Role of serum erythropoietin level in evaluating severity of tissue hypoxia in carbon monoxide intoxicated patients.

Abstract

Carbon monoxide (CO) is the second most frequent environmental pollutant worldwide. Tissue hypoxia appears to be the main cause that stands behind the harmful effects of co-poisoning. This study aimed to improve the management of carbon monoxide-intoxicated patients by predicting of use of erythropoietin levels in determining the need for hyperbaric oxygen (HBO) treatment in CO-poisoned patients who were previously categorized as non-HBO needers according to COHB level that was found to be below 25%. This cross-sectional comparative study was carried out on 71 patients presented to the Poison Control Center of Minia University with a history of CO poisoning from 1st February 2020 to April 2022. Arterial blood samples were drawn for carboxyhemoglobin (COHb) level, venous blood samples were drawn on admission and after 2 hours from patients who had COHb < 25 % for erythropoietin (EPO) value, CT and ECG were performed to all patients. We demonstrated that 23 patients had COHb > 25 %, and 48 patients had COHb < 25 %, EPO predicted the need for HBO in 17 patients after 2 hours with a sensitivity of 82.35 % and specificity of 100 %. So we concluded that EPO was a good predictor for the need for HBO in CO-poisoned patients with COHb less than 25%.