利多卡因诱发的高铁血红蛋白血症：临床警示

Lidocaine-induced methemoglobinemia: a clinical reminder.

作者信息

Barash Mark, Reich Keith A, Rademaker Dennis

机构信息

From the Medical College of Wisconsin in Milwaukee (Dr Barash); the Midwestern University Chicago College of Osteopathic Medicine in Downers Grove, Illinois, and the St. James Hospital/Franciscan Alliance in Chicago, Illinois (Dr Reich); and Franciscan Medical Specialists in Munster, Indiana (Drs Reich and Rademaker).

出版信息

J Am Osteopath Assoc. 2015 Feb;115(2):94-8. doi: 10.7556/jaoa.2015.020.

DOI:10.7556/jaoa.2015.020

PMID:25637615

Abstract

Methemoglobinemia is a rare condition in which the iron in hemoglobin is stabilized in the ferric (Fe(3+)) form, making it unable to bind oxygen and leading to tissue hypoxia and possibly death. The condition may be hereditary or acquired, the latter resulting from ingestion or application of common oxidizing agents such as lidocaine. As management of methemoglobinemia depends on prompt recognition, clinicians who administer or prescribe oxidizing agents must be aware of the clinical symptoms of methemoglobinemia, including cyanosis, pulse oximetry values that do not respond to increased oxygen delivery, and altered mental status. Currently, methylene blue is the drug of choice for the management of methemoglobinemia.

摘要

高铁血红蛋白血症是一种罕见病症，其中血红蛋白中的铁稳定于三价铁（Fe(3+)）形式，使其无法结合氧气，从而导致组织缺氧并可能致死。该病可能是遗传性的或后天获得性的，后者是由于摄入或使用常见氧化剂如利多卡因所致。由于高铁血红蛋白血症的治疗取决于及时识别，使用或开具氧化剂的临床医生必须了解高铁血红蛋白血症的临床症状，包括发绀、对增加的氧气输送无反应的脉搏血氧饱和度值以及精神状态改变。目前，亚甲蓝是治疗高铁血红蛋白血症的首选药物。