title: Therapeutic red cell exchange for severe carbon monoxide poisoning.
abstract: OBJECTIVE
  Carbon monoxide (CO) is the most common cause of fatal poisoning worldwide. Therapeutic red cell exchange (TREX) has been used in the treatment of many different diseases. Therefore, we aimed to evaluate the efficacy of TREX on the clinical status, outcome, and discharge of patients with severe CO poisoning.
  
  
  METHODS
  Demographic data, clinical status, and outcomes of 12 patients that were treated with TREX for severe CO poisoning after referral to the Emergency and Hematology Departments of Gaziantep University between November 2011 and April 2012 were evaluated.
  
  
  RESULTS
  Mean carboxyhemoglobin level decreased from (59.7 ± 12.7)% (38-79%) to (17 ± 9.4)% (8-43%), and mean Glasgow Coma Scale score increased from 4 ± 1.6 (3-8) to 9.4 ± 3.5 (3-14) after TREX therapy. Five patients were admitted to the intensive care unit. Rhabdomyolysis developed in one case. Of the 12 patients, 11 were discharged alive, and one patient died.
  
  
  CONCLUSIONS
  TREX may be an alternative treatment method for reducing mortality and morbidity in cases of severe CO poisoning.
authors.affiliation: Department of Emergency, Gaziantep University School of Medicine, Gaziantep, Turkey.
authors.forename: Suat
authors.initials: S
authors.lastname: Zengin
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yılmaz
authors.forename: Behcet
authors.initials: B
authors.lastname: Al
authors.forename: Cuma
authors.initials: C
authors.lastname: Yildirim
authors.forename: Erdal
authors.initials: E
authors.lastname: Yavuz
authors.forename: Aycan
authors.initials: A
authors.lastname: Akcali
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002249:Carbon Monoxide Poisoning / Q000628:therapy*; D002263:Carboxyhemoglobin / Q000737:chemistry; D003243:Consciousness; D016238:Cytapheresis; D017707:Erythrocyte Transfusion; D004912:Erythrocytes / Q000166:cytology; D005078:Exchange Transfusion, Whole Blood; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012206:Rhabdomyolysis / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002263:Carboxyhemoglobin
keywords: carbon monoxide poisoning; emergency department; therapeutic red cell exchange