碳氧血红蛋白在呼吸与危重症医学中的研究 进展
Research Progress of Carboxyhemoglobin in Respiratory and Critical Care Medicine
DOI: 10.12677/acm.2026.1652057, PDF,   
作者: 纪佳乐*:暨南大学第二临床医学院,深圳市人民医院重症医学科,广东 深圳;李欣怡:南方科技大学医学院,南方科技大学第一附属医院(深圳市人民医院)肾内科,广东 深圳;陈纯波#:暨南大学第二临床医学院,深圳市人民医院重症医学科,广东 深圳;南方科技大学医学院,南方科技大学第一附属医院(深圳市人民医院)肾内科,广东 深圳
关键词: 碳氧血红蛋白一氧化碳呼吸与危重症医学生物标志物Carboxyhemoglobin Carbon Monoxide Respiratory and Critical Care Medicine Biomarker
摘要: 碳氧血红蛋白(COHb)是反映机体一氧化碳(CO)暴露的特异性生物标志物,其在呼吸与危重症医学领域的诊疗价值日益凸显。本文整理COHb在急性呼吸窘迫综合征、急性肺栓塞、间质性肺病等呼吸系统疾病以及体外膜肺氧合支持、感染、溶血、休克等危重症中的病情评估与预后预测价值;同时归纳COHb检测技术进展、干扰因素、内源性CO的双重病理生理作用及外源性COHb制剂的治疗潜力。临床诊疗过程中动态监测COHb水平,有助于对危重症患者进行早期风险分层与个体化治疗,因此,本文旨在对COHb在危急重症疾病中的预测价值进行综述。
Abstract: Carboxyhemoglobin (COHb) is a specific biomarker reflecting the body’s carbon monoxide (CO) exposure, and its diagnostic and therapeutic value in the field of respiratory and critical care medicine is increasingly prominent. This article summarizes the evaluation and prognostic value of COHb in acute respiratory distress syndrome, acute pulmonary embolism, interstitial lung disease and other respiratory diseases, as well as in critical diseases such as extracorporeal membrane oxygenation support, infection, hemolysis, shock and so on; At the same time, the progress of COHb detection technology, interference factors, the dual pathophysiological effects of endogenous CO and the therapeutic potential of exogenous COHb preparations were summarized. Dynamic monitoring of COHb levels during clinical diagnosis and treatment is helpful for early risk stratification and individualized treatment of critically ill patients. Therefore, this article aims to review the predictive value of COHb in critically ill patients.
文章引用:纪佳乐, 李欣怡, 陈纯波. 碳氧血红蛋白在呼吸与危重症医学中的研究 进展[J]. 临床医学进展, 2026, 16(5): 2475-2485. https://doi.org/10.12677/acm.2026.1652057

参考文献

[1] Hampson, N.B. (2018) Carboxyhemoglobin: A Primer for Clinicians. Undersea and Hyperbaric Medicine, 45, 165-171. [Google Scholar] [CrossRef
[2] Salicio, M.A., Mana, V.A.M., Fett, W.C.R., Gomes, L.T. and Botelho, C. (2016) Environmental Variables and Levels of Exhaled Carbon Monoxide and Carboxyhemoglobin in Elderly People Taking Exercise. Ciência & Saúde Coletiva, 21, 1023-1032. [Google Scholar] [CrossRef] [PubMed]
[3] Onodera, M., Fujino, Y., Kikuchi, S., Sato, M., Mori, K., Beppu, T., et al. (2016) Utility of the Measurement of Carboxyhemoglobin Level at the Site of Acute Carbon Monoxide Poisoning in Rural Areas. Scientifica, 2016, Article ID: 6192369. [Google Scholar] [CrossRef] [PubMed]
[4] Silva, L.A.D., Robazzi, M.L.D.C.C. and Terra, F.D.S. (2013) Relation between Workplace Accidents and the Levels of Carboxyhemoglobin in Motorcycle Taxi Drivers. Revista Latino-Americana de Enfermagem, 21, 1119-1126. [Google Scholar] [CrossRef] [PubMed]
[5] Jafari, B., Hsia, W.J. and Eusebio, E. (2026) Beyond Hypoxemia: Endogenous Carboxyhemoglobin as a Prognostic Window into Acute Respiratory Distress Syndrome. Respiratory Medicine, 254, Article 108714. [Google Scholar] [CrossRef
