Pulmonary Phototherapy to Treat Carbon Monoxide Poisoning in Rats

Overview

Journal Shock

Date 2016 Nov 19

PMID 27861257

Citations 3

Authors

Luca Zazzeron

Chen Liu

Walfre Franco

Akito Nakagawa

William A Farinelli

Donald B Bloch

Richard Rox Anderson

Warren M Zapol

Affiliations

Soon will be listed here.

Abstract

Background: Carbon monoxide (CO) poisoning is a common cause of poison-related mortality. CO binds to hemoglobin in the blood to form carboxyhemoglobin (COHb), impairing oxygen delivery to peripheral tissues. Current treatment of CO-poisoned patients involves oxygen administration to rapidly remove CO and restore oxygen delivery. Light dissociates CO from COHb with high efficiency. Exposure of murine lungs to visible laser-generated light improved the CO elimination rate in vivo. The aims of this study were to apply pulmonary phototherapy to a larger animal model of CO poisoning, to test novel approaches to light delivery, and to examine the effect of chemiluminescence-generated light on the CO elimination rate.

Methods: Anesthetized and mechanically ventilated rats were poisoned with CO and subsequently treated with air or oxygen combined with or without pulmonary phototherapy delivered directly to the lungs of animals at thoracotomy, via intrapleural optical fibers or generated by a chemiluminescent reaction.

Results: Direct pulmonary phototherapy dissociated CO from COHb reducing COHb half-life by 38%. Early treatment with phototherapy in critically CO poisoned rats improved lactate clearance. Light delivered to the lungs of rats via intrapleural optical fibers increased the rate of CO elimination without requiring a thoracotomy, as demonstrated by a 16% reduction in COHb half-life. Light generated in the pleural spaces by a chemiluminescent reaction increased the rate of CO elimination in rats breathing oxygen, reducing the COHb half-life by 12%.

Conclusions: Successful application of pulmonary phototherapy in larger animals and humans may represent a significant advance in the treatment of CO-poisoned patients.

Citing Articles

Carbon monoxide poisoning and phototherapy.

Zazzeron L, Franco W, Anderson R Nitric Oxide. 2024; 146:31-36.

PMID: 38574950 PMC: 11197981. DOI: 10.1016/j.niox.2024.04.001.

Effects of intravascular laser phototherapy on delayed neurological sequelae after carbon monoxide intoxication as evaluated by brain perfusion imaging: A case report and review of the literature.

Liu C, Hsu C, He H, Cheng Y, Chang S World J Clin Cases. 2021; 9(13):3048-3055.

PMID: 33969090 PMC: 8080739. DOI: 10.12998/wjcc.v9.i13.3048.

First trimester placental mesenchymal stem cells improve cardiac function of rat after myocardial infarction via enhanced neovascularization.

Yu S, You X, Liang H, Li Y, Fu Y, Zhang X Heliyon. 2021; 7(1):e06120.

PMID: 33553765 PMC: 7855719. DOI: 10.1016/j.heliyon.2021.e06120.

References

JOELS N, Pugh L . The carbon monoxide dissociation curve of human blood. J Physiol. 1958; 142(1):63-77. PMC: 1356694. DOI: 10.1113/jphysiol.1958.sp005999. View

Hampson N, Piantadosi C, Thom S, Weaver L . Practice recommendations in the diagnosis, management, and prevention of carbon monoxide poisoning. Am J Respir Crit Care Med. 2012; 186(11):1095-101. DOI: 10.1164/rccm.201207-1284CI. View

Hoffman B, GIBSON Q . On the photosensitivity of liganded hemoproteins and their metal-substituted analogues. Proc Natl Acad Sci U S A. 1978; 75(1):21-5. PMC: 411174. DOI: 10.1073/pnas.75.1.21. View

Zavorsky G, Smoliga J, Longo L, Uhranowsky K, Cadman C, Duffin J . Increased carbon monoxide clearance during exercise in humans. Med Sci Sports Exerc. 2012; 44(11):2118-24. DOI: 10.1249/MSS.0b013e3182602a00. View

