Treatment of Acute Carbon Monoxide Poisoning with Extracorporeal Membrane Trioxygenation

Abstract

Objective

To treat acute carbon monoxide poisoning (ACOP) with extracorporeal membrane trioxygenation (ECMO₃), and to determine the efficacy and safety of ECMO₃.

Method

Thirty-two New Zealand white rabbits were divided randomly into four groups including ECMO₃ group (G1-ECMO₃) oxygen treatment group (G2–FIO₂), untreated ACOP group (G3-ACOP), and control group (G4-control). Rabbits in the first three groups were intraperitoneally injected with 99.99% CO at a dosage of 200 ml/kg, and those in the control group were treated with placebo. The dynamic changes in carboxyhemoglobin (COHb) concentration, blood oxygen saturation (SO₂) level, base excess of blood (BE-B) as well as the vital signs of the rabbits were monitored.

Results

All the experimental rabbits had significantly higher levels of COHb (p = 0.000<0.05) than those in the control group after 30 min of CO injection with poisoning reactions. The respiration and heart rate of the rabbits in the ECMO₃ group and FIO₂ group were recovered to a level close to those of the rabbits in the control group by the end of the treatment, and they were significantly lower than those in the ACOP group (p = 0.000, <0.05). The COHb levels of rabbits in the G1–ECMO₃ group were significantly lower than those in the G2-FIO₂ and the G3-ACOP groups (F = 42.799, p = 0.000), and were similar to those in the control group. After 0.5 h of treatment, the SO₂ and BE-B levels of rabbits in the G1-ECMO₃ and the G2-FIO₂ groups were higher than those in the G3-ACOP group (p<0.05, p = 0.000<0.05).

Conclusions

ECMO₃ treatment effectively lowered the COHb levels, increased SO₂ levels, and cured acid poisoning, making it a safe and promising ACOP treatment strategy.