[6] Bünger, V., Menk, M., Hunsicker, O., Krannich, A., Balzer, F., Spies, C.D., et al. (2025) Carboxyhemoglobin and Methemoglobin as Biomarkers of Hemolysis and Mortality in Acute Respiratory Distress Syndrome Treated by Veno-Venous Extracorporeal Membrane Oxygenation. Anesthesia & Analgesia, 141, 1346-1354. [Google Scholar] [CrossRef] [PubMed]
[7] Meservey, A., Krishnan, G., Green, C.L., Morrison, S., Rackley, C.R. and Kraft, B.D. (2023) U-Shaped Association between Carboxyhemoglobin and Mortality in Patients with Acute Respiratory Distress Syndrome on Venovenous Extracorporeal Membrane Oxygenation. Critical Care Explorations, 5, e0957. [Google Scholar] [CrossRef] [PubMed]
[8] Kakavas, S., Papanikolaou, A., Ballis, E., Tatsis, N., Goga, C. and Tatsis, G. (2015) Carboxyhemoglobin and Methemoglobin Levels as Prognostic Markers in Acute Pulmonary Embolism. The American Journal of Emergency Medicine, 33, 563-568. [Google Scholar] [CrossRef] [PubMed]
[9] Uzer, F. and Ozbudak, O. (2019) The Importance and Place of Methemoglobin and Carboxyhemoglobin Levels in the Diagnosis and Prognosis of Pulmonary Embolism. Tanaffos, 18, 25-33.
[10] Eyi, Y.E., Yetim, M. and Tekindur, S. (2015) Endogenous and Exogenous Factors Affecting the Levels of Carboxyhemoglobin. The American Journal of Emergency Medicine, 33, 1310-1311. [Google Scholar] [CrossRef] [PubMed]
[11] Dani, C., Remaschi, G., Monti, N., Pizzetti, C. and Pratesi, S. (2023) Carboxyhemoglobin as Biomarker of Prematurity Complications. Clinica Chimica Acta, 541, Article 117241. [Google Scholar] [CrossRef] [PubMed]
[12] Tokuriki, S., Okuno, T., Ohta, G. and Ohshima, Y. (2015) Carboxyhemoglobin Formation in Preterm Infants Is Related to the Subsequent Development of Bronchopulmonary Dysplasia. Disease Markers, 2015, Article ID: 620921. [Google Scholar] [CrossRef] [PubMed]
[13] Tagliaferro, T., Cayabyab, R. and Ramanathan, R. (2022) Association between Blood Carboxyhemoglobin Level and Bronchopulmonary Dysplasia in Extremely Low Birthweight Infants. Journal of Investigative Medicine, 70, 68-72. [Google Scholar] [CrossRef] [PubMed]
[14] Naples, R., Laskowski, D., McCarthy, K., Mattox, E., Comhair, S.A.A. and Erzurum, S.C. (2015) Carboxyhemoglobin and Methemoglobin in Asthma. Lung, 193, 183-187. [Google Scholar] [CrossRef] [PubMed]
[15] Hara, Y., Shinkai, M., Kanoh, S., Fujikura, Y., K. Rubin, B., Kawana, A., et al. (2017) Arterial Carboxyhemoglobin Measurement Is Useful for Evaluating Pulmonary Inflammation in Subjects with Interstitial Lung Disease. Internal Medicine, 56, 621-626. [Google Scholar] [CrossRef] [PubMed]
[16] Izhakian, S., Harper, E., Gorelik, O., Frajman, A., Mekiten, O., Bar-Chaim, A., et al. (2022) Carboxyhemoglobin Does Not Predict the Need of Mechanical Ventilation and Prognosis during COPD Exacerbation. Canadian Respiratory Journal, 2022, Article ID: 6689805. [Google Scholar] [CrossRef] [PubMed]
[17] Zavorsky, G.S. (2013) The Rise in Carboxyhemoglobin from Repeated Pulmonary Diffusing Capacity Tests. Respiratory Physiology & Neurobiology, 186, 103-108. [Google Scholar] [CrossRef] [PubMed]
[18] Weaver, L.K. and Deru, K. (2017) Carboxyhemoglobin Half-Life during Hyperbaric Oxygen in a Patient with Lung Dysfunction: A Case Report. Undersea and Hyperbaric Medicine, 44, 173-177. [Google Scholar] [CrossRef] [PubMed]
