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Related Experiment Videos

Carboxyhemoglobin elevation in trauma victims.

M Moncure1, C E Brathwaite, E Samaha

  • 1Department of Surgery, Kansas University Medical Center, Kansas City 66209, USA.

The Journal of Trauma
|March 24, 1999
PubMed
Summary
This summary is machine-generated.

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Carboxyhemoglobin (COH) levels were significantly elevated in trauma patients experiencing stress, sepsis, and shock. However, COH measurements alone may not reliably predict sepsis in these patients.

Area of Science:

  • Trauma critical care
  • Biochemistry of oxidative stress
  • Sepsis pathophysiology

Background:

  • Hemeoxygenase enzyme products, including carboxyhemoglobin (COH) and bilirubin, offer protective effects during stress.
  • Hemeoxygenase-1 (HO-1) expression increases in response to oxidative stress.
  • This study investigated elevated COH levels in septic trauma patients compared to nonseptic trauma patients.

Purpose of the Study:

  • To determine if carboxyhemoglobin (COH) levels are elevated in septic trauma patients.
  • To correlate COH levels with clinical parameters in trauma patients.
  • To assess the potential of COH as a biomarker for sepsis in trauma.

Main Methods:

  • A prospective study was conducted at a Level I trauma center over 3.5 months.

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  • 45 trauma patients were enrolled, with 76 samples collected at admission and later time points.
  • Samples were categorized as septic, stressed, or nonstressed nonseptic, and analyzed for COH levels and correlation with clinical indicators.

    • Main Results:

    • Carboxyhemoglobin (COH) levels were significantly higher in patients presenting with shock (systolic blood pressure ≤90 mm Hg) compared to those not in shock (p=0.013).
    • Septic patients exhibited higher Injury Severity Scores and required lower percentages of inspired oxygen compared to nonseptic patients (p<0.05).
    • COH levels were significantly elevated in samples from stressed, septic, and shock states.

    Conclusions:

    • Carboxyhemoglobin (COH) is significantly elevated during stress, sepsis, and shock in trauma patients.
    • The overlap in COH values between sepsis and stress states limits its clinical utility for sepsis prediction.
    • Further research into hemeoxygenase-1 expression and its by-products in trauma patient outcomes is recommended.