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2015 ; 192
(10
): 1191-9
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Pulmonary Phototherapy for Treating Carbon Monoxide Poisoning
#MMPMID26214119
Zazzeron L
; Liu C
; Franco W
; Nakagawa A
; Farinelli WA
; Bloch DB
; Anderson RR
; Zapol WM
Am J Respir Crit Care Med
2015[Nov]; 192
(10
): 1191-9
PMID26214119
show ga
RATIONALE: Carbon monoxide (CO) exposure is a leading cause of poison-related
mortality. CO binds to Hb, forming carboxyhemoglobin (COHb), and produces tissue
damage. Treatment of CO poisoning requires rapid removal of CO and restoration of
oxygen delivery. Visible light is known to effectively dissociate CO from Hb,
with a single photon dissociating one CO molecule. OBJECTIVES: To determine
whether illumination of the lungs of CO-poisoned mice causes dissociation of COHb
from blood transiting the lungs, releasing CO into alveoli and thereby enhancing
the rate of CO elimination. METHODS: We developed a model of CO poisoning in
anesthetized and mechanically ventilated mice to assess the effects of direct
lung illumination (phototherapy) on the CO elimination rate. Light at wavelengths
between 532 and 690 nm was tested. The effect of lung phototherapy administered
during CO poisoning was also studied. To avoid a thoracotomy, we assessed the
effect of lung phototherapy delivered to murine lungs via an optical fiber placed
in the esophagus. MEASUREMENTS AND MAIN RESULTS: In CO-poisoned mice,
phototherapy of exposed lungs at 532, 570, 592, and 628 nm dissociated CO from Hb
and doubled the CO elimination rate. Phototherapy administered during severe CO
poisoning limited the blood COHb increase and improved the survival rate.
Noninvasive transesophageal phototherapy delivered to murine lungs via an optical
fiber increased the rate of CO elimination while avoiding a thoracotomy.
CONCLUSIONS: Future development and scaling up of lung phototherapy for patients
with CO exposure may provide a significant advance for treating and preventing CO
poisoning.