Yanagawa Youichi
Department of Traumatology and Critical Care Medicine, National Defense Medical College, 3-2 Namiki Tokorozawa, Japan.
J Emerg Trauma Shock. 2012 Oct;5(4):338-41. doi: 10.4103/0974-2700.102405.
At low concentrations, carbon monoxide (CO) can confer cyto and tissue-protective effects, such as endogenous Heme oxygenase 1 expression, which has antioxidative, anti-inflammatory, antiproliferative, and antiapoptotic effects. The level of carboxyhemoglobin in the blood is an indicator of the endogenous production of CO and inhaled CO.
To investigate the significance of the value of carboxyhemoglobin for out-of-hospital (OH) cardiopulmonary arrest (CPA).
This study involved a medical chart review of cases treated from January to December 2005. The inclusion criteria included a patient who was transported to this department due to an OH CPA. The exclusion criteria included a patient who did not undergo blood gas analysis on arrival and who experienced CPA due to acute carbon monoxide intoxication. The subjects were divided into two groups based on their final outcome of either survival or non-survival.
There was no significant difference associated with the sex, age, frequency of witness collapse, bystander cardiopulmonary arrest, electrocardiogram at scene, cause of CPA, value of PCO(2), HCO(3) (-), and methemoglobin. The frequency of OH return of spontaneous circulation and the value of pH, PO(2), base excess, and carboxyhemoglobin in the survival group were greater than those values in the non-survival group. There were no subjects whose carboxyhemoglobin level was 0% on arrival in the survival groups.
There appeared to be an association between higher carboxyhemoglobin levels and survival in comparison with non-survival patients.
在低浓度时，一氧化碳（CO）可发挥细胞和组织保护作用，如内源性血红素加氧酶1的表达，该酶具有抗氧化、抗炎、抗增殖和抗凋亡作用。血液中碳氧血红蛋白水平是内源性CO产生和吸入CO的指标。
探讨碳氧血红蛋白值对院外（OH）心肺骤停（CPA）的意义。
本研究对2005年1月至12月治疗的病例进行病历回顾。纳入标准包括因院外CPA被转运至本科室的患者。排除标准包括到达时未进行血气分析以及因急性一氧化碳中毒导致CPA的患者。根据最终结局是存活还是未存活将受试者分为两组。
在性别、年龄、目击心跳骤停频率、旁观者心肺复苏、现场心电图、CPA病因、PCO₂值、HCO₃⁻和高铁血红蛋白方面无显著差异。存活组院外自主循环恢复频率以及pH值、PO₂、碱剩余和碳氧血红蛋白值均高于未存活组。存活组中没有患者到达时碳氧血红蛋白水平为0%。
与未存活患者相比，较高的碳氧血红蛋白水平似乎与存活有关。
