Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Founders Building 5074, SICU Administration, Philadelphia, PA 19104, USA.
J Telemed Telecare. 2012 Sep;18(6):362-4. doi: 10.1258/jtt.2012.120307. Epub 2012 Aug 14.
Telemedicine can be used in intensive care units (ICUs) with linked electronic medical records to enable remote clinicians to assess patients and focus on those who are deviating from their expected course. We report the case of a woman admitted to our ICU with apparent hypoxaemia, whose pulse oximetry readings were not believed by the treating team. The intensivist at the telemedicine centre was consulted and instituted treatment on the assumption that methaemoglobinemia was present. Without rapid therapy, ongoing tissue ischaemia and shock was inevitable. Within 60 min of methylene blue administration, the patient's oxygen saturation improved dramatically. The methaemoglobin level was eventually reported as 9.9% (normal value <1%). This case report demonstrates how, with the aid of a tele-intensivist, a rare diagnosis was made rapidly and successful therapy was provided.
远程医疗可以在重症监护病房（ICU）中使用，通过连接的电子病历，使远程临床医生能够评估患者，并关注那些病情偏离预期进程的患者。我们报告了一例女性患者因明显低氧血症被收入我们的 ICU，其脉搏血氧仪读数未被治疗团队所相信。远程医疗中心的重症监护专家被咨询，并根据假设高铁血红蛋白血症存在而进行了治疗。如果没有快速治疗，持续的组织缺血和休克是不可避免的。在亚甲蓝给药后 60 分钟内，患者的氧饱和度显著改善。高铁血红蛋白水平最终报告为 9.9%（正常值<1%）。本病例报告说明了在远程重症监护专家的帮助下，如何快速做出罕见诊断并提供成功治疗。
