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Vol. 46. Issue 4.
Pages 234 (April 2022)
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Vol. 46. Issue 4.
Pages 234 (April 2022)
Images in Intensive Medicine
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Red urine after hydroxycobalamin administration
Orina roja tras la administración de hidroxicobalamina
Y. Peñasco Martín
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Corresponding author.
, A. Fernández Rodríguez, A. González Castro
Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
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This is the case of a 93-year-old woman admitted to the ICU with signs of carbon monoxide (CO) poisoning. She is treated by the out-of-hospital emergency medical service with orotracheal intubation due to lowered level of consciousness (ECG score 3) with clinical stability in the remaining levels. Thirty percent carboxyhemoglobin. She is treated with hyperbaric oxygen therapy and hydroxocobalamin (5 mg/in 15 min). During the administration of hydroxocobalamin the patient’s skin and mucous membranes appear reddish. Afterwards, the patient’s urine starts looking red, which is a sign of overt hematuria (Fig. 1) and consistent with the color of the drug administered to the patient (Fig. 2, asterisk). The results of the urianalysis ruled out the presence of red blood cells in urine. This is a known phenomenon after the administration of high doses of this antidote and is associated with the unaltered secretion of the antidote through urine. The patient’s clinical course was favorable, and she was discharged after 72 h.

Figure 1
Figure 2

Please cite this article as: Peñasco Martín Y, Fernández Rodríguez A, González Castro A. Orina roja tras la administración de hidroxicobalamina. Med Intensiva. 2022;46:234.

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