16-month-old girl had methemoglobinemia (red blood cells cannot bind with oxygen to turn into red blood) after lunch - Photo: Provided by the hospital
Recently, the City Children's Hospital (HCMC) received a PTM patient (female, 16 months old, residing in Can Duoc, Long An ) in a state of cyanosis all over the body, with a severe drop in SpO₂ index to 75%.
According to the family, a few hours before, the patient had lunch consisting of crab and spinach soup cooked with well water.
About an hour after the meal, while playing, the baby showed signs of being startled, with purple lips and blue skin, but no coughing or choking. The family quickly took the baby to the City Children's Hospital for examination.
At the time of admission, the baby was fussy, had no skin rash, no fever, no wheezing, no wheezing, no vomiting, but had signs of cyanosis all over the body.
Blood gas results showed severe hypoxia, with metabolic acidosis (blood lactate increased to 4.8 mmol/L). Other tests of liver, kidney, and electrolyte function were all within normal limits.
Based on clinical symptoms, the child was tested for exposure to air by taking a blood sample from the child in a capped syringe and shaking it 50 times.
The result was that the blood's dark brown color did not change, and did not turn red as usual. Doctors diagnosed the baby with methemoglobinemia, which means red blood cells cannot bind with oxygen to turn into red blood.
Immediately, the baby was treated with oxygen, an injection of methylene blue antidote, and activated charcoal to remove the poison from the digestive tract. After only 10 minutes, the baby's skin began to turn pink again; after 30 minutes, SpO 2 recovered to 95%.
Through this case, Dr. Nguyen Minh Tien - Deputy Director of the City Children's Hospital - recommends that parents should be careful when using well water for cooking.
Well water contains a lot of nitrate (NO3-), an oxidant that causes red blood cells to convert hem F2+ into F3+, which is unable to bind oxygen to be used by body tissues, leading to cyanosis and anaerobic metabolism, increasing blood lactate and metabolic acidosis.
"Parents should use safe tap water when cooking. Some vegetables and fruits such as amaranth, beetroot... have high nitrate content. Using water cooked from these to mix with breast milk (because you think the red color is good for the baby's blood) can cause methemoglobinemia, especially in premature babies," Dr. Tien advised.
Source: https://tuoitre.vn/mau-cua-be-gai-chuyen-qua-mau-nau-sau-khi-an-canh-nau-bang-nuoc-gieng-20250624092604681.htm
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