Combined effect of inhaled nitric oxide (ino) and drug-induced methemoglobin on methemoglobinemia 1732

Selective pulmonary vasodilation by NOi results from inactivation of NO by hemoglobin. This phenomenon leads to its oxidation in methemoglobin (MetHb). The aim of the study was to

investigate the effect of NOi combined with 3 different agents known to be able to induce methemoglobin: EMLA cream, paracetamol, or vitamin K1. Forty newborn piglets (1.5±0.7 days, 1.4±0.2

kg) were sedated (ketamine=20mg/kg), intubated and mechanically ventilated (FiO2=0.3; RR=15/mn; PIP=15cmH2O; PEEP=3cmH2O; Babylog HF1 Draeger®). A peripheral venous catheter was inserted.

Animals were randomly assigned to one of the following groups (each group = 5 piglets). Four groups were treated by 80 ppm NO delivered in the inspiratory limb of the breathing circuit

during 3 hours: no additional drug was given in the group NO; a single dose of paracetamol (120 mg/kg, prodaffalgan Upsa®) and Vit K1 (5mg, Roche®) were intravenously infused in respectively

the group NO+Parac and NO+Vit, and EMLA cream (Astra®) was applied to the ventral lower abdomen (2.5 g) and covered with a semipermeable polyurethane dressing(Tegaderm®) during 3 hours in

the group NO+EMLA. Four other groups were not treated by NOi and received respectively paracetamol, Vit K1, EMLA cream, or no drug (respectively group Parac, group Vit, group EMLA and Group

Control). MetHb was measured on venous blood samples before drugs and/or iNO administration and at 3 hrs (OSM 3 Radiometer®). Results are summarized in the table (*; p < 0.05 versus

control group). In groups NO, Parac, Vit, and EMLA, MetHb were not significantly different from the control group. Conversely, MetHb concentration increased significantly in groups in which

iNO was associated to drug administration (groups NO+Parac, NO+Vit, NO+EMLA) as compared to control group or to NO group. These results suggest that the MetHb reductase may be overloaded

when iNO is administered with other MetHb-inducing agents. Special care should be taken to monitor MetHb level when iNO is combined with such drugs. AUTHOR INFORMATION AUTHORS AND

AFFILIATIONS * Department of Neonatal Medecine, CHRU de Lille, Lille, France Yvon Riou, Serge Klosowski, Thameur Rakza, Guy Congolo, Angelina Dubois, Herve Robin, Laurent Storme & Pierre

Lequien Authors * Yvon Riou View author publications You can also search for this author inPubMed Google Scholar * Serge Klosowski View author publications You can also search for this

author inPubMed Google Scholar * Thameur Rakza View author publications You can also search for this author inPubMed Google Scholar * Guy Congolo View author publications You can also search

for this author inPubMed Google Scholar * Angelina Dubois View author publications You can also search for this author inPubMed Google Scholar * Herve Robin View author publications You can

also search for this author inPubMed Google Scholar * Laurent Storme View author publications You can also search for this author inPubMed Google Scholar * Pierre Lequien View author

publications You can also search for this author inPubMed Google Scholar ADDITIONAL INFORMATION (Spon by: Jean-Michel Hascoet) Funded by the University of Lille II (BQR) and by Air Liquide

Sante development. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Riou, Y., Klosowski, S., Rakza, T. _et al._ Combined Effect of Inhaled Nitric Oxide

(iNO) and Drug-Induced Methemoglobin on Methemoglobinemia 1732. _Pediatr Res_ 43 (Suppl 4), 295 (1998). https://doi.org/10.1203/00006450-199804001-01754 Download citation * Issue Date: 01

April 1998 * DOI: https://doi.org/10.1203/00006450-199804001-01754 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a

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