Douglas T, Lawson D, LEDINGHAM I, Norman J, SHARP G, Smith G . Carbogen in experimental carbonmonoxide poisoning. Br Med J. 1961; 2(5268):1673-5. PMC: 1970830. DOI: 10.1136/bmj.2.5268.1673. View

Douglas C, Haldane J, Haldane J . The laws of combination of haemoglobin with carbon monoxide and oxygen. J Physiol. 1912; 44(4):275-304. PMC: 1512793. DOI: 10.1113/jphysiol.1912.sp001517. View

Haldane J . The Action of Carbonic Oxide on Man. J Physiol. 1895; 18(5-6):430-62. PMC: 1514663. DOI: 10.1113/jphysiol.1895.sp000578. View

Weaver L, Hopkins R, Chan K, Churchill S, Elliott C, Clemmer T . Hyperbaric oxygen for acute carbon monoxide poisoning. N Engl J Med. 2002; 347(14):1057-67. DOI: 10.1056/NEJMoa013121. View

Inoue S, Saito T, Tsuji T, Tamura K, Ohama S, Morita S . Lactate as a prognostic factor in carbon monoxide poisoning: a case report. Am J Emerg Med. 2008; 26(8):966.e1-3. DOI: 10.1016/j.ajem.2008.01.048. View

10.

Ernst A, Zibrak J . Carbon monoxide poisoning. N Engl J Med. 1998; 339(22):1603-8. DOI: 10.1056/NEJM199811263392206. View

11.

Zazzeron L, Liu C, Franco W, Nakagawa A, Farinelli W, Bloch D . Pulmonary Phototherapy for Treating Carbon Monoxide Poisoning. Am J Respir Crit Care Med. 2015; 192(10):1191-9. PMC: 4731621. DOI: 10.1164/rccm.201503-0609OC. View

12.

Weaver L, Howe S, Hopkins R, Chan K . Carboxyhemoglobin half-life in carbon monoxide-poisoned patients treated with 100% oxygen at atmospheric pressure. Chest. 2000; 117(3):801-8. DOI: 10.1378/chest.117.3.801. View

13.

GOLDBAUM L, Orellano T, Dergal E . Mechanism of the toxic action of carbon monoxide. Ann Clin Lab Sci. 1976; 6(4):372-6. View

14.

COBURN R . The carbon monoxide body stores. Ann N Y Acad Sci. 1970; 174(1):11-22. DOI: 10.1111/j.1749-6632.1970.tb49768.x. View

15.

Takeuchi A, Vesely A, Rucker J, Sommer L, TESLER J, Lavine E . A simple "new" method to accelerate clearance of carbon monoxide. Am J Respir Crit Care Med. 2000; 161(6):1816-9. DOI: 10.1164/ajrccm.161.6.9907038. View

16.

Dziewierz A, Ciszowski K, Gawlikowski T, Rakowski T, Kleczynski P, Surdacki A . Primary angioplasty in patient with ST-segment elevation myocardial infarction in the setting of intentional carbon monoxide poisoning. J Emerg Med. 2013; 45(6):831-4. DOI: 10.1016/j.jemermed.2013.05.061. View

17.

COBURN R, Ploegmakers F, Gondrie P, Abboud R . Myocardial myoglobin oxygen tension. Am J Physiol. 1973; 224(4):870-6. DOI: 10.1152/ajplegacy.1973.224.4.870. View

18.

Blumenthal I . Carbon monoxide poisoning. J R Soc Med. 2001; 94(6):270-2. PMC: 1281520. DOI: 10.1177/014107680109400604. View

19.

Hampson N, Weaver L . Carbon monoxide poisoning: a new incidence for an old disease. Undersea Hyperb Med. 2007; 34(3):163-8. View

20.

Buehler J, Berns A, Webster J, ADDINGTON W, CUGELL D . Lactic acidosis from carboxyhemoglobinemia after smoke inhalation. Ann Intern Med. 1975; 82(6):803-5. DOI: 10.7326/0003-4819-82-6-803. View