Tratamiento con hidroxicobalamina para la intoxicación por cianuro: una causa rara de pseudohematuria

Barreda, J. Torremadé; Orejas, M. Serrallach; Valles-Ortega, J.; Miranda, Eladio Franco

doi:10.1016/s0210-4806(10)70024-3

Cited by 1 publication

(1 citation statement)

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“…Chromaturia (red urine) can be observed after hydroxocobalamin treatment, lasting 7–35 days [7] and can be mistaken for hematuria [31]. Figure 1D demonstrates the red-colored urine in a different patient in our ICU who also received hydroxocobalamin for refractory post–cardiopulmonary bypass vasoplegic syndrome (this patient did not receive renal replacement therapy and urine microscopy showed no hematuria).…”

Section: Discussionmentioning

confidence: 99%

High-dose hydroxocobalamin for vasoplegic syndrome causing false blood leak alarm

Cheungpasitporn

Hui

Kashani

et al. 2017

Clinical Kidney Journal

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Blood leak alarms are important safety features in a hemodialysis machine to protect patients from loss of blood through a rupture in the dialyzer membrane (true alarms). A false blood leak alarm can be triggered by air bubbles or detector malfunction (such as deposits of grease or scale). Hydroxocobalamin is an injectable form of vitamin B12 approved by the US Food and Drug Administration for the treatment of confirmed or suspected cyanide toxicity. Due to observations of an increase in arterial pressure after high-dose hydroxocobalamin infusion for the treatment of acute cyanide poisoning, it has recently been reported as an off-label rescue treatment for post–cardiopulmonary bypass vasoplegic syndrome. We report an 83-year-old man who received hydroxocobalamin following cardiac surgery for treatment of vasoplegic syndrome. The patient developed severe acute kidney injury with volume overload. Hydroxocobalamin interference with the blood leak detector compromised his dialysis treatment. We describe the use of continuous renal replacement therapy to overcome the hydroxocobalamin-related interference with hemodialysis. As the utility of hydroxocobalamin potentially expands, physicians must be aware of its inadvertent effect on renal replacement therapy.

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Section: Discussionmentioning

confidence: 99%