TY - JOUR
T1 - Carbon monoxide poisoning in a young, healthy patient
T2 - A case study of heart failure recovery after Hyperbaric Oxygenation Treatment
AU - Kuniavsky, Michael
AU - Bechor, Yair
AU - Leitman, Marina
AU - Efrati, Shai
N1 - Publisher Copyright:
© 2018 Elsevier Ltd
PY - 2018/8
Y1 - 2018/8
N2 - The effectiveness of hyperbaric oxygen treatment for acute cardiac diseases is unknown. Similarly, the effectiveness of hyperbaric oxygen treatment for carbon monoxide intoxication is also unknown, particularly for cases in which carboxyhemoglobin (COHb) levels return to normal. Our case study revolved around a healthy twenty-year-old male patient, who suffered from carbon monoxide intoxication. The patient presented to the Emergency Department unconscious. Blood workup revealed significant carbon monoxide intoxication and cardiac injury (COHb = 41%, troponin T = 0.38 ng/dl, ST depression). He was intubated and transferred to a specialist Centre for hyperbaric oxygenation treatment, whilst mechanically ventilated. COHb on arrival (5 hours later) was 4.3%. First echocardiography revealed estimated ejection fraction of 30%, moderate-severe left ventricular dysfunction and global hypokinesis. Patient received 3 rounds of HBOT; each round was 2.4 ATA, 100% O2 and 120 minutes long within the following 24 hours. Afterwards, the patient was successfully extubated. Three days later, a second echocardiography showed remarkable improvement with normal left ventricular size and function. The patient discharged the following day without complaints or the need for long-term medication. Hyperbaric treatment for carbon monoxide intoxication with compromised cardiac function should be considered even when carboxyhaemoglobin levels have returned to normal. This is due to mitochondrial impairment caused by carbon monoxide intoxication that eventually can lead to significant cardiac deterioration.
AB - The effectiveness of hyperbaric oxygen treatment for acute cardiac diseases is unknown. Similarly, the effectiveness of hyperbaric oxygen treatment for carbon monoxide intoxication is also unknown, particularly for cases in which carboxyhemoglobin (COHb) levels return to normal. Our case study revolved around a healthy twenty-year-old male patient, who suffered from carbon monoxide intoxication. The patient presented to the Emergency Department unconscious. Blood workup revealed significant carbon monoxide intoxication and cardiac injury (COHb = 41%, troponin T = 0.38 ng/dl, ST depression). He was intubated and transferred to a specialist Centre for hyperbaric oxygenation treatment, whilst mechanically ventilated. COHb on arrival (5 hours later) was 4.3%. First echocardiography revealed estimated ejection fraction of 30%, moderate-severe left ventricular dysfunction and global hypokinesis. Patient received 3 rounds of HBOT; each round was 2.4 ATA, 100% O2 and 120 minutes long within the following 24 hours. Afterwards, the patient was successfully extubated. Three days later, a second echocardiography showed remarkable improvement with normal left ventricular size and function. The patient discharged the following day without complaints or the need for long-term medication. Hyperbaric treatment for carbon monoxide intoxication with compromised cardiac function should be considered even when carboxyhaemoglobin levels have returned to normal. This is due to mitochondrial impairment caused by carbon monoxide intoxication that eventually can lead to significant cardiac deterioration.
KW - CO intoxication
KW - Case study
KW - Heart failure recovery
KW - Hyperbaric Oxygenation Treatment
UR - http://www.scopus.com/inward/record.url?scp=85046792651&partnerID=8YFLogxK
U2 - 10.1016/j.iccn.2018.04.008
DO - 10.1016/j.iccn.2018.04.008
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C2 - 29753599
AN - SCOPUS:85046792651
SN - 0964-3397
VL - 47
SP - 85
EP - 88
JO - Intensive and Critical Care Nursing
JF - Intensive and Critical Care Nursing
ER -