دورية أكاديمية
Methemoglobinemia screening and treatment in tank warfare survivors.
| العنوان: | Methemoglobinemia screening and treatment in tank warfare survivors. |
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| المؤلفون: | Negev S; Department of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel., Gruenbaum S; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic-Florida, Jacksonville, FL, USA., Frenkel A; Department of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel., Zlotnik A; Department of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel., Gabay O; Department of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: ohadgab@gmail.com. |
| المصدر: | The American journal of emergency medicine [Am J Emerg Med] 2024 Jul; Vol. 81, pp. 159.e1-159.e5. Date of Electronic Publication: 2024 Apr 12. |
| نوع المنشور: | Case Reports; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: W B Saunders Country of Publication: United States NLM ID: 8309942 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8171 (Electronic) Linking ISSN: 07356757 NLM ISO Abbreviation: Am J Emerg Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 1983- : Philadelphia, PA : W B Saunders Original Publication: [Philadelphia, PA. : Centrum Philadelphia, c1983]- |
| مواضيع طبية MeSH: | Methemoglobinemia*/chemically induced , Methemoglobinemia*/diagnosis , Methylene Blue*/therapeutic use, Humans ; Male ; Adult ; Military Personnel ; Oximetry ; Young Adult ; Blast Injuries/complications ; Mass Screening/methods |
| مستخلص: | Introduction: Methemoglobinemia, characterized by the conversion of functional hemoglobin to methemoglobin, can significantly impede tissue oxygenation. Prompt diagnosis and treatment of methemoglobinemia are critical to optimizing clinical outcomes. Although the underlying etiology of methemoglobinemia is often attributed to a medication reaction or chemical exposure, its association with battlefield trauma remains underexplored. This case series explores the presence of methemoglobinemia in nine soldiers evacuated from tanks targeted by explosives, shedding new light on screening needs and treatment strategies. Cases Description: Nine combat trauma patients with methemoglobinemia were admitted to Soroka Medical Center over a two-month period. Detailed case descriptions illustrate the diverse presentations and treatment responses. Notably, the administration of methylene blue resulted in rapid methemoglobin reductions and an improvement in oxygenation without any observed side effects. Discussion: This series highlights an unexpected consequence of an explosion within an armored fighting vehicle and the challenges related to standard pulse oximetry interpretation and accuracy in the presence of methemoglobinemia, emphasizing the need for vigilant monitoring and co-oximetry utilization. Additionally, the coexistence of carboxyhemoglobin further warrants attention due to its synergistic and deleterious effects on oxygen delivery. Collaborative efforts with military authorities should aim to explore the underlying mechanisms associated with trauma and methemoglobinemia and optimize battlefield care. Conclusion: This case series underscores the significance of methemoglobinemia screening in combat trauma patients, and advocates for systematic co-oximetry utilization and methylene blue availability in combat zones. Early detection and intervention of methemoglobinemia in combat soldiers are often difficult in the context of battlefield injuries but are necessary to mitigate the potentially fatal consequences of this condition. Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationship that could have appeared to influent the work reported in this paper. (Copyright © 2024 Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Combat trauma; Methemoglobinemia; Tank warfare |
| المشرفين على المادة: | T42P99266K (Methylene Blue) |
| تواريخ الأحداث: | Date Created: 20240416 Date Completed: 20240605 Latest Revision: 20240606 |
| رمز التحديث: | 20240607 |
| DOI: | 10.1016/j.ajem.2024.04.013 |
| PMID: | 38627127 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1532-8171 |
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| DOI: | 10.1016/j.ajem.2024.04.013 |