Carbon monoxide intoxication: What we know

Reumuth, Georg; Alharbi, Ziyad; Houschyar, Khosrow Siamak; Kim, Bong-Sung; Siemers, Frank; Fuchs, Paul Christian; Grieb, Gerrit

doi:10.1016/j.burns.2018.07.006

Cited by 43 publications

(22 citation statements)

References 28 publications

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“…Depending on cardiac and neurological effects, symptoms such as chest pain, syncope, shortness of breath, palpitation, dizziness, or blurred vision can occur. 4 In this case, although the HbCO level was 12.2%, there were no other symptoms except mild headache. In their study, Kalay, et al showed in patients with CO poisoning that coronary arteries may appear normal, even in the presence of elevated levels of cardiac markers and myocardial dysfunction ameliorated in most of the cases they followed in the first 24 hours.…”

Section: Discussionmentioning

confidence: 56%

Transient ST Segment Elevation Caused by Intracoronary Thrombus after Acute Carbon Monoxide Poisoning

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Yıldırım

Aydın

et al. 2019

Prehosp. Disaster med.

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Carbon monoxide (CO) poisoning is the most common cause of death and injury among all poisonings. Myocardial injury is detected in one-third of CO poisonings. In this Case Report, a previously healthy 41-year-old man was referred for CO poisoning. The initial electrocardiogram (ECG) showed 1mm ST segment elevation in leads DII, DIII, and aVF. As the patient did not describe chest pain and had no cardiac symptoms, ECG was repeated 10 minutes later and it was seen that ST segment elevation disappeared. As the patient had a transient ST segment elevation and elevated high-sensitive Tn-T (HsTn-T), the patient was transferred to the coronary angiography laboratory. The patient’s left coronary system was normal, but a thrombus image narrowing the lumen by approximately 60% was observed in the right coronary artery. Intravenous tirofiban was administered for 48 hours. Control coronary angiography showed continuing thrombus formation and a bare metal stent was successfully implanted. This is the first reported case with transient ST segment elevation associated with acute coronary thrombus caused by CO poisoning. It may be recommended that patients with CO poisoning should be followed-up with a 12-lead ECG monitor or 24-hour ECG Holter monitoring, even if they show no cardiac symptoms and echocardiography shows no wall motion abnormality. Early coronary angiography upon detection of such dynamic ECG changes in these recordings as ST segment elevation can reduce the risk of myocardial infarction (MI) and mortality in these patients.

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Section: Discussionmentioning

confidence: 56%

Transient ST Segment Elevation Caused by Intracoronary Thrombus after Acute Carbon Monoxide Poisoning

Akşit

Yıldırım

Aydın

et al. 2019

Prehosp. Disaster med.

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“…Hydrogen also when combined with other elements is used as a green colorant in fireworks. Since the lower explosion limit (LEL) of Hydrogen is at 4.1% Getting 10% of the LEL would define the safe amount of Hydrogen in the environment [19,20]. In the case of Hydrogen, it is 4,100ppm, when this amount is reached the facility is in danger of experiencing a fire or an explosion [21].…”

Section: Hydrogenmentioning

confidence: 99%

Development of a portable electronic device for the detection and indication of fireworks and firecrackers for security personnel

Africa

Tan

2020

IJEECS

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The use of fireworks and firecrackers to celebrate festivities is a very common activity in the Philippines. But due to the lack of strict control and regulation, there are unwanted risks of accidents from occurring due to the poor handling and storage conditions of these devices. Proper monitoring is important to reduce any unnecessary risks imposed on human life and property. While existing storage monitoring devices exist, the developed prototype is designed to contain sensors that are more suited in monitoring the ideal conditions of where the fireworks are stored. Monitoring the climate conditions on these devices may seem trivial at first, but such climate change can involve a rapid rise in temperature that can accidentally ignite the fireworks and deal with catastrophic damage. Another concern is the rise of humidity that may alter that chemical characteristics of the gunpowder stored in the fireworks. Such changes may not have any noticeable effects until it arrives in the consumer, that may experience an unwanted and unintended change in the performance of the fireworks leading to accidents. Therefore, it is important for this device to properly monitor the surrounding area then indicate various forms of alarms as a method of redundancy.

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“…Carbon monoxide (CO) is a clear, odourless gas, exposure to which presents significant health risks ( Sjostrand, 1970 ). Environmental CO, generated for example, by the incomplete combustion of hydrocarbons found in engine exhaust fumes or by malfunctioning gas appliances, has significant toxicity, with acute CO poisoning accounting for greater than half of all fatal poisonings each year ( Varon et al, 1999 ; Reumuth et al, 2019 ; Kinoshita et al, 2020 ). As CO demonstrates a far greater affinity for haemoglobin than oxygen, acute exposure can lead to hypoxia ( Von Burg, 1999 ) and an associated increased risk of sudden death ( Gandini et al, 2001 ; Satran et al, 2005 ).…”

Section: Introductionmentioning

confidence: 99%

Deterministic and Stochastic Cellular Mechanisms Contributing to Carbon Monoxide Induced Ventricular Arrhythmias

et al. 2021

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Chronic exposure to low levels of Carbon Monoxide is associated with an increased risk of cardiac arrhythmia. Microelectrode recordings from rat and guinea pig single isolated ventricular myocytes exposed to CO releasing molecule CORM-2 and excited at 0.2/s show repolarisation changes that develop over hundreds of seconds: action potential prolongation by delayed repolarisation, EADs, multiple EADs and oscillations around the plateau, leading to irreversible repolarisation failure. The measured direct effects of CO on currents in these cells, and ion channels expressed in mammalian systems showed an increase in prolonged late Na+, and a decrease in the maximal T- and L-type Ca++. peak and late Na+, ultra-rapid delayed, delayed rectifier, and the inward rectifier K+ currents. Incorporation of these CO induced changes in maximal currents in ventricular cell models; (Gattoni et al., J. Physiol., 2016, 594, 4193–4224) (rat) and (Luo and Rudy, Circ. Res., 1994, 74, 1071–1096) (guinea-pig) and human endo-, mid-myo- and epi-cardial (O’Hara et al., PLoS Comput. Biol., 2011, 7, e1002061) models, by changes in maximal ionic conductance reproduces these repolarisation abnormalities. Simulations of cell populations with Gaussian distributions of maximal conductance parameters predict a CO induced increase in APD and its variability. Incorporation of these predicted CO induced conductance changes in human ventricular cell electrophysiology into ventricular tissue and wall models give changes in indices for the probability of the initiation of re-entrant arrhythmia.

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Carbon monoxide intoxication: What we know

Cited by 43 publications

References 28 publications

Transient ST Segment Elevation Caused by Intracoronary Thrombus after Acute Carbon Monoxide Poisoning

Transient ST Segment Elevation Caused by Intracoronary Thrombus after Acute Carbon Monoxide Poisoning

Development of a portable electronic device for the detection and indication of fireworks and firecrackers for security personnel

Deterministic and Stochastic Cellular Mechanisms Contributing to Carbon Monoxide Induced Ventricular Arrhythmias

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