The treatment effectiveness of therapeutic erythrocyte apheresis in carbon monoxide poisoning

Purpose: Carbon monoxide poisoning is a significant health problem and common cause of death in the world. In our study, we aim to determine the frequency of patients who are diagnosed with carbon monoxide poisoning in our emergency service and to cure the patients with therapeutic erythrocyte apheresis.Methods: We studied 42 patients (11 males and 31 females) who were diagnosed with carbon monoxide poisoning in our emergency service between September 2010 and May 2012. The mean age of patients was measured between 35,2±15,7. We cured 9 patients (% 21,4) (4 males and 5 females) with therapeutic erythrocyte apheresis method, who had findings of ischemia in electrocardiogram analyses and whose Glaskow coma scale score 13 or under. The remaining 33 (% 78,6) patients received normobaric oxygen therapy.Results: Before therapeutic erythrocyte apheresis, patients mean carboxyhemoglobin value was measured as 23,43±15,46 and Glaskow coma scale value as 10,7±3,0. The process took nearly 39,22±12,54 minutes. After the treatment, the average blood carboxyhemoglobin value was measured as 4,25±2,8 and Glasgow coma value was measured as 14,44±1,67. It was statistically detected that there was a significant improvement between blood carboxyhemoglobin values and Glasgow coma scale values before and after the treatment (p=0,008 and p=0,007). There was no death in patients. In only 1 (% 11,1) patient who treated with therapeutic erythrocyte apheresis, neurological complications were observed secondary to carbon monoxide poisoning; developed permanent hypoxic ischemic encephalopathy. 1 pregnant patient who had indications of hyperbaric oxygen treatment, discharged with healing after the treatment with therapeutic erythrocyte apheresis. Mean carboxyhemoglobin value was measured as 18,42±10,26 in the patients treated with normobaric oxygen therapy. Neurological complications were not observed in this group and all of them disharged with healing.Conclusion: We concluded that therapeutic erythrocyte apheresis is an efficient treatment in patients with severe carbon monoxide poisoning, and may be used as an effective treatment whenever hyperbaric oxygen therapy can not be provided. Randomized controlled studies should be conducted to compare the efficacy of therapeutic erythrocyte apheresis and hyperbaric oxygen therapy in carbon monoxide poisoning.Keywords: Carbon Monoxide Poisoning, Therapeutic Erythrocyte Apheresis