Endogenous carboxyhemoglobin concentrations in the assessment of severity in patients with community-acquired pneumonia

Çorbacıoğlu, Şeref Kerem; Kılıçaslan, İsa; Bildik, Fikret; Guleryuz, Atacan; Bekgöz, Burak; Özel, Ayça; Keleş, Ayfer; Demircan, Ahmet

doi:10.1016/j.ajem.2012.10.005

Cited by 6 publications

(9 citation statements)

References 17 publications

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“…In addition, increased CO production and carboxyhemoglobinemia are often observed in patients with pneumonia [ 17 ]. CO is mainly eliminated from the body through alveolar gas exchange and oxidation to CO 2 , which are both impaired in patients with COVID-19 due to respiratory function decline [ 18 ].…”

Section: Endogenous Carbon Monoxide and Carboxyhaemoglobin Accumulation In Patients With Severe Covid-19mentioning

confidence: 99%

Silent Hypoxemia in Patients with COVID-19 Pneumonia: A Review

et al. 2021

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During the coronavirus disease 2019 (COVID-19) pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, patients presented with COVID-19 pneumonia of varying severity. The phenomenon of severe hypoxemia without signs of respiratory distress is also known as silent or hidden hypoxemia. Although silent hypoxemia is not unique to pneumonia due to SARS-CoV-2 infection, this phenomenon is now recognized to be associated with severe COVID-19 pneumonia. Proper management of critically ill patients is the key to reducing mortality. Herein, we summarize the possible and rare factors contributing to silent hypoxemia in patients with COVID-19. Microvascular thrombosis causes dead space ventilation in the lungs, and the flow of pulmonary capillaries is reduced, which leads to an imbalance in the V/Q ratio. The dissociation curve of oxyhemoglobin shifts to the left and limits the release of oxygen to the tissue. SARS-CoV-2 interferes with the synthesis of hemoglobin and reduces the ability to carry oxygen. The accumulation of endogenous carbon monoxide and carboxyhemoglobin will reduce the total oxygen carrying capacity and interfere with pulse oxygen saturation readings. There are also some non-specific factors that cause the difference between pulse oximetry and oxygen partial pressure. We propose some potentially more effective clinical alternatives and recommendations for optimizing the clinical management processes of patients with COVID-19. This review aims to describe the prevalence of silent hypoxemia in COVID-19 pneumonia, to provide an update on what is known of the pathophysiology, and to highlight the importance of diagnosing silent hypoxemia in patients with COVID-19 pneumonia.

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Section: Endogenous Carbon Monoxide and Carboxyhaemoglobin Accumulation In Patients With Severe Covid-19mentioning

confidence: 99%

Silent Hypoxemia in Patients with COVID-19 Pneumonia: A Review

et al. 2021

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“…Moreover, proadrenomedullin, provasopressin, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, atrial natriuretic peptide, cortisol, copeptin, lactate, and carbon monoxide are some of the biomarkers evaluated in previous researches. [11][12][13][14][15] Several recent studies have evaluated the associations between CAP and the oxidant and antioxidant statuses. 9,10,16,17 Reactive oxygen species (ROS) occur normally in physiological conditions, and they are counterbalanced by oxidantantioxidant mechanisms.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Additionally, it was stated that the total antioxidant status (TAS) levels can be used as an auxiliary criterion for the pneumonia severity in the study done by Katsoulis et al 9 In a similar study, Castillo et al 10 also reported that the ferric reducing ability of the plasma and lipid peroxidation biomarkers could be used for this purpose. Moreover, proadrenomedullin, provasopressin, neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, atrial natriuretic peptide, cortisol, copeptin, lactate, and carbon monoxide are some of the biomarkers evaluated in previous researches 11–15 …”

Section: Introductionmentioning

confidence: 99%

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Evaluation of dynamic thiol/disulfide homeostasis in adult patients with community-acquired pneumonia

