Abstract—Background: Methylene blue is the first line therapy for methemoglobinemia, but it can be intermittently unavailable due to production issues.For this clinical scenario, alternative treatment options need to be explored. Hyperbaric oxygenation (HBO) is conventionally applied as an adjunctive therapy during the systemic administration of methylene blue.Currently, little is known regarding the effects of HBO monotherapy in methemoglobinemia. We report a case of methemoglobinemia that was successfully treated with HBO monotherapy. Case Report: A 41-year-old man presented to the Emergency Depart ment with dyspnea and dizziness subsequent tosmoking in a garage filled with motor vehicle exhaust gas. There were no abnormal heart or lung sounds.While administering oxygen flowing at 15 L/min via a mask with a reservoir bag, blood tests revealed high methemoglobin (MetHb) levels at 59.6%. He was treated with HBO monotherapy, and sequential tests showed that the MetHb level decreased signifi cantly to 34.0%, 12.8%, 6.2%, and eventually, 3.5%.He was discharged with stable vital signs the next day. Why Should an Emergency Physician Be Aware of This?: HBO monotherapy is an effective alternative treat ment for methemoglobinemia when methylene blue is not available.
Categories: Medical clinic, Toxicology