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DENEYSEL METHEMOGLOBİNEMİ MODELİNDE OKSİJEN İLE TEDAVİ SÜRESİ VE ETKİNLİĞİNİN BELİRLENMESİ

Yıl 2023, Cilt: 4 Sayı: 1, 49 - 56, 29.03.2023
https://doi.org/10.48176/esmj.2023.103

Öz

Giriş: Anormal bir hemoglobin şekli olan methemoglobin, öncelikle ağır santral siyanozda göz önünde bulundurulması gereken nedenlerden biridir. Methemoglobinemide birinci basamak tedavi olarak metilen mavisi ve askorbik asit kullanılır. Oksijen terapisi kullanımına ilişkin deneyim, tedavinin süresini sonuçlandırmak için yeterli değildir. Bu çalışmanın amacı, oksijen tedavisinin ilaç veya toksik ajan kaynaklı methemoglobinemi üzerindeki etkilerini bulmaktır.
Gereç ve Yöntem: Birinci grup sıçanlara (n = 6) periton içine 100 mg / kg prilokain verilmiş ve sıçanlar oda sıcaklığında tutulmuştur. İkinci grup oksijen grubu sıçanlara (n = 6) ise 10 litre / dak %100 oksijen uygulanmıştır. Tüm sıçanlar 180 dakika boyunca gözlenmiş ve deney süresi sonunda, kan gazı ve biyokimyasal analizler yapılmıştır.
Bulgular: Oda hava grubundaki (n = 3) sıçanların yüzde ellisi deneme süresi sonunda kendiliğinden ölmüştür, oksijen grubundaki (n = 6) tüm sıçanlar deneme süresinin sonuna kadar yaşamıştır.
Sağkalım açısından değerlendirildiğinde gruplar arasında istatistiksel bir fark saptanmıştır (p <0.05). Ayrıca, gruplar arasında oksijen doygunluğu seviyelerinde anlamlı bir fark olmasına rağmen (p <0.05), oksijenasyonun primer belirleyicisi olan parsiyel arteriyel oksijen basıncında anlamlı bir artış görülmemiştir.
Sonuç: Yapılan bu çalışma, sıçanların bu tür deneysel çalışma için uygun olmadığını ortaya koymuştur. Prilokain dozları mortalite nedeniyle yüksek düzeyde methemoglobinemi oluşturmamış, bu
nedenle amaç ve hedef karşılanamamıştır. Bu çalışmanın, konu ile ilgili ileride yapılacak araştırmalarda kullanılacak metodolojilerin seçiminde yol gösterici olabileceği sonucuna varılmıştır.

Destekleyen Kurum

İstanbul Üniversitesi Bilimsel Araştırmalar Proje Birimi

Proje Numarası

32967

Teşekkür

Bu çalışma İstanbul Üniversitesi Bilimsel Araştırma Projeleri Birimi tarafından ‘32967’ nolu tez projesi ile 21/06/2013 tarihinde desteklenmiştir.

