Methemoglobinemia during the Use of Glyceryl Trinitrate Patches in Neonates: Two Case Reports

Alison Mintoft, Emma Williams, Christopher Harris, Nigel Kennea, Anne Greenough*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    6 Citations (Scopus)

    Abstract

    Methemoglobinemia can result in severe hypoxia. It has been frequently reported during the use of inhaled nitric oxide, but can occur where nitrate containing medications are used. Glyceryl trinitrate (GTN) patches have been used in the treatment of digital and limb ischemia in prematurely born infants. Little is known about the pharmacokinetics of GTN when incorporated into patches. Studies of other topical forms of nitroglycerine have shown a wide range of absorption. It is likely that the increased permeability of the prematurely born infant's skin would facilitate absorption. We describe the use of GTN patches in two very prematurely born infants used to treat limb/digit ischemia. This resulted in methemoglobinemia and resultant increase in their supplementary oxygen requirements. Removal of the patches was associated with a reduction in their methemoglobin levels and the supplementary oxygen requirements back to baseline levels. In conclusion, routine monitoring of methemoglobin levels should be undertaken when GTN patches are used in very prematurely born infants.

    Original languageEnglish
    Pages (from-to)e227-e229
    JournalAJP Reports
    Volume8
    Issue number4
    Early online date15 Oct 2018
    DOIs
    Publication statusE-pub ahead of print - 15 Oct 2018

    Keywords

    • glyceryl trinitrate
    • ischemia
    • methemoglobinemia
    • preterm

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