A Multi-Center Retrospective Database Evaluation of Pediatric Subjects Diagnosed With Methemoglobinemia.

IF 1.7 Q2 PEDIATRICS Clinical Medicine Insights-Pediatrics Pub Date : 2024-09-19 eCollection Date: 2024-01-01 DOI:10.1177/11795565241271678
Neha Sinha, Brooke Lichak, Neal J Thomas, Conrad Krawiec
{"title":"A Multi-Center Retrospective Database Evaluation of Pediatric Subjects Diagnosed With Methemoglobinemia.","authors":"Neha Sinha, Brooke Lichak, Neal J Thomas, Conrad Krawiec","doi":"10.1177/11795565241271678","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Methemoglobinemia requires early identification and treatment, but limited knowledge exists regarding the current therapeutic approach taken by clinicians as well as the outcomes that occur in children.</p><p><strong>Objectives: </strong>To determine the current prevalence of this rare disease in the pediatric population, evaluate the impact of methemoglobin and functional hemoglobin levels, and assess how this disease is approached by clinicians. We hypothesize that methemoglobinemia prevalence is low and more methylene blue use would be observed in subjects with functional hemoglobin levels less than 7 g/dL.</p><p><strong>Design: </strong>This was a retrospective observational cohort study utilizing deidentified TriNetX<sup>®</sup> electronic health record (EHR) data.</p><p><strong>Methods: </strong>Using a multicenter EHR database, we evaluated subjective characteristics, diagnostic, laboratory results, medication, and procedural codes.</p><p><strong>Results: </strong>Ninety-eight children (mean age 5.3 ± 5.3 years) from 53 healthcare organizations were included. Methemoglobinemia prevalence was 0.0015% with an overall 30-day mortality of 6.1%. Subjects with methemoglobin percentages greater than 20% had a higher frequency of methylene blue administration (70.6% versus 24.7%, <i>P</i> = .0005). Critical care service requirements and methylene blue administration were similar in the subjects with functional hemoglobin less than 7 g/dL and more than 7 g/dL groups. Overall, 13 (13.2%) subjects underwent glucose-6-phosphate dehydrogenase deficiency (G6PD) testing.</p><p><strong>Conclusion: </strong>In our study, we found methemoglobinemia prevalence in children is low, there is a low frequency of G6PD testing despite methylene blue hemolysis risk, and subjects appeared to be treated similarly despite a low functional hemoglobin. These findings highlight the continued critical nature of this disease and may highlight opportunities for education aimed at improving care in children diagnosed with methemoglobinemia, particularly related to G6PD testing.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"18 ","pages":"11795565241271678"},"PeriodicalIF":1.7000,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418309/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Medicine Insights-Pediatrics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/11795565241271678","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Methemoglobinemia requires early identification and treatment, but limited knowledge exists regarding the current therapeutic approach taken by clinicians as well as the outcomes that occur in children.

Objectives: To determine the current prevalence of this rare disease in the pediatric population, evaluate the impact of methemoglobin and functional hemoglobin levels, and assess how this disease is approached by clinicians. We hypothesize that methemoglobinemia prevalence is low and more methylene blue use would be observed in subjects with functional hemoglobin levels less than 7 g/dL.

Design: This was a retrospective observational cohort study utilizing deidentified TriNetX® electronic health record (EHR) data.

Methods: Using a multicenter EHR database, we evaluated subjective characteristics, diagnostic, laboratory results, medication, and procedural codes.

Results: Ninety-eight children (mean age 5.3 ± 5.3 years) from 53 healthcare organizations were included. Methemoglobinemia prevalence was 0.0015% with an overall 30-day mortality of 6.1%. Subjects with methemoglobin percentages greater than 20% had a higher frequency of methylene blue administration (70.6% versus 24.7%, P = .0005). Critical care service requirements and methylene blue administration were similar in the subjects with functional hemoglobin less than 7 g/dL and more than 7 g/dL groups. Overall, 13 (13.2%) subjects underwent glucose-6-phosphate dehydrogenase deficiency (G6PD) testing.

Conclusion: In our study, we found methemoglobinemia prevalence in children is low, there is a low frequency of G6PD testing despite methylene blue hemolysis risk, and subjects appeared to be treated similarly despite a low functional hemoglobin. These findings highlight the continued critical nature of this disease and may highlight opportunities for education aimed at improving care in children diagnosed with methemoglobinemia, particularly related to G6PD testing.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
对确诊患有高铁血红蛋白症的儿科受试者进行多中心回顾性数据库评估。
背景:高铁血红蛋白血症需要早期识别和治疗,但目前临床医生采取的治疗方法以及儿童的治疗效果方面的知识有限:目的:确定这种罕见疾病目前在儿科人群中的发病率,评估高铁血红蛋白和功能性血红蛋白水平的影响,并评估临床医生是如何处理这种疾病的。我们假设高铁血红蛋白血症的发病率较低,而功能性血红蛋白水平低于 7 g/dL 的受试者会更多地使用亚甲蓝:这是一项利用去标识化 TriNetX® 电子健康记录(EHR)数据进行的回顾性观察队列研究:利用多中心电子病历数据库,我们评估了主观特征、诊断、实验室结果、药物和程序代码:结果:纳入了 53 家医疗机构的 98 名儿童(平均年龄为 5.3 ± 5.3 岁)。高铁血红蛋白血症的发病率为 0.0015%,30 天内的总死亡率为 6.1%。高铁血红蛋白百分比大于 20% 的受试者使用亚甲蓝的频率更高(70.6% 对 24.7%,P = 0.0005)。功能性血红蛋白低于 7 g/dL 组和高于 7 g/dL 组的重症监护服务需求和亚甲蓝用量相似。总体而言,13 名(13.2%)受试者接受了葡萄糖-6-磷酸脱氢酶缺乏症(G6PD)检测:结论:在我们的研究中,我们发现儿童高铁血红蛋白血症的发病率较低,尽管存在亚甲蓝溶血风险,但进行 G6PD 检测的频率较低,尽管功能性血红蛋白较低,但受试者似乎得到了类似的治疗。这些发现凸显了这种疾病的持续危急性,并强调了旨在改善对确诊为高铁血红蛋白血症儿童的护理的教育机会,尤其是与 G6PD 检测相关的教育机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
自引率
0.00%
发文量
5
审稿时长
8 weeks
期刊最新文献
Giant Congenital Ovarian Cyst Presenting as an Abdominal Mass. Influencing Factors on Independent Walking in Children With Lumbosacral Lipomas: A Retrospective Cohort Study Based on a 5-Year Untethering Series. Neonatal Sepsis: Aetiology, Pathophysiology, Diagnostic Advances and Management Strategies. Assessment of Voiding Dysfunction and Nocturnal Enuresis Rates in Primary School Children in Nablus, Palestine: A Cross-Sectional Study. A Multi-Center Retrospective Database Evaluation of Pediatric Subjects Diagnosed With Methemoglobinemia.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1