Kaynakça

  • 1. Sii-Felice K, Giorgi M, Leboulch P, Payen E. Hemoglobin disorders: lentiviral gene therapy in the starting blocks to enter clinical practice. Exp Hematol 2018;64:12-32.
  • 2. Özgencil EG, Hasdoğan M, Can SÖ, Sezer G, Erdoğdu P, Ökten F. Lokal anesteziklere bağlı gelişen methemoglobineminin dört olguda tartışılması. Türk Anest Rean Der 2006;34:327-32.
  • 3. Öztürk E, Aktaş TB, Öztarhan K, Adalı E. Lokal anestezik uygulaması sonrası gelişen methemoglobinemi. JOPP Der 2010;2:46-8.
  • 4. Arslan D, Yıldız G, Şahin MO. The Incidence of Methemoglobinemia Due to Prilocaine Use in Circumcision. J Urol Surg 2019;6:38-41.
  • 5. Frey B, Kehrer B. Toxic methaemoglobin concentrations in premature infants after application of a prilocaine containing cream and peridural prilocaine. Eur J Pediatr 1999;158:785-88.
  • 6. Peker E, Cagan E, Dogan M, et al. Methemoglobinemia due to local anesthesia with prilocaine for circumcision. J Paediatr Child Health 2010;46:362-3.
  • 7. Guay J. Methemoglobinemia related to local anesthetics: a summary of 242 episodes. Anesth Analg 2009;108:837-45.
  • 8. Cefalu JN, Joshi TV, Spalitta MJ, et al. Methemoglobinemia in the operating room and intensive care unit: early recognition, pathophysiology, and management. Adv Ther 2020;37:1714- 23.
  • 9. Nascimento SC, Pereira ROL, Mello HLD, Costa J. Methemoglobinemia: from diagnosis to treatment. Rev Bras Anestesiol 2008;58:651-64.
  • 10. Öncel UT. Pulse Oksimetre. J Turk Soc Intens Care 2006;4:96-106.
  • 11. Barker SJ, Tremper KK, Hyatt J. Effects of methemoglobinemia on pulse oximetry and mixed venous oximetry. Anesthesiology 1989;70:112-17.
  • 12. Meier J, Pape A, Lauscher P, Zwissler B, Habler O. Hyperoxia in lethal methemoglobinemia effects on oxygen transport, tissue oxygenation, and survival in pigs. Crit Care Med 2005;33:1582-8.
  • 13. Haymond S, Carıappa R, Eby SC, Scott MG. Laboratory assesment of oxygenation in methemoglobinemia. Clin Chem 2005;51:434-44.
  • 14. Altintop I, Sanri E, Tatli M, Akcin EA, Denizbasi A. Methemoglobinemia treated with hyperbaric oxygen therapy: A case report. Turk J Emerg Med 2018;18:176-8.
  • 15. Goldstein G, Doull J. The use of hyperbaric oxygen in the treatment of p- aminopropio-phenone-induced methemoglobinemia. Toxicol Appl Pharmacol 1973;26:247-52.
  • 16. Hampson N, Zmaeff J. Outcome of patients experiencing cardiac arrest with carbon monoxide poisoning treated with hyperbaric oxygen. Ann Emerg Med 2001;38:36-41
  • 17. Shafa M, Ionescu LI, Vadivel A, et al. Human induced pluripotent stem cell–derived lung progenitor and alveolar epithelial cells attenuate hyperoxia-induced lung injury. Cytotherapy 2018;20:108-25
  • 18. Kreuzer F, Cain SM, Turek Z, Goldstick TK. Oxygen Transport to Tissue VII. Vol. 191. New York, Springer Science & Business Media; 2013.
  • 19. Van Hollebeke M, Poddighe D, Clerckx B, et al. High-Intensity Inspiratory Muscle Training Improves Scalene and Sternocleidomastoid Muscle Oxygenation Parameters in Patients With Weaning Difficulties: A Randomized Controlled Trial. Front Physiol 2022;1- 16.
  • 20. Tsai A, Cabrales P, Winslow R, Intaglietta M. Microvasculer oxygen distribution in awake hamster window chamber model during hyperoxia. Am J Physiol Heart Circ Physiol 2003;285:1537- 45.
  • 21. Dominelli PB, Baker SE, Wiggins CC, et al. Dissociating the effects of oxygen pressure and content on the control of breathing and acute hypoxic response. J Appl Physiol 2019;127:1622-31.
  • 22. Baron J, Vicaut E, Hou X, Duvelleroy M. Independent role of arterial O2 tension in local of coronary blood flow. Am J Physiol 2001;258:1388-94.

DETERMINATION OF TREATMENT TIME AND EFFICACY WITH OXYGEN IN EXPERIMENTAL METHEMOGLOBINEMIA MODEL

Yıl 2023, Cilt: 4 Sayı: 1, 49 - 56, 29.03.2023
https://doi.org/10.48176/esmj.2023.103

