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Prediction of extravascular burden of carbon monoxide (CO) in the human heart.

Authors
Erupaka-K; Bruce-EN; Bruce-MC
Source
Ann Biomed Eng 2010 Feb; 38(2):403-438
NIOSHTIC No.
20036753
Abstract
Clinically significant myocardial abnormalities (e.g., arrhythmias, S-T elevation) occur in patients with mild-to-severe carbon monoxide (CO) poisoning. We enhanced our previous whole body model [Bruce, E. N., M. C. Bruce, and K. Erupaka. Prediction of the rate of uptake of carbon monoxide from blood by extravascular tissues. Respir. Physiol. Neurobiol. 161(2):142-159, 2008] by adding a cardiac compartment (containing three vascular and two tissue subcompartments differing in capillary density) to predict myocardial carboxymyoglobin (MbCO) and oxygen tensions (P(c)O2) for several CO exposure regimens at rest and during exercise. Model predictions were validated with experimental data in normoxia, hypoxia, and hyperoxia. We simulated exposure at rest to 6462 ppm CO (10 min) and to 265 ppm CO (480 min), and during three levels of exercise at 20% HbCO. We compared responses of carboxyhemoglobin (HbCO), MbCO and P(c)O2 to estimate the potential for myocardial injury due to CO hypoxia. Simulation results predict that during CO exposures and subsequent therapies, cardiac tissue has higher MbCO levels and lower P(c)O2's than skeletal muscle. CO exposure during exercise further decreases P(c)O2 from resting levels. We conclude that in rest and moderate exercise, the myocardium is at greater risk for hypoxic injury than skeletal muscle during the course of CO exposure and washout. Because the model can predict CO uptake and distribution in human myocardium, it could be a tool to estimate the potential for hypoxic myocardial injury and facilitate therapeutic intervention.
Keywords
Blood-analysis; Blood-gas-analysis; Blood-vessels; Cardiopulmonary-system-disorders; Epidemiology; Exposure-assessment; Exposure-levels; Exposure-methods; Hemodynamics; Humans Injury-prevention; Mathematical-models; Models; Myocardial-disorders; Physiological-response; Statistical-analysis; Tissue-disorders; Vasoactive-agents; Author Keywords: Myocardial oxygen tension; CO hypoxia; Exercise; Tissue oxygenation; Cardiac muscle; Skeletal muscle; Modeling
Contact
Kinnera Erupaka, Center for Biomedical Engineering, University of Kentucky, Lexington, KY 40506-0070
CODEN
ABMECF
Publication Date
20100201
Document Type
Journal Article
Email Address
kinnerarey@uky.edu
Funding Type
Grant
Fiscal Year
2010
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-008651
Issue of Publication
2
ISSN
0090-6964
Source Name
Annals of Biomedical Engineering
State
KY
Performing Organization
University of Kentucky
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