Facebook
Twitter
LinkedIn
Email
 |
Checking for direct PDF access through Ovid | |
Excerpt
Introduction: Recent studies indicate that endogenous production of carbon monoxide (CO) and nitric oxide (NO) are important mediators in critically ill patients [1,2]. The released CO and NO then form carboxyhaemoglobin (COHb) and methaemoglobin (MetHb). The aim of the study was to investigate the range of COHb and MetHb in a large group of cardiothoracic intensive care patients and to investigate correlations with other laboratory parameters and patient outcome.
Method: We analysed 47,587 blood-gases (ABL 700 series, Radiometer Copenhagen) obtained from 680 postoperative cardiothoracic adult patients (age: 61.4 yr (SD 15); SAPS II: 29.5 (SD 14); length of stay: 6.8 days (SD 9.2)). The maximal values of COHb and MetHb were correlated with lactate, lactate dehydrogenase, C-reactive protein, free-haemoglobin, base-excess and bilirubin.
Results: ICU mortality was 18%. Maximum COHb concentration was 2.38% (SD 0.89) and MetHb concentration was 0.93% (SD 0.68). COHb and MetHb values were higher in non-surviving patients (P < 0.001, Fig.). Stepwise logistic regression revealed a significant correlation between maximum COHb and bilirubin, base excess, C-reactive protein, lactate, free-haemoglobin, SAPS II (P < 0.0001; r2 = 0.21) and between maximum MetHb and lactate, C-reactive protein, free-haemoglobin, bilirubin and SAPS II (P < 0.0001, r2 = 0.55).
Discussion: COHb and MetHb levels of critically ill patients are slightly elevated compared to healthy adults. The difference of COHb and MetHb concentration between surviving and non-surviving patients may indicate an increased endogenous production in severe illness.
