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Friday, June 15, 2012

Metahemoglobinemia


Metemoglobinemia: do Diagnóstico ao Tratamento
(Methemoglobinemia: from Diagnosis to Treatment)

Souza do Nascimento T., Lami Pererira R, Dias de Mello H., Costa J.
Rev Bras Anestesiol 2008; 58: 6: 651-664
(Pag 651-657: en portugues - Pag 657-664: en inglés)
CONTENT: "When the concentration of methemoglobin in the blood is above 15%, the patient develops cyanosis, the main characteristic of this disorder. The color of the arterial blood changes to dark brown with normal PaO2. One should suspect the diagnosis in patients with cyanosis and low saturation (SpO2) without significant cardiopulmonary dysfunction. Co-oximetry is the gold standard and defines the diagnosis. Treatment should be based on whether the syndrome is acute or chronic (etiology) and on the severity of symptoms. Blood levels of methemoglobin are important, especially in acute cases. Basic treatment includes removal of the agent responsible for the disorder, administration of oxygen, and observation. Severe cases should be treated with the specific antidote, methylene blue, which is not effective in some situations."

METHYLENE BLUE