Gay Hawkins C, Amaral Ansel Philip
Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
McGaw Medical Center of Northwestern University, 251 East Huron Street, Galter Suite 3-150, Chicago, IL, 60611, USA.
Drug Saf Case Rep. 2018 Apr 7;5(1):15. doi: 10.1007/s40800-018-0081-4.
A 55-year-old male was admitted to the hospital with pneumonia. During an intubation procedure, the patient received an application of endobronchial lidocaine (4% gel). Within 2 h of intubation, the patient developed worsening hypoxia, and investigation of arterial blood gasses revealed a pH of 7.21, carbon dioxide partial pressure (PaCO) of 3.3 kPa, oxygen partial pressure (PaO) of 55.1 kPa, and measured oxygen saturation of 49%. Co-oximetry of this sample returned a methemoglobin level of 53%. Intravenous methylthioninium chloride (1% solution at 1 mg/kg) was delivered, and subsequent arterial blood gasses, at 30 min and 1 h post administration, showed methemoglobin levels of 12 and 9%, respectively, with return of oxygen saturation to > 90%.
一名55岁男性因肺炎入院。在插管过程中，患者接受了支气管内利多卡因（4%凝胶）应用。插管后2小时内，患者缺氧情况恶化，动脉血气检查显示pH值为7.21，二氧化碳分压（PaCO）为3.3kPa，氧分压（PaO）为55.1kPa，测得的氧饱和度为49%。该样本的共血氧定量法显示高铁血红蛋白水平为53%。给予静脉注射亚甲蓝（1%溶液，1mg/kg），给药后30分钟和1小时的后续动脉血气显示高铁血红蛋白水平分别为12%和9%，氧饱和度恢复至>90%。
