Recreational nitrous oxide and thrombotic events: a case series
Marta Patyjewicz1,2, Devan Mair1,3, Safiya A Zaloum1,3
1Royal London Hospital, Barts Health NHS Trust, London, UK.
BMJ Neurology Open
|May 17, 2024
Summary
Nitrous oxide (N2O) misuse may be linked to venous thromboembolism (VTE). Healthcare providers should monitor N2O users for VTE symptoms and consider prophylaxis due to potential hyperhomocysteinaemia risks.
Area of Science:
- Medical Research
- Hematology
- Toxicology
Background:
- Investigating the link between nitrous oxide (N2O) use and unexplained venous thromboembolism (VTE).
- Exploring the potential role of hyperhomocysteinaemia (HHcy) in N2O-associated VTE.
- Highlighting the need for clinical vigilance regarding N2O misuse and VTE risk.
Purpose of the Study:
- To determine the prevalence of N2O usage in patients presenting with unexplained VTE.
- To examine the association between N2O exposure and the occurrence of VTE.
- To identify potential underlying mechanisms, such as HHcy and vitamin B12 deficiency.
Main Methods:
- Retrospective study conducted at the Royal London Hospital from March to August 2023.
- Analysis of 50 patients admitted via the N2O ambulatory emergency care pathway.
- Collection of patient data focusing on VTE events and relevant medical history.
Main Results:
- Four out of 50 patients (8%) experienced recent or concurrent VTE.
- All identified patients with VTE had actual or functional vitamin B12 deficiency.
- Demographic data indicated a male predominance and diverse ethnic representation.
Conclusions:
- N2O misuse is a potential risk factor for VTE, necessitating clinical awareness.
- Further research is crucial to understand the N2O-VTE association and its mechanisms.
- Healthcare providers should consider VTE prophylaxis in N2O users with risk factors.
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