Hagiwara Yusuke, Inoue Nobuaki
Department of Pediatric Emergency and Critical Care Medicine, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Pediatr Int. 2015 Dec;57(6):1182-3. doi: 10.1111/ped.12708. Epub 2015 Sep 3.
When new household products are developed and distributed, new injuries often occur in children. We report the first known case of methemoglobinemia caused by a chlorine dioxide (ClO2)-based household product. A 1-year-old boy presented to the emergency department with vomiting and poor complexion after accidentally ingesting a ClO2-based household product. The patient had profound hypoxia that did not respond to oxygen therapy and required endotracheal intubation to maintain a normal oxygen level. Although oxygen saturation (SpO2) fluctuated at approximately 95% after intubation, arterial oxygen pressure (PaO2) was high on arterial blood gas analysis. We suspected methemoglobinemia based on the gap between SpO2 and PaO2, and subsequently detected increased methemoglobin at 8.0%. The patient was admitted to the pediatric intensive care unit for further management. After supportive treatment, he was discharged without any complications. He had no cognitive or motor dysfunction on follow up 3 months later.
当新的家用产品被研发和推广时，儿童中常常会出现新的伤害情况。我们报告了首例已知的由二氧化氯（ClO2）基家用产品导致的高铁血红蛋白血症病例。一名1岁男孩在意外摄入一种ClO2基家用产品后，因呕吐和面色不佳被送往急诊科。该患者存在严重的低氧血症，对氧疗无反应，需要进行气管插管以维持正常的氧水平。尽管插管后氧饱和度（SpO2）约为95%波动，但动脉血气分析显示动脉血氧分压（PaO2）较高。基于SpO2和PaO2之间的差距，我们怀疑是高铁血红蛋白血症，随后检测到高铁血红蛋白增加至8.0%。该患者被收入儿科重症监护病房进行进一步治疗。经过支持治疗后，他出院时没有任何并发症。3个月后的随访中，他没有认知或运动功能障碍。
