Risk Factors and Outcome Analysis in Children with Carbon Monoxide Poisoning

Chang, Yu-Ching; Lee, Hao-Yuan; Huang, Jing‐Long; Chiu, Cheng-Hsun; Chen, Chyi‐Liang; Wu, Chieh‐Tsai

doi:10.1016/j.pedneo.2016.03.007

Cited by 30 publications

(39 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patterns of the high number of cases of CO poisoning in the colder months of November to February and a less number of cases in the hotter months of June to August is seen in this study in concordance with other studies. [ 12 13 ] Deaths were among economically productive age group and more commonly accidental as in other studies worldwide,[ 2 11 14 15 16 17 ] but CO has long been recognized as a means of deliberate suicide too,[ 18 19 20 ] as in our study.…”

Section: Discussionsupporting

confidence: 72%

“…However, the most common sources of CO are faulty, poorly maintained, or inadequately ventilated gas appliances such as stoves and heaters. [ 2 ] Malfunctioning heating systems, improperly ventilated motor vehicles, generators, grills, stoves, and residential fires may be listed in the common sources of CO exposure. [ 3 4 ]…”

Section: Introductionmentioning

confidence: 99%

“…CO has 210 times the affinity for hemoglobin than that of oxygen and impairs oxygen delivery and peripheral utilization leading to cellular hypoxia. [ 2 ] It can result in a variety of acute symptoms in low doses, including headache, dizziness, weakness, nausea, confusion, disorientation, and visual disturbances. In extreme cases, exposure leads to unconsciousness, coma, convulsions, and even death.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Fatal carbon monoxide poisoning: A lesson from a retrospective study at All India Institute of Medical Sciences, New Delhi

Sikary

Dixit

Murty

2017

J Family Med Prim Care

View full text Add to dashboard Cite

Background:Carbon monoxide (CO) is a colorless, odorless, tasteless, and nonirritating gas which makes it difficult for those who are exposed, to detect it, leading to unexpected death. This study was undertaken to see the pattern of fatal CO poisoning and to discuss preventive aspect.Materials and Methods:It was a retrospective descriptive study of fatal CO cases which were autopsied at All India Institute of Medical Sciences, New Delhi, from the year 2010 to the year 2015. The cases were analyzed as per age groups, circumstances of death, season of death, and sources of CO formation.Results and Discussion:The study involved 40 cases of fatal CO poisoning. About 80% of cases were reported in winter months. The maximum cases were reported in the month of January followed by November and December. All the cases except one, died with a source of CO nearby and the person was inside a room or some closed space without ventilation. Source of CO was firepot and electric room heater in most of the cases. Some cases were of CO build inside the car with a running engine. Most of the cases occurred accidentally.Conclusion:Clustering of cases is seen in winters. Poisoning can occur in different ways. The study documents the various possibilities of CO poisoning and advocates community education targeting the high-risk groups and masses, especially during the winter season.

show abstract

Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Fatal carbon monoxide poisoning: A lesson from a retrospective study at All India Institute of Medical Sciences, New Delhi

Sikary

Dixit

Murty

2017

J Family Med Prim Care

View full text Add to dashboard Cite

show abstract

“…Twenty-five percent of patients had HBOT and their baseline COHb levels were found to be statistically significantly higher compared to conventional treatment subjects. 26 In our study, 3 (1.2%) patients were followed up in the intensive care unit and these patients did not have a significantly higher COHb level compared to the other conventional treatment group. These 3 patients received conventional mechanical ventilation therapy and all three recovered without sequelae without taking HBOT.…”

Section: Discussionmentioning

confidence: 55%

Factors that Affect Prognosis and Morbidity in Pediatric Patients with Carbon Monoxide Poisoning

