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10.5606/tgkdc.dergisi.2017.14771
Inhaled nitric oxide induced methemoglobinemia on extracorporeal circulatory support: Black versus red
Evren Özçınar, Fatih Gümüş, Sadık Eryılmaz, Ahmet Rüçhan Akar
Department of Cardiovascular Surgery, Medical Faculty of Ankara University, Ankara, Turkey
DOI : 10.5606/tgkdc.dergisi.2017.14771
Administration of inhaled nitric oxide after left ventricular assist
device implantation decreases pulmonary vascular resistance and
right ventricular afterload. However, inhaled nitric oxide is not
innocent and serious adverse effects may occur. In this article,
we report a case of severe methemoglobinemia caused by inhaled
nitric oxide administration after left ventricular assist device
implantation. We stabilized the patients hemodynamic status
with veno-arterial-venous extracorporeal membrane oxygenation
support and inhaled nitric oxide treatment. Nevertheless, severe
methemoglobinemia was detected with discolorization of the
tubing lines of the extracorporeal membrane oxygenation circuit
in association with hypoxia. The methemoglobin levels up to
19.9% were accompanied by hypoxemia and fatal arrhythmias.
Methemoglobinemia was successfully treated by exchange blood
transfusion.
Keywords : Extracorporeal membrane oxygenation; heart failure; mechanical support; methemoglobinemia; nitric oxide
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