Ameku Takao no Suiri Karte Episode 2 Discussion

Crossburn said:
I should have been more precise with that statement. Methylene blue does turn human plasma blue (urine is filtered plasma after all), but the deep red/chocolate brown colour of haemoglobin will likely overpower the blue hue unless the patient is severely anaemic. That said, I would buy an artistic decision to colour the patient's blood a dark blue IF ONLY the methylene blue had actually been given.

When applying the drug, there may be a “drop” in oxygen saturation, because methylene blue turns the blood blue, and it falsely reduces the saturation value measured via pulse oximetry.

Laboratorydata demonstrateda hemoglobin of 15.2 gm/100 ml, a white blood cell count of 9,400/cu mm with a normal differential, an arterial pH of 7.43, a PCO 2 of 30 torr, and a PO2 of 90 torr while the patient was breathing room air. Specimens of arterial blood appeared dark blue. Serum electrolytes revealed sodium of 141 mEq/L and bicarbonateof 20 mEq/L. A serum toxicology screen was negative. Serum alcohols showed an ethanol level of 83 mEq/100ml.
The diagnosis of nitrite-induced methemoglobinemia was made, and the patient was treated with 70 mg methyleneblue IV, 500 mg ascorbic acid IV, and oxygenby nasal prongs. This produceda rapid and marked improvementof the cyanosis, and the patient became calmer and re- oriented. He was admitted to the intensive care unit and had an uneventful clinical course.