Şener¹,

Çelik

Özhasenekler

et al. 2018

Hong Kong Journal of Emergency Medicine

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Background: Community-acquired pneumonia is an important cause of mortality and morbidity in all age groups. Oxidant and antioxidant mechanisms play an important role in the pathogenesis and mortality of community-acquired pneumonia. Objectives: In this study, the role of thiol/disulfide homeostasis in the diagnosis and prognosis of community-acquired pneumonia was investigated. Methods: This was a prospective, controlled, observational study involving 73 community-acquired pneumonia patients and 68 healthy volunteers. Results: The native thiol and total thiol, which are thiol/disulfide homeostasis components, were significantly lower in the community-acquired pneumonia group. It was also found that the native thiol was lower in the high-risk community-acquired pneumonia group and that the native thiol and total thiol were associated with the Pneumonia Severity Index, CRB65 (confusion, respiratory rate, blood pressure, ⩾65 years old), and CURB65 (confusion, uremia, respiratory rate, blood pressure, ⩾65 years old) scores. The thiol compound levels were also associated with the C-reactive protein and procalcitonin levels. However, there was no significant difference between the survivors and non-survivors in terms of the thiol/disulfide homeostasis parameters. Conclusion: This study demonstrated the important role that oxidative stress plays in the pathogenesis of community-acquired pneumonia. The thiol/disulfide homeostasis biomarkers especially the native thiol and index-1 levels were significantly lower in patients with community-acquired pneumonia. Further studies are needed to investigate the diagnostic and prognostic value of thiol/disulfide homeostasis parameters in community-acquired pneumonia.

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“…In the last decade, evidence has accumulated regarding an association between higher COHb levels and poor prognosis in various disorders such as pneumonia [ 5 ], pulmonary embolism [ 6 ], sepsis [ 7 ], postresuscitation care [ 8 ], and critical illness [ 9 ]. Increased concentrations of COHb were also found to be associated with pulmonary inflammation among patients with asthma [ 10 ] and interstitial lung disease [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Carboxyhemoglobin Does Not Predict the Need of Mechanical Ventilation and Prognosis during COPD Exacerbation

Izhakian

Harper

Gorelik

et al. 2022

Canadian Respiratory Journal

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Background. Carboxyhemoglobin (COHb) is a complex formed by the binding of carbon monoxide to hemoglobin in blood. Higher COHb levels have been associated with poor prognosis in a variety of pulmonary disorders. However, little is known regarding the prognostic significance of COHb among individuals with chronic obstructive pulmonary disease (COPD) exacerbation. Methods. In a retrospective study, we evaluated associations of venous COHb levels on hospital admission with the need for invasive mechanical ventilation, in-hospital mortality, and rehospitalization, among 300 patients hospitalized for COPD exacerbation in internal medical wards. Results. Rates of in-hospital death and 1-year recurrent hospitalizations were 11.0% and 59.6%, respectively. COHb levels were not significantly associated with in-hospital mortality (OR = 0.82, P = 0.25 , 95% CI 0.59–1.15) or with 1-year rehospitalizations (OR = 0.91, P = 0.18 , 95% CI 0.79–1.04). The mean COHb level did not differ significantly between patients who needed invasive mechanical ventilation and those who were not invasively mechanically ventilated during the current hospitalization (2.01 ± 1.42% vs. 2.19 ± 1.68%, P = 0.49 ). Conclusions. Among patients hospitalized with COPD exacerbation in internal medicine wards, COHb levels on admission were not associated with invasive mechanical ventilation treatment, rehospitalizations, or mortality.

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Endogenous carboxyhemoglobin concentrations in the assessment of severity in patients with community-acquired pneumonia

Cited by 6 publications

References 17 publications

Silent Hypoxemia in Patients with COVID-19 Pneumonia: A Review

Silent Hypoxemia in Patients with COVID-19 Pneumonia: A Review

Evaluation of dynamic thiol/disulfide homeostasis in adult patients with community-acquired pneumonia

Carboxyhemoglobin Does Not Predict the Need of Mechanical Ventilation and Prognosis during COPD Exacerbation

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