Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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A Preliminary Study for Effect of High Flow Oxygen through Nasal Cannula Therapy in Carbon Monoxide Poisoning

일산화탄소 중독 환자에서 고유속 비강 캐뉼라 산소치료 효과에 대한 예비 연구

  • Kim, Young-Min (Department of Emergency Medicine, Chungbuk National University, School of Medicine, Chungbuk National University Hospital) ;
  • Kim, Sang-Chul (Department of Emergency Medicine, Chungbuk National University, School of Medicine, Chungbuk National University Hospital) ;
  • Park, Kwan-Jin (Department of Emergency Medicine, Chungbuk National University, School of Medicine, Chungbuk National University Hospital) ;
  • Lee, Seok-Woo (Department of Emergency Medicine, Chungbuk National University, School of Medicine, Chungbuk National University Hospital) ;
  • Lee, Ji-Han (Department of Emergency Medicine, Chungbuk National University, School of Medicine, Chungbuk National University Hospital) ;
  • Kim, Hoon (Department of Emergency Medicine, Chungbuk National University, School of Medicine, Chungbuk National University Hospital)
  • 김영민 (충북대학교 의과대학 충북대학교병원 응급의학과) ;
  • 김상철 (충북대학교 의과대학 충북대학교병원 응급의학과) ;
  • 박관진 (충북대학교 의과대학 충북대학교병원 응급의학과) ;
  • 이석우 (충북대학교 의과대학 충북대학교병원 응급의학과) ;
  • 이지한 (충북대학교 의과대학 충북대학교병원 응급의학과) ;
  • 김훈 (충북대학교 의과대학 충북대학교병원 응급의학과)
  • Received : 2019.06.28
  • Accepted : 2019.07.30
  • Published : 2019.12.31
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Abstract

Purpose: Acute carbon monoxide (CO) poisoning is one of the most common types of poisoning and a major health problem worldwide. Treatment options are limited to normobaric oxygen therapy, administered using a non-rebreather face mask or hyperbaric oxygen. Compared to conventional oxygen therapy, high-flow nasal cannula oxygen (HFNC) creates a positive pressure effect through high-flow rates. The purpose of this human pilot study is to determine the effects of HFNC on the rate of CO clearance from the blood, in patients with mild to moderate CO poisoning. Methods: CO-poisoned patients were administered 100% oxygen from HFNC (flow of 60 L/min). The fraction of COHb (fCOHb) was measured at 30-min intervals until it decreased to under 10%, and the half-life time of fCOHb (fCOHb t1/2) was subsequently determined. Results: At the time of ED arrival, a total of 10 patients had fCOHb levels ≥10%, with 4 patients ranging between 10% and 50%. The mean rate of fCOHb elimination patterns exhibits logarithmic growth curves that initially increase quickly with time (HFNC equation, Y=0.3388*X+11.67). The mean fCOHbt1/2 in the HFNC group was determined to be 48.5±12.4 minutes. Conclusion: In patients with mild to moderate CO poisoning, oxygen delivered via high flow nasal cannula is a safe and comfortable method to treat acute CO toxicity, and is effective in reducing the COHb half-life. Our results indicate HFNC to be a promising alternative method of delivering oxygen for CO toxicity. Validating the effectiveness of this method will require larger studies with clinical outcomes.

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References

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