Extracorporeal Hyperoxygenation Therapy (EHT) for Carbon Monoxide Poisoning: In-Vitro Proof of Principle

Carbon monoxide (CO) poisoning is the leading cause of poisoning-related deaths globally. The currently available therapy options are normobaric oxygen (NBO) and hyperbaric oxygen (HBO). While NBO lacks in efficacy, HBO is not available in all areas and countries. We present a novel method, extracorporeal hyperoxygenation therapy (EHT), for the treatment of CO poisoning that eliminates the CO by treating blood extracorporeally at elevated oxygen partial pressure. In this study, we proof the principle of the method in vitro using procine blood: Firstly, we investigated the difference in the CO elimination of a hollow fibre membrane oxygenator and a specifically designed batch oxygenator based on the bubble oxygenator principle at elevated pressures (1, 3 bar). Secondly, the batch oxygenator was redesigned and tested for a broader range of pressures (1, 3, 5, 7 bar) and temperatures (23, 30, 37 °C). So far, the shortest measured carboxyhemoglobin half-life in the blood was 21.32 min. In conclusion, EHT has the potential to provide an easily available and effective method for the treatment of CO poisoning.

Analysis of cardiopulmonary bypass status in China: eight-year development trends

Objective: To study the development of cardiopulmonary bypass (CPB) in the past 8 years and to come up with predictions and recommendations for the future in China. Methods: Domestic hospitals performing cardiovascular operations were supplied with questionnaires, annually (between 2003 and 2008), upon the number of on-pump and off-pump cardiovascular operations, oxygenators of different types and the number of extracorporeal membrane oxygenation (ECMO). All the hospitals in this study were divided into 8 grades, according to the number of cardiovascular operations. The market share of hospitals in each grade was analyzed. Results: The total anumber of cardiovascular operations was 170,547 in 2010, of which 136,753 were performed under CPB. The ratio of imported membrane oxygenators increased from 43.22% in 2003 to 59.75% in 2010, while bubble oxygenator composition decreased from 43.78% in 2003 to 14.59% in 2010. Forty-four hospitals carried out 206 cases of ECMO in 2010. There were 32 hospitals that performed cardiovascular operations of over 1,000 cases and their market share was 43%. There were 255 hospitals that performed cardiovascular operations in less than 50 cases and their market share was only 3%. Conclusions: CPB in China has gone through a rapid development in the past eight years. Medical resources for CPB should be concentrated and systematic training regulations should be established in the future.