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CC BY 4.0 · J Neuroanaesth Crit Care
DOI: 10.1055/s-0043-1776389
Case Report

Methemoglobinemia as a Cause of Unexplained Hypoxia in Neurosurgical Patients: A Report of Two Cases

Sonia Bansal
1   Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
,
Bharath Srinivasaiah
1   Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
,
Vidya Sriram
1   Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
,
Vishal Baradwad
1   Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
,
Parthiban Giribabu
1   Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
,
Rajeeb K. Mishra 
1   Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Abstract

In methemoglobinemia, ferrous iron in the hemoglobin is oxidized to a ferric state. Hemoglobin in this state cannot carry oxygen resulting in hypoxemia, which manifests as low peripheral oxygen saturation (SpO2). Bedside co-oximetry can identify this condition. We present here two cases of methemoglobinemia. Our experience with the first case enabled swift diagnosis of the second case. This also enabled us to prepare ourselves better in the second case if worsening of hypoxemia had occurred. Therefore, we learn here that whenever there is low SpO2 with a normal partial pressure of oxygen, methemoglobinemia should be suspected and diagnosis should be confirmed using co-oximetry.

Keywords

methemoglobinemia - methemoglobin - hypoxia - co-oximetry


Publication History

Article published online:
05 April 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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