METHEMOGLOBINEMIA, RARE BUT LETHAL SIDE EFFECT DURING CARDIAC SURGERY: A CASE REPORT
MAHNOOSH FOROUGHI
Fellowship in Cardiac Surgery, Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
MAJID GOLESTANI ERAGHI
Chronic Respiratory Diseases Research Center, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
ALI DABBAGH
Fellowship in Anesthesia Cardiac Surgery, Anesthesiology Research Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
MASOUD MAJIDI TEHRANI *
Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
*Author to whom correspondence should be addressed.
Abstract
Methemoglobin has been developed after iron oxidation in hemoglobin. Increase in the concentration of methemoglobin causes loss of oxygen carrying capacity and cascade of aerobic oxidation impairment, metabolic acidosis and cyanosis. Even though it is rare, it has potentially life threatening effects if neglected. Therefore, it must be recognized and corrected on time. Methemoglobinemia should be considered as one of differential diagnosis whenever low arterial oxygen saturation with preserved oxygen tension has no response to supplementary oxygen administration. In this paper, we reported a patient who developed methemoglobinemia with high dose nitroglycerin infusion during coronary artery bypass graft. He was treated with ascorbic acid.
Keywords: Methemoglobinemia, nitroglycerin, oximetry