Does Hypoxia Inducible Factor 1? Levels Contribute to the Diagnosis and Follow Up of Carbon Monoxide Poisoning?

Abstract

non-irritating toxic gas. COP is one of the common types of poisoning in the world.Approximately 50000 patients are admitted toemergency departmentswith COPin a yearin the USA. [1,2] The incidence of COP increases due to the use of carbon-based fuels, and the use of flue-free stoves, barbecues and water heaters in small areas with insufficient ventilation is the most important cause of poisoning in our country. [3,4] CO leads to various tempo-rary and permanent effects on human bodydepending on the time of exposure and the effects of treatment. [5] Heart and brain are the most responsive organs to COP due to their high metabolic rates, and neuropsychiatric. [6] Classical complaints in acute intoxications are headache, dizziness, nausea, vomiting, dyspnea, and chest pain. Findings range from minimal symptoms to nonresponsiveness, hypotension, severe acidemia and/or acute respiratory failure. [7] Objectives: This study aimed to evaluate the levels of HIF-1α (Hypoxia-Induced Factor) in acute Carbonmonoxide poisoning (COP) at admission and after the treatment. Methods: The study was conducted prospectively and cross-sectionally in the adult Emergency Department of our hospitalbetween 01. 01.2018 and 30.06.2018. Results: This study included 42 patients admitted to the emergency department with suspected COP. When the cases were grouped according to carboxyhemoglobin (COHb) level, the levels of 38.1% (n=16) and 61.5% (n=26) of the patients were found to be moderate and severe, respectively. There were no mild cases among our cases. After the treatment, HIF-1α, COHb, mean platelet volume (MPV), lymphocyte, lactate, pH and base deficit values were statistically significantly lower than the pre-treatment values(p value<0.0001, <0.0001, <0.0001, 0.039, <0.0001, 0.032, 0.01, respectively). A positive correlation was found between COHb level and white blood cell (WBC), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), pH, HIF-1α and lactate levels. There was a statistical significance only at pH value (p=0.001, r=0.474). Conclusion: HIF-1α increases significantly in parallel withCarbonmonoxide(CO) exposure and these high levels are positively correlated with COHb concentrations. Based on this data, COHb concentrations are still the best biomarkers in the diagnosis and follow-up of COP.