Öz

Introduction: Methemoglobin, an abnormal form of hemoglobin, is one of the causes that should be considered primarily in severe central cyanosis. Methylene blue and ascorbic acid are used as the first-line therapies in methemoglobinemia. Experience with the use of oxygen therapy is not sufficient to conclude the duration of therapy. The aim of the present study is to find out the effects of oxygen therapy on drug or toxic agent-induced methemoglobinemia.
Material and Method: First group rats (n=6) were administered 100 mg/kg prilocaine intraperitoneally, and the rats were kept at room temperature. The second group of oxygen group rats (n=6) were administered 100% oxygen at 10 liters/min. All rats were observed for 180 minutes, and blood gas and biochemical analyses were performed at the end of the experiment period.
Results: Fifty percent of the rats in the room air group (n=3) died spontaneously at the end of the trial period, while all rats in the oxygen group (n=6) survived to the end of the trial period. When evaluated in terms of survival, a statistical difference was found between the groups (p <0.05). In addition, although there was a significant difference in oxygen saturation levels between the groups (p <0.05), there was no significant increase in partial arterial oxygen pressure, the primary determinant of oxygenation.
Conclusion: This study revealed that rats are not suitable for this type of experimental study. Prilocaine doses did not cause high levels of methemoglobinemia due to mortality, so the goal and target could not be met. It has been concluded that this study can serve as a guide for choosing methodologies to be employed in planned future investigations of the topic.

Proje Numarası

32967

Kaynakça

  • 1. Sii-Felice K, Giorgi M, Leboulch P, Payen E. Hemoglobin disorders: lentiviral gene therapy in the starting blocks to enter clinical practice. Exp Hematol 2018;64:12-32.
  • 2. Özgencil EG, Hasdoğan M, Can SÖ, Sezer G, Erdoğdu P, Ökten F. Lokal anesteziklere bağlı gelişen methemoglobineminin dört olguda tartışılması. Türk Anest Rean Der 2006;34:327-32.
  • 3. Öztürk E, Aktaş TB, Öztarhan K, Adalı E. Lokal anestezik uygulaması sonrası gelişen methemoglobinemi. JOPP Der 2010;2:46-8.
  • 4. Arslan D, Yıldız G, Şahin MO. The Incidence of Methemoglobinemia Due to Prilocaine Use in Circumcision. J Urol Surg 2019;6:38-41.
  • 5. Frey B, Kehrer B. Toxic methaemoglobin concentrations in premature infants after application of a prilocaine containing cream and peridural prilocaine. Eur J Pediatr 1999;158:785-88.
  • 6. Peker E, Cagan E, Dogan M, et al. Methemoglobinemia due to local anesthesia with prilocaine for circumcision. J Paediatr Child Health 2010;46:362-3.
  • 7. Guay J. Methemoglobinemia related to local anesthetics: a summary of 242 episodes. Anesth Analg 2009;108:837-45.
  • 8. Cefalu JN, Joshi TV, Spalitta MJ, et al. Methemoglobinemia in the operating room and intensive care unit: early recognition, pathophysiology, and management. Adv Ther 2020;37:1714- 23.
  • 9. Nascimento SC, Pereira ROL, Mello HLD, Costa J. Methemoglobinemia: from diagnosis to treatment. Rev Bras Anestesiol 2008;58:651-64.
  • 10. Öncel UT. Pulse Oksimetre. J Turk Soc Intens Care 2006;4:96-106.
  • 11. Barker SJ, Tremper KK, Hyatt J. Effects of methemoglobinemia on pulse oximetry and mixed venous oximetry. Anesthesiology 1989;70:112-17.
  • 12. Meier J, Pape A, Lauscher P, Zwissler B, Habler O. Hyperoxia in lethal methemoglobinemia effects on oxygen transport, tissue oxygenation, and survival in pigs. Crit Care Med 2005;33:1582-8.
  • 13. Haymond S, Carıappa R, Eby SC, Scott MG. Laboratory assesment of oxygenation in methemoglobinemia. Clin Chem 2005;51:434-44.
  • 14. Altintop I, Sanri E, Tatli M, Akcin EA, Denizbasi A. Methemoglobinemia treated with hyperbaric oxygen therapy: A case report. Turk J Emerg Med 2018;18:176-8.
  • 15. Goldstein G, Doull J. The use of hyperbaric oxygen in the treatment of p- aminopropio-phenone-induced methemoglobinemia. Toxicol Appl Pharmacol 1973;26:247-52.
  • 16. Hampson N, Zmaeff J. Outcome of patients experiencing cardiac arrest with carbon monoxide poisoning treated with hyperbaric oxygen. Ann Emerg Med 2001;38:36-41
  • 17. Shafa M, Ionescu LI, Vadivel A, et al. Human induced pluripotent stem cell–derived lung progenitor and alveolar epithelial cells attenuate hyperoxia-induced lung injury. Cytotherapy 2018;20:108-25
  • 18. Kreuzer F, Cain SM, Turek Z, Goldstick TK. Oxygen Transport to Tissue VII. Vol. 191. New York, Springer Science & Business Media; 2013.
  • 19. Van Hollebeke M, Poddighe D, Clerckx B, et al. High-Intensity Inspiratory Muscle Training Improves Scalene and Sternocleidomastoid Muscle Oxygenation Parameters in Patients With Weaning Difficulties: A Randomized Controlled Trial. Front Physiol 2022;1- 16.
  • 20. Tsai A, Cabrales P, Winslow R, Intaglietta M. Microvasculer oxygen distribution in awake hamster window chamber model during hyperoxia. Am J Physiol Heart Circ Physiol 2003;285:1537- 45.
  • 21. Dominelli PB, Baker SE, Wiggins CC, et al. Dissociating the effects of oxygen pressure and content on the control of breathing and acute hypoxic response. J Appl Physiol 2019;127:1622-31.
  • 22. Baron J, Vicaut E, Hou X, Duvelleroy M. Independent role of arterial O2 tension in local of coronary blood flow. Am J Physiol 2001;258:1388-94.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makaleleri
Yazarlar

