Elevated carboxyhemoglobin associated with sodium nitroprusside treatment
- 136 Downloads
To report four cases of carboxyhemoglobinemia associated with high doses of sodium nitroprusside after cardiac transplant in children.
Four children in the pediatric care unit of a university hospital aged 6 months–4 years.
Carboxyhemoglonemia developed at levels of 5.5–7.7% in patients receiving high doses of sodium nitroprusside (7–16 µg/kg per minute and no other medication that could caused elevated carboxyhemoglobin). One patient died, and three recovered with no sequelae after discontinuation of sodium nitroprusside.
High doses of sodium nitroprusside can induce carboxyhemoglobinemia in children after heart transplant, probably by inducing hemeoxygenase, with no other secondary effects.
KeywordsSodium nitroprusside Carboxyhemoglobin Children Critically ill
- 2.Taketomo CK, Hodding JH, Kraus DM (2003) Pediatric dosage handbook, 10th edn. Lexi-Comp, Ohio, pp 818–819Google Scholar
- 9.Morse D, Sethi J, Choi AM (2002) Carbon monoxide-dependent signaling. Crit Care Med 30 [Suppl 1]:S12–S17Google Scholar
- 16.Takeda R, Tanaka A, Maeda T, Yamaoka Y, Nakamura K, Sano K, Kataoka M, Nakamura Y, Morimoto T, Mukaihara S (2002) Perioperative changes in carbonylhemoglobin and methemoglobin during abdominal surgery: alteration in endogenous generation of carbon monoxide. J Gastroenterol Hepatol 17:535–541CrossRefPubMedGoogle Scholar