Methemoglobinemia after transesophageal echocardiography: a life-threatening complication

Journal of Clinical Anesthesia
Michael J JackaNaomi Glick

Abstract

Methemoglobinemia is an uncommon cause of tissue hypoxemia that can be life-threatening if not promptly identified and treated. It can occur after exposure to an oxidizing agent from contaminated well water or from nitroglycerin, sodium nitroprusside, or certain local anesthetics. During oropharyngeal use of topical anesthetics for transesophageal echocardiography, systemic drug uptake is unpredictable and unexplained complications can ensue. Treatment of acquired methemoglobinemia may require methylene blue, as oxygen is not usually sufficient. Avoidance of the oxidizing agent, probably benzocaine in the cases presented, is prudent.

References

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Citations

Aug 19, 2007·Critical Care Medicine·Stephen P Hoole, Florian Falter
Oct 30, 2012·International Surgery·Annette RebelZaki-Udin Hassan
Dec 23, 2008·The Journal of Emergency Medicine·Nam-Young ChungMary Baldauf
Jan 20, 2007·Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics·Rajesh Gutta, Patrick J Louis
Feb 11, 2015·The International Journal of Cardiovascular Imaging·Dominika Filipiak-StrzeckaPiotr Lipiec
Sep 21, 2010·Anesthesiology Clinics·Deya N Jourdy, Ashutosh Kacker
Feb 15, 2013·QJM : Monthly Journal of the Association of Physicians·A NéelM Hamidou

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