[19] Ozturan, I.U., Yaka, E., Suner, S., Ozbek, A.E., Alyesil, C., Dogan, N.O., et al. (2019) Determination of Carboxyhemoglobin Half-Life in Patients with Carbon Monoxide Toxicity Treated with High Flow Nasal Cannula Oxygen Therapy. Clinical Toxicology, 57, 617-623. [Google Scholar] [CrossRef] [PubMed]
[20] Kimura, S., Gelbart, B., Chiletti, R., Stephens, D. and Butt, W. (2022) Carboxyhemoglobin Levels in Children during Extracorporeal Membrane Oxygenation Support: A Retrospective Study. Perfusion, 37, 797-804. [Google Scholar] [CrossRef] [PubMed]
[21] Tripathi, R.S. and Papadimos, T.J. (2011) ECMO and Endogenous Carboxyhemoglobin Formation. International Journal of Critical Illness and Injury Science, 1, Article 168. [Google Scholar] [CrossRef] [PubMed]
[22] Materne, L.A., Hunsicker, O., Menk, M. and Graw, J.A. (2021) Hemolysis in Patients with Extracorporeal Membrane Oxygenation Therapy for Severe Acute Respiratory Distress Syndrome—A Systematic Review of the Literature. International Journal of Medical Sciences, 18, 1730-1738. [Google Scholar] [CrossRef] [PubMed]
[23] Appelt, H., Philipp, A., Mueller, T., Foltan, M., Lubnow, M., Lunz, D., et al. (2020) Factors Associated with Hemolysis during Extracorporeal Membrane Oxygenation (ECMO)—Comparison of VA-versus VV ECMO. PLOS ONE, 15, e0227793. [Google Scholar] [CrossRef] [PubMed]
[24] Bemtgen, X., Rilinger, J., Holst, M., Rottmann, F., Lang, C.N., Jäckel, M., et al. (2022) Carboxyhemoglobin (CO-Hb) Correlates with Hemolysis and Hospital Mortality in Extracorporeal Membrane Oxygenation: A Retrospective Registry. Diagnostics, 12, Article 1642. [Google Scholar] [CrossRef] [PubMed]
[25] Cousin, V.L., Giraud, R., Assouline, B., Silva, I.N. and Bendjelid, K. (2022) Use of Carboxyhemoglobin as an Early Sign of Oxygenator Dysfunction in Patients Supported by Extracorporeal Membrane Oxygenation. Frontiers in Medicine, 9, Article ID: 893642. [Google Scholar] [CrossRef] [PubMed]
[26] Erlebach, R., Buhlmann, A., Andermatt, R., Seeliger, B., Stahl, K., Bode, C., et al. (2024) Carboxyhemoglobin Predicts Oxygenator Performance and Imminent Oxygenator Change in Extracorporeal Membrane Oxygenation. Intensive Care Medicine Experimental, 12, Article No. 41. [Google Scholar] [CrossRef] [PubMed]
[27] Dorresteijn, M. and Pickkers, P. (2012) Carboxyhemoglobin Levels during Human Inflammation. Critical Care, 16, Article 24. [Google Scholar] [CrossRef] [PubMed]
[28] hinai, A.A., Yazidi, L.A., Jaju, S., Sidairi, N.A., habsi, K.A., Lawati, M.A., et al. (2025) Utility of Carboxyhemoglobin Level for the Diagnosis of Invasive Bacterial Infection in a Febrile Neonate at Paediatric Emergency Department. Sultan Qaboos University Medical Journal, 25, 531-538. [Google Scholar] [CrossRef] [PubMed]
[29] Vardar, G. and Ozek, E. (2023) Carboxyhemoglobin Levels in Preterm Neonatal Late-Onset Sepsis: To Predict or Not to Predict. Mediterranean Journal of Hematology and Infectious Diseases, 15, e2023017. [Google Scholar] [CrossRef] [PubMed]
