Successful treatment of carbon monoxide toxicity with high flow nasal oxygen compared to mechanical ventilation

Abstract

AbstractTwo dogs were presented to the emergency room for suspected carbon monoxide toxicity associated with a furnace malfunction. Both dogs exhibited signs of impaired ambulation, abnormal mentation, and respiratory distress. Arterial co‐oximetry confirmed elevated carboxyhaemoglobin levels (27.6% and 23.6%). Initial treatment consisted of bilateral nasal oxygen administration. Due to progression of clinical signs, dog 1 was mechanically ventilated and dog 2 was administered high flow nasal oxygen (HFNO). After approximately 3 hours of treatment, both dogs had improved carboxyhaemoglobin levels of 4.9% and 5.2%, respectively, and had significant improvement of reported clinical signs. The calculated half‐life of carboxyhaemoglobin in dog 1 with mechanical ventilation was 150 minutes, and in dog 2 was 167 minutes with HFNO. Both dogs survived to discharge and no long‐term complications were reported. This is the first described case using HFNO as a treatment option for carbon monoxide toxicity in dogs.