Waikato Hospital, Lower Hutt, New Zealand.
Emerg Med Australas. 2010 Oct;22(5):463-5. doi: 10.1111/j.1742-6723.2010.01335.x.
Inadvertent ingestion of sodium nitrite is known to precipitate metheamoglobinaemia. No cases exist, however, of intentional suicide by methaemoglobinaemia following self-poisoning with sodium nitrite. A 76-year-old man collapsed and rapidly developed brady-asystolic cardiac arrest 25 min following self-poisoning with an unknown quantity of crystalline sodium nitrite. On arrival in the ED the patient was asystolic with cardiopulmonary resuscitation in progress. Haemoglobin concentration was 110 g/L, arterial methaemoglobin measured 82.6% and serum lactate 9.6 mmol/L. Antioxidative treatment was undertaken with total 5 mg/kg intravenous methylene blue administered in divided aliquots. Despite prolonged resuscitative efforts the patient died. Resuscitation from methaemoglobinaemia-induced asystole following self-poisoning presents a unique therapeutic challenge. Treatment of methaemoglobinaemia-induced cardiovascular instability and overt cardiopulmonary arrest are discussed.
误食亚硝酸盐会导致高铁血红蛋白血症。然而，尚无蓄意自杀导致的高铁血红蛋白血症的病例，因为摄入的亚硝酸盐剂量不足以导致自杀。一名 76 岁男性在摄入未知剂量的结晶亚硝酸盐后 25 分钟发生晕厥，且迅速出现心动过缓性心脏停搏。患者到达急诊科时处于心脏停搏状态，心肺复苏正在进行中。血红蛋白浓度为 110 g/L，动脉高铁血红蛋白测定值为 82.6%，血清乳酸值为 9.6 mmol/L。给予患者抗氧化治疗，静脉注射 5 mg/kg 亚甲蓝，分批次给药。尽管进行了长时间的复苏努力，患者还是死亡了。亚硝酸盐中毒导致的心脏停搏患者的复苏存在独特的治疗挑战。讨论了高铁血红蛋白血症导致的心血管不稳定和明显心搏骤停的治疗方法。
