title: Reversible cardiac failure in an adolescent after prolonged exposure to carbon monoxide.
abstract: 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.
authors.affiliation: Intensive Care Department, University Hospital, Vrije Universiteit Brussel, Belgium.
authors.forename: M W
authors.initials: MW
authors.lastname: Diltoer
authors.forename: I O
authors.initials: IO
authors.lastname: Colle
authors.forename: I
authors.initials: I
authors.lastname: Hubloue
authors.forename: J
authors.initials: J
authors.lastname: Ramet
authors.forename: H D
authors.initials: HD
authors.lastname: Spapen
authors.forename: N
authors.initials: N
authors.lastname: Nguyen
authors.forename: L P
authors.initials: LP
authors.lastname: Huyghens
mesh_terms: 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
chemical_list: D002263:Carboxyhemoglobin