Tuo Lingling, Zhang Aifeng, Li Xinyun, Zhao Jiejin
The First People's Hospital of Xiaoshan District, Hangzhou, China.
School of Rehabilitation, Hangzhou Medical College, Hangzhou, China.
Medicine (Baltimore). 2025 Jun 27;104(26):e42934. doi: 10.1097/MD.0000000000042934.
Hyperkalemia and acute carbon monoxide (CO) poisoning are both life-threatening conditions. When these conditions coexist, there is a debate on whether hemodialysis or hyperbaric oxygen (HBO) therapy should be prioritized. Our discussion suggests that HBO therapy may help by lowering residual carbon dioxide levels and correcting electrolyte imbalances, consequently decreasing the risks linked to both CO poisoning and hyperkalemia.
A 25-year-old man presented with hyperkalemia and CO poisoning. He was promptly taken to the emergency room where he received immediate interventions including intravenous infusion of 5% sodium bicarbonate solution, glucose plus insulin, diuretics, and calcium supplementation in a HBO environment. Subsequently, hemodialysis was performed. Following this treatment protocol, the patient showed significant improvements in hyperkalemia, CO levels, general weakness, cardiac arrhythmias, and other symptoms. This sequential therapy effectively eliminated the remaining CO in his system and addressed the electrolyte imbalances crucial to his recovery. After 4 weeks of comprehensive treatment, the patient's hyperkalemia and CO poisoning issues were successfully resolved.
Based on the thorough history, electrocardiographs and the laboratory tests.
The interventions included intravenous infusion of 5% sodium bicarbonate solution, glucose plus insulin, diuretics, calcium supplementation in a HBO environment, and followed by hemodialysis.
The following clinical improvements were detected: consciousness was clear; the cardiac arrhythmia symptoms were improved (electrocardiograph became normal); normal electrolytes with no other abnormalities; displayed no nervous system symptoms.
Sequential treatment of intravenous fluid rehydration, HBO, hemodialysis may be effective in treating patients with hyperkalemia combined with CO poisoning.
高钾血症和急性一氧化碳（CO）中毒均为危及生命的病症。当这两种情况并存时，对于应优先进行血液透析还是高压氧（HBO）治疗存在争议。我们的讨论表明，HBO治疗可能通过降低残余二氧化碳水平和纠正电解质失衡来发挥作用，从而降低与CO中毒和高钾血症相关的风险。
一名25岁男性出现高钾血症和CO中毒。他被迅速送往急诊室，在那里接受了包括在HBO环境下静脉输注5%碳酸氢钠溶液、葡萄糖加胰岛素、利尿剂和补钙在内的紧急干预措施。随后进行了血液透析。按照此治疗方案，患者在高钾血症、CO水平、全身无力、心律失常及其他症状方面均有显著改善。这种序贯治疗有效清除了其体内残留的CO，并解决了对其康复至关重要的电解质失衡问题。经过4周的综合治疗，患者的高钾血症和CO中毒问题得到成功解决。
基于详尽的病史、心电图及实验室检查。
干预措施包括静脉输注5%碳酸氢钠溶液、葡萄糖加胰岛素、利尿剂，在HBO环境下补钙，随后进行血液透析。
检测到以下临床改善情况：意识清醒；心律失常症状改善（心电图恢复正常）；电解质正常，无其他异常；无神经系统症状。
静脉补液、HBO、血液透析的序贯治疗可能对治疗高钾血症合并CO中毒的患者有效。
