Karbonmonoksit Zehirlenmesinde Hiperbarik Oksijen Tedavisinin Acil Servis İşleyişindeki Yeri

Abstract

Aim:The aim of this study is to investigate the relationship between high carboxyhemoglobin (CoHb) levels and hyperbaricoxygen (HBO) treatment in acute carbonmonoxide (CO) poisoning.Material and Methods: Patients examined due to CO poisoning with a COHb level> 20 were evaluated retrospectively. In accordance to the CoHb levels after the treatment of patients with normobaric oxygen or HBO; duration of emergency stay, indications for HBO treatment, current clinical findings were evaluated.Results: While the CO source was coal stove in 66 cases (60%), 99.1% of the exposures occurred in the home environment. HBO therapy was applied in 20.9% (n: 23) patients. Indications for HBO treatment were syncope in 10 (9.1%) patients, blurred consciousness in 7 (6.4%), and cardiac toxicity in 2 (1.8%). A positive correlation was found between the arrival COHb values of the patients and their length of stay in the emergency room (p = 0,000).Conclusion: CO poisoning is a common emergency. Oxygen therapy with a reservoir mask is the main treatment in the emergency room and provides adequate treatment for the majority of patients. HBO treatment is not available in every center and emergency departments experience difficulties in terms of establishing correct indications. Regardless of COHb level, the patient should be evaluated clinically for HBO indication.

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

“…[1] The severity of intoxication is divided into 3 groups as mild, moderate, severe, based on the measured COHb levels. [9] In a recent study in Turkey, 35 patients with COHb levels above10% were recruited, but these patients were not classified among themselves. [3] In our study, most of the patients were in the severe poisoning class and no patients were in the mild poisoning class.…”

“…[8] >10% of COHb without clinical symptoms and signs is mild poisoning; >10% of COHb with mild symptoms and signs (headache, lethargy, fatigue) is moderate poisoning; >20-25% of COHb with loss of consciousness, confusion or cardiac ischemia is severe poisoning. [9] High flow oxygen (NBO) with mask is the first and main treatment approach to patients who are suspected or diagnosed in the emergency department (ED), and treatment should be continued until COHb levels of patients reach normal levels (≤3%) and their symptoms resolve (at least 6 hours). [1] COP is discussed in two parts.According to the hypoxia theorem, CO particlereduces the oxygen carrying capacity of the cells by binding to hemoglobin 230-270 times more than oxygen, resulting in hypoxia in all tissues in the body.…”