Unexpected carboxyhemoglobin half-life during cardiopulmonary resuscitation: a case report.
(2023) International Journal of Emergency Medicine — Vol. 16, n° 1, p. 22 [1-5] (2023)
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- Authors
Delvau, Nicolas 
- Abstract
- BACKGROUND: Cardiac arrest (CA) following CO poisoning (CO-induced CA) exposes patients to an extremely high risk of mortality and remains challenging to treat effectively. Terminal carboxyhemoglobin elimination half-life (COHbt1/2) is critically affected by ventilation, oxygen therapy, and cardiac output, which are severely affected conditions in cases of CA. CASE PRESENTATION: Asystole occurred in an 18-year-old woman after unintentional exposure to CO in her bathroom. Cardiopulmonary resuscitation (CPR) was started immediately, including mechanical ventilation with a fraction of inspired oxygen (FiO2) of 1.0 and external chest compressions with a LUCAS® device. CPR was stopped after 101 min, as it was unsuccessful. During this period, we calculated a COHbt1/2 of 40.3 min using a single compartmental model. CONCLUSIONS: This result suggests that prolongation of CPR time needed to back COHb at 10%, a level more compatible with successful return of spontaneous circulation (ROSC), could be compatible with a realistic CPR time. Calculating COHbt1/2 during CPR may help with decision-making regarding the optimal duration of resuscitation efforts and further with HBO2 or ECLS. Further evidence-based data are needed to confirm this result.
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Citations
Delvau, N., Penaloza-Baeza, A., Franssen, V., Thys, F., Roy, P.-M., & Hantson, P. (2023). Unexpected carboxyhemoglobin half-life during cardiopulmonary resuscitation: a case report. International Journal of Emergency Medicine, 16(1), 22 [1-5]. https://doi.org/10.1186/s12245-023-00492-2 (Original work published 2023)