氧饱和度为53%），继发于高铁血红蛋白血症（高铁血红蛋白饱和度为45%）。中毒性高铁血红蛋白血症被认为是由局部麻醉剂引起的。他对静脉注射亚甲蓝治疗反应显著。在经食管超声心动图检查及其他使用了潜在致病剂的内镜检查后出现不明原因的紫绀时，应怀疑中毒性高铁血红蛋白血症。