Treatment of acute carbon monoxide poisoning with extracorporeal membrane trioxygenation.

Objective: To treat acute carbon monoxide poisoning (ACOP) with extracorporeal membrane trioxygenation (ECMO3), and to determine the efficacy and safety of ECMO3.

Method: Thirty-two New Zealand white rabbits were divided randomly into four groups including ECMO3 group (G1-ECMO3), oxygen treatment group (G2-FIO2), untreated ACOP group (G3-ACOP), and control group (G4-control). Rabbits in the first three groups were intraperitoneally injected with 99.99% CO at a dosage of 200 ml/kg, and those in the control group were treated with placebo. The dynamic changes in carboxyhemoglobin (COHb) concentration, blood oxygen saturation (SO2) level, base excess of blood (BE-B) as well as the vital signs of the rabbits were monitored.

Results: All the experimental rabbits had significantly higher levels of COHb (p = 0.000<0.05) than those in the control group after 30 min of CO injection with poisoning reactions. The respiration and heart rate of the rabbits in the ECMO3 group and FIO2 group were recovered to a level close to those of the rabbits in the control group by the end of the treatment, and they were significantly lower than those in the ACOP group (p = 0.000, <0.05). The COHb levels of rabbits in the G1-ECMO3 group were significantly lower than those in the G2-FIO2 and the G3-ACOP groups (F = 42.799, p = 0.000), and were similar to those in the CONTROL GROUP. AFTER 0.5 H OF TREATMENT, THE SO2 AND BE-B LEVELS OF RABBITS IN THE G1-ECMO3 AND THE G2-FIO2 GROUPS WERE HIGHER THAN THOSE IN THE G3-ACOP GROUP (P<0.05, P = 0.000<0.05).

Conclusions: ECMO3 treatment effectively lowered the COHb levels, increased SO2 levels, and cured acid poisoning, making it a safe and promising ACOP treatment strategy.