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Severe methaemoglobinaemia treated with adjunctive hyperbaric oxygenation
Jörg Lindenmann1, Nicole Fink-Neuboeck2, Gernot Schilcher3
1Division of Thoracic and Hyperbaric Surgery, Department of General Surgery, Medical University Graz, Auenbruggerplatz 29, 8036 Graz, Austria, Phone: +43-(0)316-385-13302,
Diving and Hyperbaric Medicine
|July 14, 2015
Summary
Severe methaemoglobinaemia from nitrite poppers was treated with toluidine blue and hyperbaric oxygenation (HBOT). HBOT enhanced methaemoglobin reduction and tissue re-oxygenation, leading to a rapid patient recovery.
Area of Science:
- Toxicology
- Emergency Medicine
- Hematology
Background:
- Methaemoglobinaemia arises from oxidizing agents like nitrites, impairing oxygen transport.
- Oxidation of hemoglobin's iron to ferric state inhibits oxygen and carbon dioxide transport, affecting cellular respiration.
Observation:
- A 23-year-old male presented with severe methaemoglobinaemia (68%) after consuming nitrites ('poppers') and alcohol.
- Initial treatment included toluidine blue, followed by hyperbaric oxygenation (HBOT).
Findings:
- Hyperbaric oxygenation (HBOT) accelerated methaemoglobin reduction.
- HBOT facilitated rapid tissue re-oxygenation, independent of methaemoglobinaemia levels.
Implications:
- Supportive HBOT can be a valuable, time-saving therapeutic intervention for severe methaemoglobinaemia.
- This case highlights HBOT's potential in managing nitrite-induced toxicity.
- Prompt treatment led to uneventful recovery and discharge within three days.
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