Brown D B, Golich F C, Tappel J J, Dykstra T A, Ott D A
92nd Medical Group Hospital, Fairchild AFB, WA, USA.
Aviat Space Environ Med. 1996 Mar;67(3):262-5.
A 10-yr-old female presented at Deaconess Medical Center, Spokane WA, comatose after being rescued from a house fire. Her carboxyhemoglobin was 48%. An 11-yr-old playmate presented with a carboxyhemoglobin level of 51% and later expired. Our patient was treated with hyperbaric oxygen therapy and manual artificial ventilation for 2.5 h. She recovered fully, and 7 mo later has had no neurologic deficits. Carbon monoxide bonds to the hemoglobin more tightly than oxygen, displacing the oxygen hemoglobin dissociation curve to the left and resulting in tissue hypoxia and hypotension. Carbon monoxide also exerts a negative influence on the electron transport chain, may lead to delayed neurologic sequelae because of free radical formation, and produces profound changes in the myocardium. Once seen as a capricious treatment for many symptoms, hyperbaric oxygen therapy is now an accepted treatment for carbon monoxide poisoning. The outcome suggests that in a patient whose prognosis is grave, a good outcome may be achieved with aggressive HBO therapy.
一名10岁女性在华盛顿州斯波坎市的迪肯斯医疗中心就诊，她从一场房屋火灾中获救后昏迷不醒。她的碳氧血红蛋白水平为48%。一名11岁的玩伴碳氧血红蛋白水平为51%，后来死亡。我们的患者接受了高压氧治疗和手动人工通气2.5小时。她完全康复，7个月后没有神经功能缺损。一氧化碳与血红蛋白的结合比氧气更紧密，使氧合血红蛋白解离曲线向左移动，导致组织缺氧和低血压。一氧化碳还对电子传递链产生负面影响，可能由于自由基形成导致迟发性神经后遗症，并使心肌发生深刻变化。高压氧治疗曾经被视为对许多症状的随意治疗方法，现在已成为一氧化碳中毒的公认治疗方法。结果表明，对于预后严重的患者，积极的高压氧治疗可能会取得良好的效果。
