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Methylene blue by intraosseous infusion for methemoglobinemia.

Abstract
Intraosseous administration of methylene blue may be an emergency alternative to intravascular administration. A 6-week-old female infant (3 kg) presented to the emergency department after a 1-week illness and appeared cyanotic and listless. Oxygen saturation by oximetry was 86% while the patient was receiving oxygen. Vital signs were blood pressure, 107/80 mm Hg; pulse, 190; respirations, 47; temperature, 39.0 degreesC. A metabolic acidosis and a methemoglobin level of 29.3% were present. After several unsuccessful attempts to establish intravenous access, an intraosseous needle was placed in the infant's left tibia. Methylene blue, 1 mg/kg, normal saline solution, and sodium bicarbonate were given intraosseously. The patient's oxygen saturation rose to 98% to 100%, and her cyanosis improved. Three hours later, her methemoglobin level was 8.2%. The child recovered uneventfully and was sent home after 3 days. Intraosseous administration of standard intravenous doses of methylene blue rapidly terminated the effects of acquired methemoglobinemia.
AuthorsM I Herman, P A Chyka, A Y Butler, S E Rieger
JournalAnnals of emergency medicine (Ann Emerg Med) Vol. 33 Issue 1 Pg. 111-3 (Jan 1999) ISSN: 0196-0644 [Print] United States
PMID9867898 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antidotes
  • Methylene Blue
Topics
  • Antidotes (administration & dosage)
  • Bone and Bones
  • Emergency Treatment (methods)
  • Female
  • Humans
  • Infant
  • Injections
  • Methemoglobinemia (drug therapy)
  • Methylene Blue (administration & dosage)
  • Oximetry

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