Methemoglobinemia treated with hyperbaric oxygen therapy: A case report

Ismail Altintop; Erkman Sanri; Mehmet Tatli; Mehmet Emin Akcin; Arzu Denizbasi

doi:10.1016/j.tjem.2018.03.005

Ismail Altintop¹, Erkman Sanri², Mehmet Tatli¹, Mehmet Emin Akcin³, Arzu Denizbasi²

¹University of Health Sciences, Kayseri Education and Research Hospital, Department of Emergency Medicine, Kayseri, Turkey
²Marmara University Pendik Education and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey
³University of Health Sciences, Kayseri Education and Research Hospital, Department of Undersea and Hyperbaric Medicine, Kayseri, Turkey

Keywords: Methemoglobinaemia, Methylene blue therapy, Hyperbaric oxygen therapy, Cyanosis

Abstract

Methemoglobinemia is a rare but clinically important condition that should be considered among differential diagnosis' in cyanosis. The conventional treatments of methemoglobinemia are high flow oxygen and methylene blue therapies.

We present a 52-year-old male patient who admitted to emergency room with severe cyanosis and dyspnea after he was exposed to paint thinner and zinc phosphate solution. The patient was diagnosed with methemoglobinemia with a MetHb level of 49.1mm/Hg in his arterial blood gas test. Patient's symptoms and increased MetHb levels were resistant to high flow oxygen and methylene blue therapies so hyperbaric oxygen therapy (HBO) as an alternative treatment was initiated and the patient was cured promptly.

In this case presentation, we aim to discuss the alternative treatment modalities in methemoglobinemia patients with persistent hypoxia and cyanosis, who are unresponsive to standard methylene blue treatment.