First Things First

  • Cyanosis in the face of normal PaO2 is key item.
  • Tissue dysoxia and hypoxia cause the deleterious signs/symptoms seen.
  • This state causes significant tissue hypoxia, cyanosis and oxidative stress.
  • This stressful oxidative state can also lead to hemolysis.
  • Supportive treatment
    • High-concentration FiO2 to saturate remaining normal HgG
    • In symptomatic pts, consider methylene blue (see below).
    • Most patients respond within 15-30 minutes.
  • Poison control is a good resource for management.

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Last updated: May 9, 2010