J Korean Soc Clin Toxicol.  2019 Dec;17(2):86-93. 10.22537/jksct.2019.17.2.86.

PaCOâ‚‚ at Early Stage is Associated with Adverse Cardiovascular Events in Acute Carbon Monoxide Poisoning

Affiliations
  • 1Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Korea. emdrmjm@gmail.com

Abstract

PURPOSE
The objective was to determine the association between PaCOâ‚‚ and adverse cardiovascular events (ACVEs) in carbon monoxide (CO)-poisoned patients.
METHODS
This retrospective study included 194 self-breathing patients after CO poisoning with an indication for hyperbaric oxygen therapy and available arterial blood gas analysis at presentation and 6 hours later. The baseline characteristics and clinical course during hospitalization were collected and compared. The mean PaCOâ‚‚ during the first 6 hours after presentation was calculated.
RESULTS
The incidence rates of moderate (30 mmHg< PaCO₂<35 mmHg) or severe (PaCO₂≤30 mmHg) hypocapnia at presentation after acute CO poisoning were 40.7% and 26.8%, respectively. The mean PaCO₂ during the first 6 hours was 33 (31–36.7) mmHg. The incidence of ACVEs during hospitalization was 50.5%. A significant linear trend in the incidence of ACVEs was observed across the total ranges of PaCO₂ variables. In multivariate regression analysis, mean PaCO₂ was independently associated with ACVEs (OR 0.798 (95% CI 0.641–0.997)).
CONCLUSION
Mean PaCOâ‚‚ during the first 6 hours was associated with increased ACVEs. Given the high incidence of ACVEs and PaCOâ‚‚ derangement and the observed association between PaCOâ‚‚ and ACVEs, this study suggests that 1) PaCOâ‚‚ should be monitored at the acute stage to predict and/or prevent ACVEs; and 2) further study is needed to validate this result and investigate early manipulation of PaCOâ‚‚ as treatment.

Keyword

Carbon monoxide; Carbon dioxide; Poisoning; Blood gas analysis
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