[30] Dani, C., Remaschi, G., Monti, N. and Pratesi, S. (2023) Carboxyhemoglobin as Biomarker of Late-Onset Sepsis in Preterm Infants. European Journal of Pediatrics, 182, 4523-4528. [Google Scholar] [CrossRef] [PubMed]
[31] Corbacioglu, S.K., Kilicaslan, I., Bildik, F., Guleryuz, A., Bekgoz, B., Ozel, A., et al. (2013) Endogenous Carboxyhemoglobin Concentrations in the Assessment of Severity in Patients with Community—Acquired Pneumonia. The American Journal of Emergency Medicine, 31, 520-523. [Google Scholar] [CrossRef] [PubMed]
[32] McArdle, A.J., Webbe, J., Sim, K., Parrish, G., Hoggart, C., Wang, Y., et al. (2016) Determinants of Carboxyhemoglobin Levels and Relationship with Sepsis in a Retrospective Cohort of Preterm Neonates. PLOS ONE, 11, e0161784. [Google Scholar] [CrossRef] [PubMed]
[33] Zelivianskaia, A., Hazen, N., Morozov, V. and Robinson, J.K. (2022) Prospective Study Investigating Change in Carboxyhemoglobin Blood Level during Operative Hysteroscopy. Journal of Minimally Invasive Gynecology, 29, 1260-1267. [Google Scholar] [CrossRef] [PubMed]
[34] Fitzgerald, J.J., Davitt, J.M., Frank, S.R. and Robinson, J.K. (2020) Critically High Carboxyhemoglobin Level Following Extensive Hysteroscopic Myomectomy. Journal of Minimally Invasive Gynecology, 27, 548-550. [Google Scholar] [CrossRef] [PubMed]
[35] Gavrilovska-Brzanov, A., Shosholcheva, M., Kuzmanovska, B., Kartalov, A., MojsovaMijovska, M., JovanovskiSrceva, M., et al. (2017) The Influence of Smoking on the Variations in Carboxyhemoglobin and Methemoglobin during Urologic Surgery. Medical Archives, 71, 178-182. [Google Scholar] [CrossRef] [PubMed]
[36] Godai, K., Hasegawa-Moriyama, M., Kuniyoshi, T., Matsunaga, A. and Kanmura, Y. (2013) Increased Carboxyhemoglobin Level during Liver Resection with Inflow Occlusion. Journal of Anesthesia, 27, 306-308. [Google Scholar] [CrossRef] [PubMed]
[37] Maeda, A., Pandey, D., Inokuchi, R., Spano, S., Chaba, A., Phongphithakchai, A., et al. (2024) Carboxyhemoglobin in Cardiac Surgery Patients and Its Association with Risk Factors and Biomarkers of Hemolysis. Anesthesia & Analgesia, 139, 789-797. [Google Scholar] [CrossRef] [PubMed]
[38] Maeda, A., Chaba, A., Inokuchi, R., Pandey, D., Spano, S., Phongphithakchai, A., et al. (2024) Carboxyhemoglobin as Potential Biomarker for Cardiac Surgery Associated Acute Kidney Injury. Journal of Cardiothoracic and Vascular Anesthesia, 38, 2221-2230. [Google Scholar] [CrossRef] [PubMed]
[39] Yoshida, T., Sakura, T., Shimizu, K., Kimura, S., Iwasaki, T., Kanazawa, T., et al. (2023) Carboxyhemoglobin and Methemoglobin Levels and Hemolysis in Children Undergoing Cardiac Surgery with Cardiopulmonary Bypass. ASAIO Journal, 69, 1099-1105. [Google Scholar] [CrossRef] [PubMed]
[40] Coburn, R.F. (2021) Effects of Increases in Carboxyhemoglobin Percent Saturation and Tissue Hypoxia on Carbon Monoxide Binding to Skeletal and Heart Extravascular Tissues. Journal of Applied Physiology, 131, 64-71. [Google Scholar] [CrossRef] [PubMed]
[41] Kaldirim, U., Yolcu, U., Arziman, I., et al. (2014) The Relationship between Blood Lactate, Carboxy-Hemoglobin and Clinical Status in CO Poisoning. European Review of Medical and Pharmaceutical Sciences, 18, 2777.
