Document Detail


Cardiac arrest induced by accidental inhalation of anoxic gases, is the cause always a lack of oxygen?
MedLine Citation:
PMID:  10958035     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We experienced a case of accidental administration of 100% carbon dioxide (CO2) during anesthesia, which resulted in cardiac arrest. After successful cardio-pulmonary resuscitation the child recovered without brain damage. This outcome was quite different than that of the more commonly reported accidental administration of 100% nituous oxide (N2O), as the latter usually results in death from cerebral damage rather than cardiac arrest. We speculated that the cause of death and/or cardiac arrest may differ between these two anoxic gases. METHODS: Fourteen dogs were anesthetized and divided into two groups to receive either 100% CO2 or 100% N2O. Blood pressure (BP), heart rate (HR), cardiac output (CO), dp/dt, pulmonary artery pressure (PAP), central venous pressure (CVP) and blood gases (BG) were measured every 30 seconds until cardiac arrest (CA) occurred. RESULTS: The CO2 group showed a rapid decline in BP, HR, dp/dt, CO, pH, and PaO2 and a rise in PAP, CVP, and PaCO2, with CA occurring at 119 +/- 41 seconds. At the time of CA, the BG values were pH 6.6 +/- 0.09, PaCO2 375 +/- 69, and PaO2 62 +/- 15 mm Hg. The N2O group maintained BP, HR, dp/dt, pH, PaCO2, and experienced a rapid decline in PaO2 as in the CO2 group until 180 seconds, at which time the PaO2 was 12.3 +/- 3 mm Hg. CA occurred at 390 +/- 52 seconds. The values for pH, PaCO2 and PaO2 were 7.5 +/- 0.05, 25 +/- 15 and 4.8 +/- 1 mm Hg, respectively, at the time of CA. CONCLUSION: One hundred percent CO2-induced cardiac arrest occurred in 119 seconds and was not oxygen-dependent, whereas 100% N2O induced cardiac arrest occurred in 390 seconds and was clearly dependent on hypoxemia.
Authors:
B Jawan; J H Lee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chang Gung medical journal     Volume:  23     ISSN:  2072-0939     ISO Abbreviation:  Chang Gung Med J     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-09-07     Completed Date:  2000-09-07     Revised Date:  2008-12-16    
Medline Journal Info:
Nlm Unique ID:  101088034     Medline TA:  Chang Gung Med J     Country:  CHINA (REPUBLIC: 1949- )    
Other Details:
Languages:  eng     Pagination:  331-8     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Chang Gung Memorial Hospital, Kaohsiung, Taoyuan, R.O.C. jawanb@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Animals
Anoxia / complications*
Carbon Dioxide / blood,  toxicity*
Child
Dogs
Heart Arrest / etiology*
Hemodynamics
Humans
Nitrous Oxide / toxicity
Chemical
Reg. No./Substance:
10024-97-2/Nitrous Oxide; 124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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