Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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PaCO2 at Early Stage is Associated with Adverse Cardiovascular Events in Acute Carbon Monoxide Poisoning

급성 일산화탄소 중독 환자에서 응급실 내원 초기 동맥혈 이산화탄소 분압의 임상적 의미

  • Yang, Keun Mo (Department of Emergency Medicine, Chonnam National University Medical School) ;
  • Chun, Byeong Jo (Department of Emergency Medicine, Chonnam National University Medical School) ;
  • Moon, Jeong Mi (Department of Emergency Medicine, Chonnam National University Medical School) ;
  • Cho, Young Soo (Department of Emergency Medicine, Chonnam National University Medical School)
  • 양근모 (전남대학교 의과대학 응급의학교실) ;
  • 전병조 (전남대학교 의과대학 응급의학교실) ;
  • 문정미 (전남대학교 의과대학 응급의학교실) ;
  • 조용수 (전남대학교 의과대학 응급의학교실)
  • Received : 2019.12.03
  • Accepted : 2019.12.19
  • Published : 2019.12.31
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Abstract

Purpose: The objective was to determine the association between PaCO2 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 PaCO2 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 PaCO2 during the first 6 hours was associated with increased ACVEs. Given the high incidence of ACVEs and PaCO2 derangement and the observed association between PaCO2 and ACVEs, this study suggests that 1) PaCO2 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 PaCO2 as treatment.

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References

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