Use of telemedicine for the identification and treatment of sulfamethoxazole-induced methaemoglobinemia

Telemedicine can be used in intensive care units (ICUs) with linked electronic medical records to enable remote clinicians to assess patients and focus on those who are deviating from their expected course. We report the case of a woman admitted to our ICU with apparent hypoxaemia, whose pulse oxime...

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Bibliographic Details
Published in:Journal of telemedicine and telecare 2012-09, Vol.18 (6), p.362-364
Main Authors: Kohl, Benjamin A, Domski, Ann, Pavan, Kimberly, Fortino, Margaret
Format: Article
Language:English
Subjects:
Anti-Infective Agents - adverse effects
Female
Humans
Intensive Care Units - organization & administration
Methemoglobinemia - chemically induced
Methemoglobinemia - diagnosis
Methemoglobinemia - drug therapy
Methylene Blue - therapeutic use
Middle Aged
Sulfamethoxazole - adverse effects
Telemedicine
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Summary:Telemedicine can be used in intensive care units (ICUs) with linked electronic medical records to enable remote clinicians to assess patients and focus on those who are deviating from their expected course. We report the case of a woman admitted to our ICU with apparent hypoxaemia, whose pulse oximetry readings were not believed by the treating team. The intensivist at the telemedicine centre was consulted and instituted treatment on the assumption that methaemoglobinemia was present. Without rapid therapy, ongoing tissue ischaemia and shock was inevitable. Within 60 min of methylene blue administration, the patient's oxygen saturation improved dramatically. The methaemoglobin level was eventually reported as 9.9% (normal value
ISSN:1357-633X
1758-1109
DOI:10.1258/jtt.2012.120307