Objective: The aim of this study was to assess the role of blood lactate levels at admission in carbon monoxide (CO)-poisoned patients for establishing severity of poisoning and short term prognosis.
Method: All cases of CO poisoning visited in the emergency department during the years 2012 and 2013 were retrieved from the hospital database. The concentration of COHb and lactate was assessed in arterial blood in all patients with suspected CO poisoning, along with the plasma concentration of troponin I (TnI). The control population for TnI results consisted in 125 blood donors.
Results: Twenty three (61%) out of 38 CO-poisoned patients underwent hyperbaric oxygen (HBO) treatment, and 10 (26%) were admitted to a hospital ward. A significant correlation was found between lactate and COHb (r=0.54; p<0.001), and between lactate and TnI (r=0.44; p=0.001). A significant correlation was also found between COHb and TnI (r=0.38; p=0.020). Blood lactate levels were higher in patients treated with HBO and hospital admission. In multivariate analysis, none of the parameters was associated with HBO treatment, whereas increased value of blood lactate (p=0.036) was the only significant predictor of hospital admission. Twenty five (66%) patients had detectable TnI levels compared to 13% controls (p<0.001), whereas 16% CO-poisoned patients had TnI levels >99th percentile compared to 2% controls (p=0.003). The odds ratio for detectable TnI and TnI >99th percentile in CO-poisoned patients were 13.1 (p<0.001) and 7.6 (p=0.006), respectively.
Conclusion: Initial blood lactate level may be useful for risk stratification of CO-poisoned patients, especially for predicting hospitalization.
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http://dx.doi.org/10.1016/j.clinbiochem.2014.09.016 | DOI Listing |
Inhal Toxicol
July 2024
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Objectives: Delayed neuropsychiatric sequelae (DNS) are critical complications following acute carbon monoxide (CO) poisoning that can substantially affect the patient's life. Identifying high-risk patients for developing DNS may improve the quality of follow-up care. To date, the predictive DNS determinants are still controversial.
View Article and Find Full Text PDFNitric Oxide
May 2024
Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Carbon monoxide (CO) poisoning is a leading cause of poison-related morbidity and mortality worldwide. By binding to hemoglobin and other heme-containing proteins, CO reduces oxygen delivery and produces tissue damage. Prompt treatment of CO-poisoned patients is necessary to prevent acute and long-term complications.
View Article and Find Full Text PDFScand J Clin Lab Invest
April 2024
Medical Direction, Rovereto Hospital, Provincial Agency for Social and Sanitary Services (APSS), Trento, Italy.
No definitive prognostic biomarkers for carbon monoxide (CO) poisoning have been proposed. The aim of this study is to investigate, through a systematic literature review and pooled analysis, whether red blood cell distribution width (RDW) can predict disease severity in CO-poisoned patients. We performed an electronic search in Scopus and PubMed using the keywords: 'red blood cell distribution width' OR 'RDW' AND 'carbon monoxide' AND 'poisoning,' with no time or language restrictions (i.
View Article and Find Full Text PDFUndersea Hyperb Med
January 2023
Neuro Specialty Clinic, The Orthopedic Specialty Hospital, Murray, Utah U.S.
Introduction: Hyperbaric oxygen (HBO₂) improves outcome in patients with acute carbon monoxide (CO) poisoning, but optimal dose/timing are unknown. In this double-blind, sham-controlled randomized trial, we compared neuropsychological sequelae at six weeks and six months in patients receiving three HBO₂ sessions or one HBO₂ session and two sham chamber sessions after acute CO poisoning.
Methods: After completing one HBO₂ session (3.
Undersea Hyperb Med
June 2023
Former Department of Neuropsychiatry, Kumamoto University School of Medicine.
On November 9, 1963, a coal dust explosion occurred at the Miike Mikawa Coal Mine (Omuta, Kyushu Region of Japan). This resulted in a massive release of carbon monoxide (CO) gas that resulted in 458 fatalities and 839 victims of CO poisoning. After the accident, the Department of Neuropsychiatry, Kumamoto University School of Medicine (including the authors) immediately began to conduct periodic medical examinations of the victims.
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