L K Weaver1, S Howe, R Hopkins, K J Chan. 1. Hyperbaric Medicine and Pulmonary Division, LDS Hospital, Salt Lake City, UT 84143, USA. lweaver@ihc.com
Abstract
STUDY OBJECTIVES: There are large reported differences for the carboxyhemoglobin (COHb) half-life (COHb t(1/2)) in humans breathing 100% atmospheric O(2) following CO inhalation in tightly controlled experiments compared to the COHb t(1/2) observed in clinical CO poisoning (range, 36 to 131 min, respectively). Other reports have suggested that the COHb t(1/2) may be affected by gender differences, age, and lung function. We wished to test the hypothesis that the COHb t(1/2) might also be influenced by CO poisoning vs experimental CO exposure, by a history of loss of consciousness (LOC), concurrent tobacco smoking, and by PaO(2). The purpose of the present study was to measure the COHb t(1/2) in a cohort of CO-poisoned patients and to determine if those listed factors influenced the COHb t(1/2). DESIGN: Retrospective chart review from 1985 to 1995. We calculated the COHb t(1/2) of CO-poisoned patients who were treated with high-flow supplemental atmospheric pressure O(2) delivered by nonrebreather face mask or endotracheal tube. SETTING: Hyperbaric medicine department of a tertiary-care teaching hospital. PATIENTS: Of 240 CO-poisoned patients, 93 had at least two COHb measurements > 2% (upper limit of normal) with recorded times of the measurements, permitting calculation of the COHb t(1/2). RESULTS: The COHb t(1/2) was 74 +/- 25 min (mean +/- 1 SD) with a range from 26 to 148 min. By stepwise multiple linear regression analysis, the PaO(2) influenced the COHb t(1/2) (R(2) = 0.19; p < 0.001), whereas the COHb t(1/2) was not influenced by gender, age, smoke inhalation, history of LOC, concurrent tobacco smoking, degree of initial metabolic acidosis (base excess), or initial COHb level. CONCLUSIONS: The COHb t(1/2) of 93 CO-poisoned patients treated with 100% O(2) at atmospheric pressure was 74 +/- 25 min, considerably shorter than the COHb t(1/2) reported in prior clinical reports (approximately 130 +/- 130 min) and was influenced only by the patient's PaO(2).
STUDY OBJECTIVES: There are large reported differences for the carboxyhemoglobin (COHb) half-life (COHb t(1/2)) in humans breathing 100% atmospheric O(2) following CO inhalation in tightly controlled experiments compared to the COHb t(1/2) observed in clinical CO poisoning (range, 36 to 131 min, respectively). Other reports have suggested that the COHb t(1/2) may be affected by gender differences, age, and lung function. We wished to test the hypothesis that the COHb t(1/2) might also be influenced by CO poisoning vs experimental CO exposure, by a history of loss of consciousness (LOC), concurrent tobacco smoking, and by PaO(2). The purpose of the present study was to measure the COHb t(1/2) in a cohort of CO-poisoned patients and to determine if those listed factors influenced the COHb t(1/2). DESIGN: Retrospective chart review from 1985 to 1995. We calculated the COHb t(1/2) of CO-poisoned patients who were treated with high-flow supplemental atmospheric pressure O(2) delivered by nonrebreather face mask or endotracheal tube. SETTING: Hyperbaric medicine department of a tertiary-care teaching hospital. PATIENTS: Of 240 CO-poisoned patients, 93 had at least two COHb measurements > 2% (upper limit of normal) with recorded times of the measurements, permitting calculation of the COHb t(1/2). RESULTS: The COHb t(1/2) was 74 +/- 25 min (mean +/- 1 SD) with a range from 26 to 148 min. By stepwise multiple linear regression analysis, the PaO(2) influenced the COHb t(1/2) (R(2) = 0.19; p < 0.001), whereas the COHb t(1/2) was not influenced by gender, age, smoke inhalation, history of LOC, concurrent tobacco smoking, degree of initial metabolic acidosis (base excess), or initial COHb level. CONCLUSIONS: The COHb t(1/2) of 93 CO-poisoned patients treated with 100% O(2) at atmospheric pressure was 74 +/- 25 min, considerably shorter than the COHb t(1/2) reported in prior clinical reports (approximately 130 +/- 130 min) and was influenced only by the patient's PaO(2).
Authors: Laura E Fredenburgh; Mark A Perrella; Diana Barragan-Bradford; Dean R Hess; Elizabeth Peters; Karen E Welty-Wolf; Bryan D Kraft; R Scott Harris; Rie Maurer; Kiichi Nakahira; Clara Oromendia; John D Davies; Angelica Higuera; Kristen T Schiffer; Joshua A Englert; Paul B Dieffenbach; David A Berlin; Susan Lagambina; Mark Bouthot; Andrew I Sullivan; Paul F Nuccio; Mamary T Kone; Mona J Malik; Maria Angelica Pabon Porras; Eli Finkelsztein; Tilo Winkler; Shelley Hurwitz; Charles N Serhan; Claude A Piantadosi; Rebecca M Baron; B Taylor Thompson; Augustine Mk Choi Journal: JCI Insight Date: 2018-12-06
Authors: Ivan Azarov; Ling Wang; Jason J Rose; Qinzi Xu; Xueyin N Huang; Andrea Belanger; Ying Wang; Lanping Guo; Chen Liu; Kamil B Ucer; Charles F McTiernan; Christopher P O'Donnell; Sruti Shiva; Jesús Tejero; Daniel B Kim-Shapiro; Mark T Gladwin Journal: Sci Transl Med Date: 2016-12-07 Impact factor: 17.956
Authors: Jason J Rose; Ling Wang; Qinzi Xu; Charles F McTiernan; Sruti Shiva; Jesus Tejero; Mark T Gladwin Journal: Am J Respir Crit Care Med Date: 2017-03-01 Impact factor: 21.405