Hyperventilation with Maintenance of Isocapnia. An "Old New" Method in Carbon Monoxide Intoxication

• Published in: PloS one 2017-01, Vol.12 (1), p.e0170621
• Main Authors: Sein Anand, Jacek, Schetz, Daria, Waldman, Wojciech, Wiśniewski, Marek
• Format: Article
• Language: English
• Subjects: Adult; Alkalosis; Bioethics; Biology and Life Sciences; Blood Pressure; Carbon dioxide; Carbon Dioxide - administration & dosage; Carbon Dioxide - therapeutic use; Carbon monoxide; Carbon Monoxide - blood; Carbon monoxide poisoning; Carbon Monoxide Poisoning - therapy; Carboxyhemoglobin; Carboxyhemoglobin - analysis; Care and treatment; Dyspnea; Environmental health; Exposure; Female; Headache; Heart diseases; Heart Rate; Humans; Hyperbaric oxygen therapy; Hyperventilation; Intoxication; Isocapnia; Male; Medicine and Health Sciences; Middle Aged; Oxygen; Oxygen - administration & dosage; Oxygen - blood; Oxygen - therapeutic use; Oxygen therapy; Patients; Physical Sciences; Respiration; Risk factors; Side effects; Smoking; Therapy; Toxicology; Ventilation
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0170621

Exposure to carbon monoxide (CO) is among the most common causes of acute and chronic poisonings worldwide. The crucial point of treatment of such acute poisonings is to eliminate CO from the body as fast as possible. There are currently two approaches to the management of the CO intoxication: hyperbaric oxygen therapy (HOT) and normobaric oxygen therapy (NOT). HOT is highly effective and capable of achieving the CO elimination half-time (T½) as low as 15 minutes. Unfortunately this method is expensive and not always readily available. The elimination of CO with the use of NOT (T½~70 min) is slower, but treatment can be started even on the site of the exposure and continued while the patient is transported to a hospital. The aim of the study was to evaluate the effectiveness of a method using therapeutic hyperventilation with maintenance of isocapnia (IH) in the elimination of CO in volunteers exposed to CO and to compare selected gasometric and respiratory parameters during IH with the values obtained during hyperventilation with pure oxygen ("non-isocapnic hyperventilation"-NIH). The study involved 13 healthy, chronically-smoking volunteers. Each of them participated in two independent hyperventilation tests: IH and NIH. The levels of carboxyhemoglobin (COHb) and selected gasometric, cardiac and respiratory parameters were measured at 0, 10 and 20 minutes during both tests. Among 13 volunteers (8 women and 5 men) the initial COHb level was 5.0±1.5% (mean±SD) before the IH tests and 5.1±1.9% before the NIH tests (p>0.05). After 20 minutes of the procedures the mean COHb level was 2.9±0.9% for IH and 3.6±1.2% for NIH (p