Clinical and Magnetic Resonance Imaging Findings of Patients with Acute Carbon Monoxide Poisoning

Abstract

We aim to evaluate the demographic and clinical characteristics of patients with acute carbon monoxide (CO) poisoning, who had a Glasgow Coma Score (GCS) below 15, and who had cerebral lesions detected in magnetic resonance imaging (MRI). Methods: The age, gender, causes of CO intoxication, clinical signs, neurological findings, GCS, blood carboxyhemoglobin level (COHb), serum pH, lactate, creatine kinase (CK), creatinine kinase-myocardial band MB (CK-MB), troponin-I level, brain MRI (T1weighted, T2-weighted, FLAIR and diffusion-weighted imaging), treatment, and mortality status of 327 patients were evaluated retrospectively. Results: The median age of patients was 31.5 years (IQR=19.5 years), 72.2% of the patients were women. Neurological findings were detected in 34 (10.4%) of the patients. The frequency of dyspnea was significantly higher in patients with neurological findings (p<0.05). The COHb and lactate levels of patients with neurological findings were found to be significantly high, the pH level was significantly lower (p<0.05). There was no significant relationship between the presence of neurological findings and CK, CK-MB, and troponin-I levels (p>0.05). Patients with neurological findings were found to have a significantly longer follow-up period, more frequently received hyperbaric oxygen therapy (p<0.05). The rate of hospitalization was 10.7%, the mortality rate was 0.9%. Hospitalization and mortality rates were significantly high in patients with neurological findings (p <0.05). Pathological findings were detected in 13 (40.6%) of 32 of patients (except for 2 patients who did not respond to the resuscitation) who had an MRI. Conclusions: It was determined that acute CO poisoning may lead to acute brain damage, 40.6% would be detected in brain MRIs taken in patients during the acute phase.