Carboxyhemoglobin and methemoglobin levels as prognostic markers in acute pulmonary embolism

Kakavas, Sotirios; Papanikolaou, Aggeliki; Ballis, Evangelos; Tatsis, Nikolaos; Goga, Christina; Tatsis, Giorgos

doi:10.1016/j.ajem.2015.01.046

Cited by 15 publications

(23 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…APACHE II score is generally accepted as a scoring system for critically ill patients, but its predictive yield for mortality in PE patients has been studied less. In one study, although the median APACHE II score was higher in nonsurvivors, it was not found as an independent predictor for mortality [18]. However, the study cohort consisted of moderately ill patients and was performed in a pulmonary clinic outside of ICU.…”

Section: Discussionmentioning

confidence: 99%

Mortality Related Risk Factors in High-Risk Pulmonary Embolism in the ICU

Ergan

Ergün

Çalışkan

et al. 2016

Canadian Respiratory Journal

View full text Add to dashboard Cite

Introduction. We sought to identify possible risk factors associated with mortality in patients with high-risk pulmonary embolism (PE) after intensive care unit (ICU) admission. Patients and Methods. PE patients, diagnosed with computer tomography pulmonary angiography, were included from two ICUs and were categorized into groups: group 1 high-risk patients and group 2 intermediate/low-risk patients. Results. Fifty-six patients were included. Of them, 41 (73.2%) were group 1 and 15 (26.7%) were group 2. When compared to group 2, need for vasopressor therapy (0 vs 68.3%; p < 0.001) and need for invasive mechanical ventilation (6.7 vs 36.6%; p = 0.043) were more frequent in group 1. The treatment of choice for group 1 was thrombolytic therapy in 29 (70.7%) and anticoagulation in 12 (29.3%) patients. ICU mortality for group 1 was 31.7% (n = 13). In multivariate logistic regression analysis, APACHE II score >18 (OR 42.47 95% CI 1.50–1201.1), invasive mechanical ventilation (OR 30.10 95% CI 1.96–463.31), and thrombolytic therapy (OR 0.03 95% CI 0.01–0.98) were found as independent predictors of mortality. Conclusion. In high-risk PE, admission APACHE II score and need for invasive mechanical ventilation may predict death in ICU. Thrombolytic therapy seems to be beneficial in these patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Mortality Related Risk Factors in High-Risk Pulmonary Embolism in the ICU

Ergan

Ergün

Çalışkan

et al. 2016

Canadian Respiratory Journal

View full text Add to dashboard Cite

show abstract

“…In univariate logistic regression analysis, COHb and MetHb levels, both significantly correlated with increased Acute Physiology and Chronic Health Evaluation II score and decreased PaO 2 /FiO 2 ratio. However, in multivariate analysis, only COHb remained significant as an independent predictor of in-hospital mortality and the increased level of MetHb is associated with severe illness, but these findings require further prospective validation [28] .…”

Section: Discussionmentioning

confidence: 88%

Carboxyhemoglobin and Methemoglobin as Markers of Postoperative Pulmonary Complications

Gavrilovska-Brzanov¹,

Miceska²,

Shosholcheva³

et al. 2018

JAS

View full text Add to dashboard Cite

Introduction: The inhalation of tobacco smoke can substantially raise the level of carboxyhemoglobin in the blood. Determination of the level of carboxyhemoglobin and methemoglobin can identify patients with increased risk for development of postoperative pulmonary complications. Material and Methods: Thirty patients scheduled for elective urologic surgery under general endotracheal anesthesia were allocated in two groups (n = 15 each). The study group comprised patients who were smoking cigarettes or tobacco pipe, while the control group included non-smokers. In both group's carboxyhemoglobin and methemoglobin levels were determined preoperatively, after preoxygenation, and one hour after completing the anesthesia. Postoperative pulmonary complications were assessed and recorded during the period of hospitalization. Results: The average values of carboxyhemoglobin between the two groups were statistically significantly different. Postoperative carboxyhemoglobin was higher in smokers compared to control non-smokers group (p = 0.000). On the other hand, methemoglobin was higher in the control non-smokers group compared to smokers, but without statistical significance (p = 0.88). Regarding postoperative pulmonary complications, 13.3% of the patients in the control non-smokers group and 26.6% of the patients in smokers group had pulmonary complications. Conclusion: In our sample there was a difference between the incidence rates of postoperative pulmonary complications; however, we cannot confirm the hypothesis that carboxyhemoglobin and methemoglobin can serve as predictors for postoperative pulmonary complications.

show abstract

“…Interestingly, while elevated COHb levels seem to be correlated with COVID-19 severity, intensive care mortality from other causes was found to be associated with too low [12,77] and both too low or too high COHb values [11], indicating the existence of an optimal COHb level for optimal physiological functioning [12]. HO-1 upregulation, associated with elevations of COHb, has immunomodulatory and anti-inflammatory effects [78].…”

Section: Possible Reasons For Carboxyhemoglobinemia In Covid-19 Patientsmentioning

confidence: 99%

The Role of Methemoglobin and Carboxyhemoglobin in COVID-19: A Review

Scholkmann

Restin

Ferrari

et al. 2020

JCM

View full text Add to dashboard Cite

Following the outbreak of a novel coronavirus (SARS-CoV-2) associated with pneumonia in China (Corona Virus Disease 2019, COVID-19) at the end of 2019, the world is currently facing a global pandemic of infections with SARS-CoV-2 and cases of COVID-19. Since severely ill patients often show elevated methemoglobin (MetHb) and carboxyhemoglobin (COHb) concentrations in their blood as a marker of disease severity, we aimed to summarize the currently available published study results (case reports and cross-sectional studies) on MetHb and COHb concentrations in the blood of COVID-19 patients. To this end, a systematic literature research was performed. For the case of MetHb, seven publications were identified (five case reports and two cross-sectional studies), and for the case of COHb, three studies were found (two cross-sectional studies and one case report). The findings reported in the publications show that an increase in MetHb and COHb can happen in COVID-19 patients, especially in critically ill ones, and that MetHb and COHb can increase to dangerously high levels during the course of the disease in some patients. The medications given to the patient and the patient’s glucose-6-phospate dehydrogenase (G6PD) status seem to be important factors determining the severity of the methemoglobinemia and carboxyhemoglobinemia. Therefore, G6PD status should be determined before medications such as hydroxychloroquine are administered. In conclusion, MetHb and COHb can be elevated in COVID-19 patients and should be checked routinely in order to provide adequate medical treatment as well as to avoid misinterpretation of fingertip pulse oximetry readings, which can be inaccurate and unreliable in case of elevated MetHb and COHb levels in the blood.

show abstract

Carboxyhemoglobin and methemoglobin levels as prognostic markers in acute pulmonary embolism

Cited by 15 publications

References 28 publications

Mortality Related Risk Factors in High-Risk Pulmonary Embolism in the ICU

Mortality Related Risk Factors in High-Risk Pulmonary Embolism in the ICU

Carboxyhemoglobin and Methemoglobin as Markers of Postoperative Pulmonary Complications

The Role of Methemoglobin and Carboxyhemoglobin in COVID-19: A Review

Contact Info

Product

Resources

About