[42] Aykut, A., Günsoy, E., Karabulut, B.Ö., Aktaş, R.S., Öncül, M.V. and Karabulut, A.E. (2025) Serum Lactate and Carboxyhemoglobin as Predictors of Hyperbaric Oxygen Therapy in Carbon Monoxide Poisoning: A Retrospective Study. BMC Emergency Medicine, 25, Article No. 252. [Google Scholar] [CrossRef
[43] Delvau, N., Penaloza, A., Liistro, G., Thys, F., Delattre, I.K., Hantson, P., et al. (2018) Effect of Pressure Support Ventilation on Carboxyhemoglobin Toxicokinetic after Acute Carbon Monoxide Intoxication: A Swine Model. Journal of Medical Toxicology, 14, 128-133. [Google Scholar] [CrossRef] [PubMed]
[44] Fukuda, S., Niimi, Y., Andersen, C.R., Manyeza, E.R., Rojas, J.D., Prough, D.S., et al. (2020) Blood Carboxyhemoglobin Elimination Curve, Half-Lifetime, and Arterial-Venous Differences in Acute Phase of Carbon Monoxide Poisoning in Ovine Smoke Inhalation Injury Model. Biochemical and Biophysical Research Communications, 526, 141-146. [Google Scholar] [CrossRef] [PubMed]
[45] Liu, H., Yu, S., Peng, Y., Chang, X. and Yu, X. (2017) The Protective Effects of Carboxyhemoglobin during the Resuscitation from Hemorrhagic Shock in Rats. Oncotarget, 8, 83619-83625. [Google Scholar] [CrossRef] [PubMed]
[46] Hongo, T., Yumoto, T., Naito, H., Hiraoka, T., Murakami, Y., Obara, T., et al. (2025) Association of Blood Carboxyhemoglobin Levels with Mortality and Neurological Outcomes in Out‐of‐Hospital Cardiac Arrest. Acute Medicine & Surgery, 12, e70053. [Google Scholar] [CrossRef] [PubMed]
[47] Delvau, N., Penaloza, A., Franssen, V., Thys, F., Roy, P. and Hantson, P. (2023) Unexpected Carboxyhemoglobin Half-Life during Cardiopulmonary Resuscitation: A Case Report. International Journal of Emergency Medicine, 16, Article No. 22. [Google Scholar] [CrossRef] [PubMed]
[48] Hariri, G., Hodjat Panah, K., Beneteau-Burnat, B., Chaquin, M., Mekinian, A. and Ait-Oufella, H. (2021) Carboxyhemoglobin, a Reliable Diagnosis Biomarker for Hemolysis in Intensive Care Unit: A Retrospective Study. Critical Care, 25, Article No. 7. [Google Scholar] [CrossRef] [PubMed]
[49] van Vuren, A.J., Minniti, C.P., Mendelsohn, L., Baird, J.H., Kato, G.J. and van Beers, E.J. (2021) Lactate Dehydrogenase to Carboxyhemoglobin Ratio as a Biomarker of Heme Release to Heme Processing Is Associated with Higher Tricuspid Regurgitant Jet Velocity and Early Death in Sickle Cell Disease. American Journal of Hematology, 96, E315-E318. [Google Scholar] [CrossRef] [PubMed]
[50] Dilbaz Akyuz, C., Arayici, S., Akcan Paksoy, B. and Akyuz, B. (2026) Assessing Blood Carboxyhemoglobin Levels as an Early Predictor of Phototherapy in ABO Incompatible Newborns. Journal of Neonatal-Perinatal Medicine, Online ahead of Print.
[51] Karabulut, B. and Arcagok, B.C. (2020) A Neglected and Promising Predictor of Severe Hyperbilirubinemia Due to Hemolysis: Carboxyhemoglobin. Fetal and Pediatric Pathology, 39, 124-131. [Google Scholar] [CrossRef] [PubMed]
[52] Douglas-Escobar, M., Mendes, M., Rossignol, C., Bliznyuk, N., Faraji, A., Ahmad, A.S., et al. (2018) A Pilot Study of Inhaled CO Therapy in Neonatal Hypoxia-Ischemia: Carboxyhemoglobin Concentrations and Brain Volumes. Frontiers in Pediatrics, 6, Article ID: 120. [Google Scholar] [CrossRef] [PubMed]
[53] Kulcke, A., Feiner, J., Menn, I., Holmer, A., Hayoz, J. and Bickler, P. (2016) The Accuracy of Pulse Spectroscopy for Detecting Hypoxemia and Coexisting Methemoglobin or Carboxyhemoglobin. Anesthesia & Analgesia, 122, 1856-1865. [Google Scholar] [CrossRef] [PubMed]
[54] Roth, D., Herkner, H., Schreiber, W., Hubmann, N., Gamper, G., Laggner, A.N., et al. (2011) Accuracy of Noninvasive Multiwave Pulse Oximetry Compared with Carboxyhemoglobin from Blood Gas Analysis in Unselected Emergency Department Patients. Annals of Emergency Medicine, 58, 74-79. [Google Scholar] [CrossRef] [PubMed]
