Abstract
Purpose: Patients with severe carbon monoxide (CO) poisoning may develop acute respiratory failure, which needs endotracheal intubation and mechanical ventilation (MV). The objective of this study was to identify the predictors for duration of MV in patients with severe CO poisoning and acute respiratory failure. Materials and methods: This is a retrospective observational study of 796 consecutive patients diagnosed with acute CO poisoning that presented to the emergency department. Patients who received MV were divided into 2 groups: the early extubation (EE) consisting of patients who were on MV for less than 72 hours and the nonearly extubation (NEE) consisting of patients who were on MV for more than 72 hours. Demographic and clinical data of the two groups were extracted for analysis. Results: The intubation rate of all CO-poisoned patients was 23.4%. A total of 168 patients were enrolled in this study. The main source of CO exposure was intentional CO poisoning by charcoal burning (137 patients). Positive toxicology screening result was found in 104 patients (61.9%). The EE group had 105 patients (62.5%). On arriving at the emergency department, high incidence of hypotension; high white blood cell count; and elevation of blood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, creatine kinase, and troponin-I levels were statistically significant in the NEE group (P < .05). Positive toxicology screening result was statistically significant in the EE group (P < .05). In a multivariate analysis, elevation of troponin-I level was an independent factor for NEE (odds ratio, 1.305; 95% confidence interval, 1.024-1.663; P = .032). Positive toxicology screening result was an independent factor for EE (odds ratio, 0.222; 95% confidence interval, 0.101-0.489; P = .001). Conclusions: A positive toxin screen predicts extubation within the first 72 hours for patients with severe CO poisoning and acute respiratory failure. On the other hand, elevation of initial troponin-I level is a predictor for a longer duration of MV.
| Original language | English |
|---|---|
| Pages (from-to) | 19-24 |
| Number of pages | 6 |
| Journal | Journal of Critical Care |
| Volume | 30 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Feb 1 2015 |
| Externally published | Yes |
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Keywords
- Benzodiazepine
- Carbon monoxide
- Extubation
- Mechanical ventilation
- Toxicology screen
- Troponin-I
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
Cite this
Predicting duration of mechanical ventilation in patients with carbon monoxide poisoning : A retrospective study. / Shen, Chih Hao; Peng, Chung Kan; Chou, Yu Ching; Pan, Ke Ting; Chang, Shun Cheng; Chang, Shan Yueh; Huang, Kun Lun.
In: Journal of Critical Care, Vol. 30, No. 1, 01.02.2015, p. 19-24.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Predicting duration of mechanical ventilation in patients with carbon monoxide poisoning
T2 - A retrospective study
AU - Shen, Chih Hao
AU - Peng, Chung Kan
AU - Chou, Yu Ching
AU - Pan, Ke Ting
AU - Chang, Shun Cheng
AU - Chang, Shan Yueh
AU - Huang, Kun Lun
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Purpose: Patients with severe carbon monoxide (CO) poisoning may develop acute respiratory failure, which needs endotracheal intubation and mechanical ventilation (MV). The objective of this study was to identify the predictors for duration of MV in patients with severe CO poisoning and acute respiratory failure. Materials and methods: This is a retrospective observational study of 796 consecutive patients diagnosed with acute CO poisoning that presented to the emergency department. Patients who received MV were divided into 2 groups: the early extubation (EE) consisting of patients who were on MV for less than 72 hours and the nonearly extubation (NEE) consisting of patients who were on MV for more than 72 hours. Demographic and clinical data of the two groups were extracted for analysis. Results: The intubation rate of all CO-poisoned patients was 23.4%. A total of 168 patients were enrolled in this study. The main source of CO exposure was intentional CO poisoning by charcoal burning (137 patients). Positive toxicology screening result was found in 104 patients (61.9%). The EE group had 105 patients (62.5%). On arriving at the emergency department, high incidence of hypotension; high white blood cell count; and elevation of blood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, creatine kinase, and troponin-I levels were statistically significant in the NEE group (P < .05). Positive toxicology screening result was statistically significant in the EE group (P < .05). In a multivariate analysis, elevation of troponin-I level was an independent factor for NEE (odds ratio, 1.305; 95% confidence interval, 1.024-1.663; P = .032). Positive toxicology screening result was an independent factor for EE (odds ratio, 0.222; 95% confidence interval, 0.101-0.489; P = .001). Conclusions: A positive toxin screen predicts extubation within the first 72 hours for patients with severe CO poisoning and acute respiratory failure. On the other hand, elevation of initial troponin-I level is a predictor for a longer duration of MV.
AB - Purpose: Patients with severe carbon monoxide (CO) poisoning may develop acute respiratory failure, which needs endotracheal intubation and mechanical ventilation (MV). The objective of this study was to identify the predictors for duration of MV in patients with severe CO poisoning and acute respiratory failure. Materials and methods: This is a retrospective observational study of 796 consecutive patients diagnosed with acute CO poisoning that presented to the emergency department. Patients who received MV were divided into 2 groups: the early extubation (EE) consisting of patients who were on MV for less than 72 hours and the nonearly extubation (NEE) consisting of patients who were on MV for more than 72 hours. Demographic and clinical data of the two groups were extracted for analysis. Results: The intubation rate of all CO-poisoned patients was 23.4%. A total of 168 patients were enrolled in this study. The main source of CO exposure was intentional CO poisoning by charcoal burning (137 patients). Positive toxicology screening result was found in 104 patients (61.9%). The EE group had 105 patients (62.5%). On arriving at the emergency department, high incidence of hypotension; high white blood cell count; and elevation of blood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, creatine kinase, and troponin-I levels were statistically significant in the NEE group (P < .05). Positive toxicology screening result was statistically significant in the EE group (P < .05). In a multivariate analysis, elevation of troponin-I level was an independent factor for NEE (odds ratio, 1.305; 95% confidence interval, 1.024-1.663; P = .032). Positive toxicology screening result was an independent factor for EE (odds ratio, 0.222; 95% confidence interval, 0.101-0.489; P = .001). Conclusions: A positive toxin screen predicts extubation within the first 72 hours for patients with severe CO poisoning and acute respiratory failure. On the other hand, elevation of initial troponin-I level is a predictor for a longer duration of MV.
KW - Benzodiazepine
KW - Carbon monoxide
KW - Extubation
KW - Mechanical ventilation
KW - Toxicology screen
KW - Troponin-I
UR - http://www.scopus.com/inward/record.url?scp=84920559136&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84920559136&partnerID=8YFLogxK
U2 - 10.1016/j.jcrc.2014.08.003
DO - 10.1016/j.jcrc.2014.08.003
M3 - Article
C2 - 25194589
AN - SCOPUS:84920559136
VL - 30
SP - 19
EP - 24
JO - Journal of Critical Care
JF - Journal of Critical Care
SN - 0883-9441
IS - 1
ER -