Seçilmiş¹,

Öztürk²

2018

cayd

View full text Add to dashboard Cite

Carbonmonoxide poisoning continues to be a major health problem worldwide, especially in developing countries, and constitutes an important part of the patients admitted to the pediatric emergency clinics due to poisoning. The aim of this study was to evaluate the correlation between clinical severity, morbidity, hospital stay, intensive care need, and full systemic effects in patients who were followed up and treated for carbon monoxide poisoning in our pediatric emergency clinic. Methods: The study was performed between January 2013 and 2015. We included patients under 18 years of age who were admitted to the pediatric emergency with carbon monoxide poisoning. Assessments were made prospectively. The epidemiological characteristics, complaints, physical examination and vital findings of all patients were recorded. Carboxyhemoglobin (COHb) level, oxygen saturation, electrocardiography, complete blood count, liver and kidney functions, and cardiac enzymes were studied, and Glasgow Coma scale (GCS) was calculated. Results: The mean length of hospital stay for 232 patients was calculated as 7.08±1 hours and the mean duration of exposure to carbon monoxide gas was 3.17±2.5 hours. Higher COHb levels and cardiotoxicity were detected in patients with a longer duration of exposure and a lower GCS and an increased intensive care need (p<0.01). There was no correlation between COHb levels and clinical severity, GCS, or intensive care unit need. However, it was found that high COHb levels (especially above 30%) increased cardiac injury and neurological symptoms but did not cause a permanent sequela (p<0.05). None of the patients had permanent neurological, cardiac, or renal damage. Conclusion: We found that duration of exposure is the most important and accurate parameter for the evaluation of clinical course and morbidity. In patients with high COHb levels, the effects are more prominent, however, we considered that there was no change in sequelae at long-term follow up.

show abstract

“…However, no statistical significance was revealed for ECG conducted >6 h after CO exposure ( Figure 2 ). This is reasonable because CO is eliminated through pulmonary circulation, and the elimination half-life of CO is approximately 300, 90, and 30 min under the breathing of room air, 100% oxygen via a reservoir or NRM facemask, and HBOT, respectively [ 9 ]. In our study, the median time from CO exposure to ED admission was 4 h (interquartile: 2.5–8 h).…”

Section: Discussionmentioning

confidence: 99%

Predictive Role of QTc Prolongation in Carbon Monoxide Poisoning-Related Delayed Neuropsychiatric Sequelae

Liao

Mao

Hung

et al. 2018

BioMed Research International

View full text Add to dashboard Cite

Objective Delayed neuropsychiatric sequelae (DNS) are serious complications of carbon monoxide (CO) poisoning that adversely affect poisoned patients' quality of life as well as socioeconomic status. This study aimed to determine clinical predictors of DNS in patients with CO poisoning. Methods This retrospective study included all CO-poisoned patients admitted to the emergency department (ED) of Linkou Chang Gung Memorial Hospital in Taiwan from 1 January 2009 to 31 December 2015. The medical records of all patients with CO poisoning were carefully reviewed, and relevant data were abstracted into a standardised form. Univariate and multivariate logistic regression models were used to identify predictors of DNS after CO poisoning. Receiver operating characteristic (ROC) curve analysis was used to determine the ideal cut-off value for continuous variables that predict the development of DNS. Results A total of 760 patients with CO poisoning were identified during the study period. Among them, 466 were eligible for the analysis of predictors of DNS. In multivariate analysis, Glasgow Coma Scale <9 (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.21–6.21), transient loss of consciousness (OR, 3.59; 95% CI, 1.31–9.79), longer duration from CO exposure to ED presentation (OR, 1.05; 95% CI, 1.03–1.08), and corrected QT (QTc) prolongation (OR, 2.61; 95% CI, 1.21–5.61) were found to be associated with a higher risk of DNS. The area under the ROC curve (AUC) for QTc interval measured within 6 h after exposure best predicted the development of DNS, with a result of 0.729 (95% CI 0.660–0.791). Moreover, the best cut-off value of the QTc interval was 471 ms, with a sensitivity of 53.3% and a specificity of 85.1%. Conclusions We identified several potential predictors of DNS following CO poisoning. Among them, QTc prolongation found within 6 h after exposure is a novel predictor of DNS, which may be helpful in the future care of patients with CO poisoning.

show abstract

Risk Factors and Outcome Analysis in Children with Carbon Monoxide Poisoning

Abstract: For those with treatment in the intensive care unit because of prolonged loss of consciousness and rescue by a ventilator, special attention should be given and follow-up should be performed to determine whether DNS or PNS occurs, particularly epilepsy and cognitive deficits.

Cited by 30 publications

References 29 publications

Fatal carbon monoxide poisoning: A lesson from a retrospective study at All India Institute of Medical Sciences, New Delhi

Fatal carbon monoxide poisoning: A lesson from a retrospective study at All India Institute of Medical Sciences, New Delhi

Factors that Affect Prognosis and Morbidity in Pediatric Patients with Carbon Monoxide Poisoning

Predictive Role of QTc Prolongation in Carbon Monoxide Poisoning-Related Delayed Neuropsychiatric Sequelae

Contact Info

Product

Resources

About