[55] Bidstrup, D., Ravn, F., Smidt-Nielsen, I.G., Wahl, A.M., Jansen, E.C. and Hyldegaard, O. (2021) Non-Invasive Monitoring of Carboxyhemoglobin during Hyperbaric Oxygen Therapy. Undersea and Hyperbaric Medicine, 48, 33-42. [Google Scholar] [CrossRef] [PubMed]
[56] Yeo, T.W., Lampah, D.A., Kenangalem, E., Tjitra, E., Price, R.N. and Anstey, N.M. (2013) Increased Carboxyhemoglobin in Adult Falciparum Malaria Is Associated with Disease Severity and Mortality. The Journal of Infectious Diseases, 208, 813-817. [Google Scholar] [CrossRef] [PubMed]
[57] Zaouter, C. and Zavorsky, G.S. (2012) The Measurement of Carboxyhemoglobin and Methemoglobin Using a Non-Invasive Pulse Co-Oximeter. Respiratory Physiology & Neurobiology, 182, 88-92. [Google Scholar] [CrossRef] [PubMed]
[58] Caboot, J.B., Jawad, A.F., McDonough, J.M., Bowdre, C.Y., Arens, R., Marcus, C.L., et al. (2012) Non‐Invasive Measurements of Carboxyhemoglobin and Methemoglobin in Children with Sickle Cell Disease. Pediatric Pulmonology, 47, 808-815. [Google Scholar] [CrossRef] [PubMed]
[59] Lozar-Krivec, J., Bratanic, B. and Paro-Panjan, D. (2015) The Role of Carboxyhemoglobin Measured with Co-Oximetry in the Detection of Hemolysis in Newborns with ABO Alloimmunization. The Journal of Maternal-Fetal & Neonatal Medicine, 29, 452-456. [Google Scholar] [CrossRef] [PubMed]
[60] Koyuncu, S., Bol, O., Ertan, T., Günay, N. and Akdogan, H.İ. (2020) The Detection of Occult CO Poisoning through Noninvasive Measurement of Carboxyhemoglobin: A Cross-Sectional Study. The American Journal of Emergency Medicine, 38, 1110-1114. [Google Scholar] [CrossRef] [PubMed]
[61] Sokolova-Djokić, L., Milosević, S., Skrbić, R., et al. (2011) Pulse Carboxyhemoglobin-Oximetry and Cigarette Smoking. Journal of Balkan Union of Oncology, 16, 170-173.
[62] Kristoffersen, L., Vevelstad, M., Hansen, I., Strømsvåg, B. and Strand, D.H. (2023) Comparative Evaluation of Carboxyhemoglobin Quantification in Postmortem Whole Blood by Co-Oximetry and Headspace Gas Chromatography with Flame Ionization Detection and Atom Absorption Spectrophotometry. Journal of Analytical Toxicology, 47, 311-316. [Google Scholar] [CrossRef] [PubMed]
[63] Chen, Z., Yang, S. and Xing, D. (2012) In Vivo Detection of Hemoglobin Oxygen Saturation and Carboxyhemoglobin Saturation with Multiwavelength Photoacoustic Microscopy. Optics Letters, 37, 3414-3416. [Google Scholar] [CrossRef] [PubMed]
[64] Bickler, M.P. and Rhodes, L.J. (2018) Accuracy of Detection of Carboxyhemoglobin and Methemoglobin in Human and Bovine Blood with an Inexpensive, Pocket-Size Infrared Scanner. PLOS ONE, 13, e0193891. [Google Scholar] [CrossRef] [PubMed]
[65] Wu, J., Luan, Y., Zhang, Q., Wang, F. and Rao, Y. (2025) Effects of Dichloromethane, Nitrate, and Sulfhemoglobin-Induced Substances on Carboxyhemoglobin Detection: A Comprehensive Review. Journal of Analytical Toxicology, 49, 170-179. [Google Scholar] [CrossRef] [PubMed]
[66] Pace, R., Bon Homme, M., Hoffman, R.S. and Lugassy, D. (2014) Effects of Hydroxocobalamin on Carboxyhemoglobin Measured under Physiologic and Pathologic Conditions. Clinical Toxicology, 52, 647-650. [Google Scholar] [CrossRef] [PubMed]
[67] Motterlini, R. and Foresti, R. (2017) Biological Signaling by Carbon Monoxide and Carbon Monoxide-Releasing Molecules. American Journal of Physiology-Cell Physiology, 312, C302-C313. [Google Scholar] [CrossRef] [PubMed]
[68] Olson, J.S., Foley, E.W., Maillett, D.H., et al. (2003) Measurement of Rate Constants for Reactions of O2, CO, and NO with Hemoglobin. Methods in Molecular Medicine, 82, 65-91.
