Acquired methemoglobinemia: A systematic review of reported cases

Gao, Haijuan; Basri, Rabia; Tran, Minh‐Ha

doi:10.1016/j.transci.2021.103299

Cited by 6 publications

(10 citation statements)

References 66 publications

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“…The normal methemoglobin levels in the blood are less than 1.5%. The severity of symptoms depends on the level of methemoglobin in the blood with severe symptoms appearing at levels above 30% [ 8 ]. The suspicion of methemoglobinemia should be considered when hypoxia does not improve with oxygenation in a patient with no previous cardiopulmonary diseases [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Acquired Methemoglobinemia in an Infant: Consequence of Prolonged Application of Eutectic Mixture of Local Anesthetics (EMLA) Cream for Spontaneous Abscess Drainage

Kadri¹,

Eldos²,

AlAnsari³

2022

Cureus

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Topical anesthetics are commonly used in emergency departments. One of the side effects can be methemoglobinemia if not appropriately used. We present a case of a six-week-old baby who developed methemoglobinemia with levels of 30.6% after prolonged (15 hours) application of Eutectic Mixture of Local Anesthetics (EMLA) cream. The cream was applied for spontaneous drainage of a perianal abscess. The patient received IV methylene blue with a resolution of methemoglobinemia.

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Section: Discussionmentioning

confidence: 99%

Acquired Methemoglobinemia in an Infant: Consequence of Prolonged Application of Eutectic Mixture of Local Anesthetics (EMLA) Cream for Spontaneous Abscess Drainage

Kadri¹,

Eldos²,

AlAnsari³

2022

Cureus

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“…1 At this level, patient will typically develop cyanosis that does not improve with supplemental oxygen. 1 The standard of care for methemoglobinemia is prompt diagnosis followed by removal of the inciting oxidant stressor. Supportive care should be provided with supplemental oxygen for mild cases of methemoglobinemia with levels less than 30%.…”

mentioning

confidence: 99%

“…Patients are typically asymptomatic until methemoglobin level rises to 10% or greater. 1 At this level, patient will typically develop cyanosis that does not improve with supplemental oxygen. 1…”

mentioning

confidence: 99%

“…1 At this level, patient will typically develop cyanosis that does not improve with supplemental oxygen. 1…”

mentioning

confidence: 99%

“…With increasing methemoglobin levels, methemoglobinemia can result in varying symptoms of hypoxia, such as cyanosis, headache, hypoxemia, altered mental status, dysrhythmia, and even death. 1 Therefore, it is essential to be familiar with the more subtle signs of methemoglobinemia to aid in earlier detection and prevention of potentially lethal side effects. The presentation of acquired methemoglobinemia can be immediate or delayed.…”

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confidence: 99%

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Acquired Methemoglobinemia in the Surgical Intensive Care Unit

Tackett

Mathews

Mentzer

et al. 2023

The American Surgeon™

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Acquired methemoglobinemia is a potentially lethal medical condition caused by exposure to oxidizing xenobiotics, including antibiotics such as dapsone and inhaled anesthetics such as benzocaine. In this case report, we describe two presentations of acquired methemoglobinemia which presented to our surgical intensive care unit within one month. This highlights the potential connection between an emergent surgery or procedure and the development of methemoglobinemia in an environment where it is presumed that this condition would be extremely rare. High clinical suspicion for methemoglobinemia is warranted if the patient develops cyanosis or a decreased oxygen saturation unresponsive to supplemental oxygen when another etiology is not identifiable. If methemoglobinemia is suspected, a direct measurement of blood methemoglobin levels can be obtained to confirm the diagnosis. Prompt treatment with intravenous methylene blue is highly effective.

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