JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (2)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ziemann-Gimmel, P.
Right arrow Articles by Schwartz, D. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ziemann-Gimmel, P.
Right arrow Articles by Schwartz, D. E.
Related Collections
Right arrow Blood
Right arrow Complications
Right arrow Critical Care

Anesth Analg 2004;99:1800-1802
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000136478.70425.BF

CRITICAL CARE AND TRAUMA

Increased Carboxyhemoglobin in a Patient with a Large Retroperitoneal Hematoma

Patrick Ziemann-Gimmel, MD, and David E. Schwartz, MD, FCCP

Department of Anesthesiology, Division of Critical Care Medicine, University of Illinois at Chicago

Address correspondence and reprint requests to Patrick Ziemann-Gimmel, MD, University of Illinois at Chicago, Department of Anesthesiology, 1740 W. Taylor St., Ste. 3200 W, M/C 515, Chicago, IL 60612-7239. Address e-mail to pzg{at}uic.edu

In humans, the sole endogenous source of carbon monoxide is heme degradation. We report the development of prolonged carboxyhemoglobinemia in a critically ill mechanically ventilated patient who required massive transfusion because of retroperitoneal hemorrhage secondary to pheochromocytoma. After the transfusion of 27 U of packed red blood cells, the maximum carboxyhemoglobin level was 6.4%. Although ventilation was controlled with a fraction of inspired oxygen of 0.35–0.5 and external drainage of blood occurred, the concentration of carboxyhemoglobin remained at 1.7%–5.6% for days. Red blood cells for transfusion may be contaminated with carbon monoxide and may have carboxyhemoglobin levels of up to 12%; this may also have contributed to carboxyhemoglobinemia in our patient. If significantly increased concentrations of carboxyhemoglobin develop, therapy to decrease the concentration of carboxyhemoglobin (such as fraction of inspired oxygen of 1.0 and/or minute ventilation or hyperbaric oxygen) or removal of the source should be considered.

IMPLICATIONS: We report the development of significant carboxyhemoglobinemia in a critically ill, mechanically ventilated patient who required massive transfusion because of retroperitoneal hemorrhage secondary to pheochromocytoma.




This article has been cited by other articles:


Home page
 ChestHome page
D. J. Funk and A. S. Clay
A 29-Year-Old Woman With Sudden Anemia and Arterial Oxygen Desaturation
Chest, February 1, 2007; 131(2): 621 - 623.
[Full Text] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.