Carbon Monoxide Poisoning

Am J Respir Crit Care Med. 2015 Jul 27. [Epub ahead of print]

Pulmonary Phototherapy for Treating Carbon Monoxide Poisoning.

Zazzeron L1, Liu C2, Franco W3, Nakagawa A4, Farinelli WA5, Bloch DB6,7, Anderson RR8, Zapol WM9.

Author information

  • 1Massachusetts General Hospital and Harvard Medical School, Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine, Boston, Massachusetts, United States ; lzazzeron@partners.org.
  • 2Massachusetts General Hospital and Harvard Medical School, Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine, Boston, Massachusetts, United States ; cliu26@partners.org.
  • 3Massachusetts General Hospital and Harvard Medical School, Wellman Center for Photomedicine, Department of Dermatology, Boston, Massachusetts, United States ; wfranco@partners.org.
  • 4Massachusetts General Hospital and Harvard Medical School, Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine, Boston, Massachusetts, United States ; anakagawa@partners.org.
  • 5Massachusetts General Hospital and Harvard Medical School, Wellman Center for Photomedicine, Department of Dermatology, Boston, Massachusetts, United States ; bfarinelli@partners.org.
  • 6Massachusetts General Hospital and Harvard Medical School, Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine, Boston, Massachusetts, United States.
  • 7Massachusetts General Hospital and Harvard Medical School, Division of Rheumatology, Allergy and Immunology, Department of Medicine, Boston, Massachusetts, United States ; bloch@helix.mgh.harvard.edu.
  • 8Massachusetts General Hospital and Harvard Medical School, Wellman Center for Photomedicine, Department of Dermatology, Boston, Massachusetts, United States ; rranderson@partners.org.
  • 9Massachusetts General Hospital, Harvard Medical School, Dep. of Anesthesia and Critical Care , 55 Fruit Street , Boston, Massachusetts, United States , 02114 , (617) 726 3030 , (617) 726 3032 ; wzapol@partners.org.

Abstract

RATIONALE:

Carbon monoxide (CO) exposure is a leading cause of poison-related mortality. CO binds to hemoglobin (Hb) forming carboxyhemoglobin (COHb) and produces tissue damage. Treatment of CO poisoning requires rapid removal of CO and restoration of oxygen delivery. Visible light is known to effectively dissociate CO from Hb, with a single photon dissociating one CO molecule.

OBJECTIVES:

To determine whether illumination of the lungs of CO-poisoned mice will cause dissociation of COHb from blood transiting the lungs releasing CO into alveoli, thereby enhancing the rate of CO elimination.

METHODS:

We developed a model of CO poisoning in anesthetized and mechanically ventilated mice to assess the effects of direct lung illumination (phototherapy) on the CO elimination rate. Light at wavelengths between 532 and 690 nm was tested. The effect of lung phototherapy administered during CO poisoning was also studied. To avoid a thoracotomy, we assessed the effect of lung phototherapy delivered to murine lungs via an optical-fiber placed in the esophagus.

MEASUREMENTS AND MAIN RESULTS:

In CO-poisoned mice, phototherapy of exposed lungs at 532, 570, 592 and 628 nm dissociated CO from Hb and doubled the CO elimination rate. Phototherapy administered during severe CO poisoning limited the blood COHb increase and improved the survival rate. Non-invasive trans-esophageal phototherapy delivered to murine lungs via an optical-fiber increased the rate of CO elimination while avoiding a thoracotomy.

CONCLUSIONS:

Future development and scaling-up of lung phototherapy for patients with CO exposure may provide a significant advance for treating and preventing CO poisoning.

Klin Khir. 1998;(11):21-3.

 

Intensive therapy in burns and carbon monoxide poisoning.

[Article in Russian]

Grigor'eva TG, Balenko AA.

While treatment conduction of 38 patients with severe burns and poisoning with carbonic oxide in complex of antishock measures there was applied a nondirect electrochemical oxidation of blood and internal laser irradiation of blood. There was used He-Nd laser. The mortality lowering by 3.3 times in comparison with 40 patients, in whom the traditional intensive therapy was applied, was noted.