[69] Palmeri, R. and Gupta, V. (2026) Carboxyhemoglobin Toxicity. StatPearls Publishing.
[70] Kaya, H., Coşkun, A., Beton, O., Zorlu, A., Kurt, R., Yucel, H., et al. (2016) COHgb Levels Predict the Long-Term Development of Acute Myocardial Infarction in CO Poisoning. The American Journal of Emergency Medicine, 34, 840-844. [Google Scholar] [CrossRef] [PubMed]
[71] Oh, S. and Choi, S.C. (2015) Acute Carbon Monoxide Poisoning and Delayed Neurological Sequelae: A Potential Neuroprotection Bundle Therapy. Neural Regeneration Research, 10, 36-38. [Google Scholar] [CrossRef] [PubMed]
[72] Abuchowski, A. (2017) SANGUINATE (Pegylated Carboxyhemoglobin Bovine): Mechanism of Action and Clinical Update. Artificial Organs, 41, 346-350. [Google Scholar] [CrossRef] [PubMed]
[73] Guerci, P., Ergin, B., Kandil, A., Ince, Y., Heeman, P., Hilty, M.P., et al. (2020) Resuscitation with Pegylated Carboxyhemoglobin Preserves Renal Cortical Oxygenation and Improves Skeletal Muscle Microcirculatory Flow during Endotoxemia. American Journal of Physiology-Renal Physiology, 318, F1271-F1283. [Google Scholar] [CrossRef] [PubMed]
[74] Macko, A., Sheppard, F.R., Nugent, W.H., Abuchowski, A. and Song, B.K. (2020) Improved Hemodynamic Recovery and 72-Hour Survival Following Low-Volume Resuscitation with a Pegylated Carboxyhemoglobin in a Rat Model of Severe Hemorrhagic Shock. Military Medicine, 185, e1065-e1072. [Google Scholar] [CrossRef] [PubMed]
[75] Kawaguchi, A.T., Salybekov, A.A., Yamano, M., Kitagishi, H., Sekine, K. and Tamaki, T. (2018) Pegylated Carboxyhemoglobin Bovine (SANGUINATE) Ameliorates Myocardial Infarction in a Rat Model. Artificial Organs, 42, 1174-1184. [Google Scholar] [CrossRef] [PubMed]
[76] DeSimone, R.A., Berlin, D.A., Avecilla, S.T. and Goss, C.A. (2018) Investigational Use of Pegylated Carboxyhemoglobin Bovine in a Jehovah’s Witness with Hemorrhagic Shock. Transfusion, 58, 2297-2300. [Google Scholar] [CrossRef] [PubMed]
[77] Romito, B.T., McBroom, M.M., Bryant, D., Gamez, J., Merchant, A. and Hill, S.E. (2019) The Effect of SANGUINATE® (Pegylated Carboxyhemoglobin Bovine) on Cardiopulmonary Bypass Functionality Using a Bovine Whole Blood Model of Normovolemic Hemodilution. Perfusion, 35, 19-25. [Google Scholar] [CrossRef] [PubMed]
[78] Linfante, I., Clark, W., Haussen, D.C., et al. (2024) HEMERA 1 CarboxyHEMoglobin Oxygen Delivery for Revascularization in Acute Stroke: A Prospective, Randomized Phase 1 Clinical Trial. Stroke (Hoboken, N.J.), 4, e001246.
[79] Goldstein, S.R., Liu, C., Safo, M.K., Nakagawa, A., Zapol, W.M. and Winkler, J.D. (2018) Design, Synthesis, and Biological Evaluation of Allosteric Effectors That Enhance CO Release from Carboxyhemoglobin. ACS Medicinal Chemistry Letters, 9, 714-718. [Google Scholar] [CrossRef] [PubMed]
[80] Wollborn, J., Hermann, C., Goebel, U., Merget, B., Wunder, C., Maier, S., et al. (2018) Overcoming Safety Challenges in CO Therapy—Extracorporeal CO Delivery under Precise Feedback Control of Systemic Carboxyhemoglobin Levels. Journal of Controlled Release, 279, 336-344. [Google Scholar] [CrossRef] [PubMed]