Mehmet Korkut 0000-0002-6708-5868

Proje Numarası 32967
Yayımlanma Tarihi 29 Mart 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 4 Sayı: 1

Kaynak Göster

APA Korkut, M. (2023). DETERMINATION OF TREATMENT TIME AND EFFICACY WITH OXYGEN IN EXPERIMENTAL METHEMOGLOBINEMIA MODEL. Eskisehir Medical Journal, 4(1), 49-56. https://doi.org/10.48176/esmj.2023.103
AMA Korkut M. DETERMINATION OF TREATMENT TIME AND EFFICACY WITH OXYGEN IN EXPERIMENTAL METHEMOGLOBINEMIA MODEL. Eskisehir Med J. Mart 2023;4(1):49-56. doi:10.48176/esmj.2023.103
Chicago Korkut, Mehmet. “DETERMINATION OF TREATMENT TIME AND EFFICACY WITH OXYGEN IN EXPERIMENTAL METHEMOGLOBINEMIA MODEL”. Eskisehir Medical Journal 4, sy. 1 (Mart 2023): 49-56. https://doi.org/10.48176/esmj.2023.103.
EndNote Korkut M (01 Mart 2023) DETERMINATION OF TREATMENT TIME AND EFFICACY WITH OXYGEN IN EXPERIMENTAL METHEMOGLOBINEMIA MODEL. Eskisehir Medical Journal 4 1 49–56.
IEEE M. Korkut, “DETERMINATION OF TREATMENT TIME AND EFFICACY WITH OXYGEN IN EXPERIMENTAL METHEMOGLOBINEMIA MODEL”, Eskisehir Med J, c. 4, sy. 1, ss. 49–56, 2023, doi: 10.48176/esmj.2023.103.
ISNAD Korkut, Mehmet. “DETERMINATION OF TREATMENT TIME AND EFFICACY WITH OXYGEN IN EXPERIMENTAL METHEMOGLOBINEMIA MODEL”. Eskisehir Medical Journal 4/1 (Mart 2023), 49-56. https://doi.org/10.48176/esmj.2023.103.
JAMA Korkut M. DETERMINATION OF TREATMENT TIME AND EFFICACY WITH OXYGEN IN EXPERIMENTAL METHEMOGLOBINEMIA MODEL. Eskisehir Med J. 2023;4:49–56.
MLA Korkut, Mehmet. “DETERMINATION OF TREATMENT TIME AND EFFICACY WITH OXYGEN IN EXPERIMENTAL METHEMOGLOBINEMIA MODEL”. Eskisehir Medical Journal, c. 4, sy. 1, 2023, ss. 49-56, doi:10.48176/esmj.2023.103.
Vancouver Korkut M. DETERMINATION OF TREATMENT TIME AND EFFICACY WITH OXYGEN IN EXPERIMENTAL METHEMOGLOBINEMIA MODEL. Eskisehir Med J. 2023;4(1):49-56.