Reversible cardiac failure in an adolescent after prolonged exposure to carbon monoxide.
We describe the case of an adolescent who developed a severe but fully reversible cardiac dysfunction with low blood levels of carboxy haemoglobin (COHb = 10%) after a prolonged exposure to carbon monoxide. A 15-year-old male was admitted with a Glasgow Coma Scale of 8/15 with suspected postictal state and postanoxic encephalopathy. The cardiorespiratory failure which he developed soon after admission mandated mechanical ventilation, inotropic support and ultimately left ventricular support by intra-aortic balloon counterpulsation. The cardiac dysfunction was documented by radionuclide imaging and echocardiography. The patient fully recovered without neurological deficit. A low blood COHb concentration is a poor safety indicator since high tissue levels of accumulated carbon monoxide can be associated with coma and fulminant cardiorespiratory failure requiring advanced life support facilities.
Diltoer
M W
MW
Intensive Care Department, University Hospital, Vrije Universiteit Brussel, Belgium.
Colle
I O
IO
Hubloue
I
I
Ramet
J
J
Spapen
H D
HD
Nguyen
N
N
Huyghens
L P
LP
D000061:Accidents, Home; D000293:Adolescent; D002249:Carbon Monoxide Poisoning / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D002263:Carboxyhemoglobin / Q000032:analysis*; D002303:Cardiac Output, Low / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D018572:Disease-Free Survival; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D012121:Respiration, Artificial; D013997:Time Factors
D002263:Carboxyhemoglobin