Cardiac injury after acute carbon monoxide poisoning and its clinical treatment scheme

This study was designed to investigate cardiac injury after acute carbon monoxide poisoning and its clinical treatment scheme. Seventy patients with moderate and severe acute carbon monoxide poisoning (ACOP) admitted from January 2017 to December 2018 into The Affiliated Hospital of Qingdao University were regarded as a research group (RG), and another 30 healthy adults undergoing physical examination in the hospital during the same period were selected as a control group (CG). Thirty-five patients in the RG who received hyperbaric oxygen therapy were considered as group A, and 35 patients who received extracorporeal membrane oxygenation therapy were considered as group B. The effective rates and complications of the two groups after treatment were compared. The concentrations of creatine kinase isoenzyme (CK-MB) and lactate dehydrogenase (LDH) of myocardial enzymes at different time points before and after treatment were detected. Expression of miR-30a in the blood of experimental subjects was detected by time-fluorescence quantitative PCR, and the relationship between miR-30a expression and ACOP patients was analyzed. Patients in groups A and B achieved obvious efficacy, but the effective rate and incidence rate of complications in the extracorporeal membrane oxygenation (ECMO) group were better than those in the hyperbaric oxygen group. The concentrations of CK-MB and LDH in group A and group B were significantly higher than those in control group (P<0.01). The expression level of miR-30a in the RG was significantly higher than that in the control group (P<0.05). Both hyperbaric oxygen therapy and ECMO therapy have obvious efficacy on ACOP patients, but the latter is better than the former. The expression level of miR-30a in blood of ACOP patients increased significantly, which is positively correlated with myocardial injury, and it decreased after treatment. It is believed that miR-30a can provide a reference index for early diagnosis and prediction of disease progression and prognosis in cardiac injury of ACOP.

[1]  H. Yasunaga,et al.  Hyperbaric oxygen therapy and mortality from carbon monoxide poisoning: A nationwide observational study. , 2020, The American journal of emergency medicine.

[2]  J. Varon,et al.  Effectiveness of Hyperbaric Oxygenation Versus Normobaric Oxygenation Therapy in Carbon Monoxide Poisoning: A Systematic Review , 2019, Cureus.

[3]  A. Asiri,et al.  Management of carbon monoxide poisoning-induced cardiac failure and multiorgan dysfunction with combined respiratory and circulatory extracorporeal membrane oxygenation , 2019, Saudi Critical Care Journal.

[4]  C. Simonsen,et al.  ECMO improves survival following cardiogenic shock due to carbon monoxide poisoning - an experimental porcine model , 2018, Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.

[5]  Mei-Yi Wu,et al.  Treatment with normobaric or hyperbaric oxygen and its effect on neuropsychometric dysfunction after carbon monoxide poisoning , 2018, Medicine.

[6]  N. Huang,et al.  Myocardial injury was associated with neurological sequelae of acute carbon monoxide poisoning in Taiwan , 2018, Journal of the Chinese Medical Association : JCMA.

[7]  Yan Kang,et al.  Bioinformatic Analysis of the Possible Regulative Network of miR-30a/e in Cardiomyocytes 2 Days Post Myocardial Infarction. , 2018, Acta Cardiologica Sinica.

[8]  W. Aronow,et al.  Cardiovascular Abnormalities in Carbon Monoxide Poisoning , 2014, American journal of therapeutics.

[9]  How-Ran Guo,et al.  Hyperbaric Oxygen Therapy Is Associated With Lower Short‐ and Long‐Term Mortality in Patients With Carbon Monoxide Poisoning , 2017, Chest.

[10]  V. Arıca,et al.  Epidemiology, pathophysiology, clinical evaluation, and treatment of carbon monoxide poisoning in child, infant, and fetus , 2017, Northern clinics of Istanbul.

[11]  M. Gladwin,et al.  Carbon Monoxide Poisoning: Pathogenesis, Management, and Future Directions of Therapy , 2017, American journal of respiratory and critical care medicine.

[12]  Jun Zhang,et al.  Combined application of dexamethasone and hyperbaric oxygen therapy yields better efficacy for patients with delayed encephalopathy after acute carbon monoxide poisoning , 2017, Drug design, development and therapy.

[13]  Andrea Morelli,et al.  Venovenous extracorporeal membrane oxygenation for acute respiratory failure , 2016, Intensive Care Medicine.

[14]  Xiang Cheng,et al.  Exosomal transfer of miR-30a between cardiomyocytes regulates autophagy after hypoxia , 2016, Journal of Molecular Medicine.

[15]  Yishan Luo,et al.  Role of MiR-30a in cardiomyocyte autophagy induced by Angiotensin II , 2015, Journal of the renin-angiotensin-aldosterone system : JRAAS.

[16]  S. Choi,et al.  Acute carbon monoxide poisoning and delayed neurological sequelae: a potential neuroprotection bundle therapy , 2015, Neural regeneration research.

[17]  Su Wan Kim,et al.  Application of veno-arterial-venous extracorporeal membrane oxygenation in differential hypoxia , 2014, Multidisciplinary Respiratory Medicine.

[18]  N. Safaie,et al.  High Creatine Kinase (CK)-MB and Lactate Dehydrogenase in the Absence of Myocardial Injury or Infarction: A Case Report , 2014, Journal of cardiovascular and thoracic research.

[19]  K. Kohshi.  [Diagnosis and treatment for carbon monoxide poisoning]. , 2007, Chudoku kenkyu : Chudoku Kenkyukai jun kikanshi = The Japanese journal of toxicology.

[20]  S KAYE,et al.  Carbon monoxide poisoning. , 1957, Virginia medical monthly.