TITLE

Carboxyhemoglobinemia in a pediatric cardiopulmonary bypass patient derived from a contaminated unit of allogenic blood

AUTHOR(S)
McRobb, C.; Walczak, R.; Lawson, S.; Lodge, A.; Lockhart, E.; Bandarenko, N.; Ing, R.
PUB. DATE
July 2011
SOURCE
Perfusion;Jul2011, Vol. 26 Issue 4, p302
SOURCE TYPE
Academic Journal
DOC. TYPE
Case Study
ABSTRACT
A 4.3 kg, three-month-old patient, diagnosed with a perimembranous ventricular septal defect, presented for cardiac surgery. Upon initiation of cardiopulmonary bypass (CPB), the patient developed carboxyhemoglobinemia (11.1%). Potential sources for the unexpected acquired carboxyhemoglobinemia were sought quickly. Testing of residual blood from the unit of packed red blood cells (PRBCs) used to prime the CPB circuit revealed a carboxyhemoglobin (COHb) of 15.1 %. A decrease in cerebral oximetry (rSO2) on CPB was initially felt to be a result of the elevated COHb levels. When ventilation of the oxygenator with 100% oxygen (O2) failed to decrease COHb levels, a partial exchange transfusion was performed with reduction in COHb to 7.1%. The operation was completed successfully and the patient’s COHb levels returned to normal within 75 minutes.Post case analysis of events and data collected during the case revealed a broader differential for explaining the compromised patient’s O2 delivery than the transient acquired carboxyhemoglobinemia. A partial obstruction of the superior vena cava could have triggered the drop in rSO2 on CPB.Follow-up of the donor blood confirmed the donor had previously undiagnosed carboxyhemoglobinemia as a result of chronic carbon monoxide exposure from a faulty vehicle exhaust system.
ACCESSION #
62586989

 

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics