Management of carbon monoxide poisoning-induced cardiac failure and multiorgan dysfunction with combined respiratory and circulatory extracorporeal membrane oxygenation

Abstract

Carbon monoxide (CO) is an odorless, colorless, and nonirritant gas; it is the most common cause of poisoning and poisoning-related death. The main mechanism of CO toxicity is ischemic hypoxia secondary to hypoxemia. The heart is the major target organ of acute CO poisoning. Cardiac failure is the most common cardiac presentation; however, other cardiovascular manifestations include arrhythmia, pulmonary edema, and myocardial infarction. Recovery time from CO-induced cardiomyopathy varies from 4 days to 6 weeks. To our knowledge, there are a limited number of reported cases that demonstrated successful extracorporeal membrane oxygenation (ECMO) in adult and pediatric patients with CO poisoning and multiple organ failure. We present our experience with a case we think that it is the first case to be published for a patient with acute CO poisoning received both circulatory and respiratory support (hybrid venoarterial-venous ECMO).