Karbonmonoksit Zehirlenmesi

Year 2022, Volume: 4 Issue: 2, 44 - 50, 30.08.2022

Yeşim İşler

https://doi.org/10.51262/ejtox.1101903

Cited By: 1

Abstract

Karbon monoksit (CO), düşük konsantrasyonlarda havaya benzer moleküler ağırlığa sahip kokusuz, renksiz ve tatsız zehirli bir gazdır. Bu nedenle “sessiz katil” olarak da tanımlanan CO, en sık ölümcül zehirlenme sebeplerindendir. Ölüm oranı, CO'ya maruz kalma sürelerine ve konsantrasyonlarına bağlıdır. CO intoksikasyonu halen dünyada ön sıralarda yer alan zehirlenmeler arasında yer almaktadır. Gerek suisidal amaçlı, gerekse kaza sonucu olsun, önlenebilir, önemli bir morbidite ve mortalite sebebidir. Bu derlemede CO zehirlenmesinin patofizyolojisi, nedenleri, tanısı, tedavisi, prognozu ve komplikasyonlarının gözden geçirilmesi amaçlanmıştır. Tanı ve tedavide yapılması gerekenler, güncel tedavi yaklaşımları anlatılmaya çalışılmıştır.

Keywords

Karbon monoksit, zehirlenme, Acil

Carbon Monoxide Poisoning

Abstract

Carbon monoxide (CO) is an odorless, colorless and tasteless poisonous gas with a molecular weight similar to air in low concentrations. For this reason, CO, which is also defined as the “silent killer”, is one of the most common causes of fatal poisoning. Mortality depends on the duration of exposure to CO and its concentrations. CO poisoning, is still among the leading poisonings in the world. Whether it is for suicidal purposes or as a result of accident, it is a preventable, important cause of morbidity and mortality. In this review, it is aimed to review the pathophysiology, causes, diagnosis, treatment, prognosis and complications of CO poisoning. It has been tried to explain what needs to be done in diagnosis and treatment, and current treatment approaches.

Keywords

Carbon monoxide, poisoning, emergency

References

• Gupta RC. Handbook of Toxicology of Chemical Warfare Agents, 2nd edn. Elsevier Inc, 2015.
• Vreman H., Wong R., Stevenson D., Smialek J., Fowler D., Li L., et al. Concentration of carbon monoxide (CO) in postmortem human tissues: effect of environmental CO exposure. Journal of Forensic Sciences, 2006;51, 1182–90.
• Fazlzadeh M., Rostami R., Hazrati S., Rastgu A. Concentrations of carbon monoxide in indoor and outdoor air of Ghalyun cafes. Atmospheric Pollution Research, 2015;6, 550–5.
• WHO guidelines for indoor air quality. WHO Regional Office for Europe, Copenhagen 2009.
• Prockop LD. Chichkova RI. Carbon monoxide intoxication: an updated review. J. Neurol. Sci. 2007; 262: 122-30.
• Harper A., Croft-Baker J. Carbon monoxide poisoning: undetected by both patients and their doctors. Age and Ageing 2004;33, 105–109.
• Guzman JA. Carbon Monoxide Poisoning. Crit Care Clin 2012; 28:537–48. https://doi.org/10.1016/j. ccc.2012.07.007 PMID: 22998990
• Rose JJ, Nouraie M, Gauthier MC, Pizon AF, Saul MI, Donahoe MP, et al. Clinical Outcomes and Mortality Impact of Hyperbaric Oxygen Therapy in Patients With Carbon Monoxide Poisoning. Crit Care Med 2018; 46:e649–55. https://doi.org/10.1097/CCM.0000000000003135 PMID: 29629990
• Huang CC, Ho CH, Chen YC, Hsu CC, Wang YF, Lin HJ, et al. Impact of Hyperbaric Oxygen Therapy on Subsequent Neurological Sequelae Following Carbon Monoxide Poisoning. J Clin Med 2018; 7:349. https://doi.org/10.3390/jcm7100349 PMID: 30322113
• Lippi G, Rastelli G, Meschi T, Borghi L, Cervellin G. Pathophysiology, clinics, diagnosis and treatment of heart involvement in carbon monoxide poisoning. Clin Biochem. 2012;45(16-17):1278-85.
• Omaye ST. Metabolic modulation of carbon monoxide toxicity. Toxicology. 2002;180(2):139-50.
• Rose JJ, Wang L, Xu Q, McTiernan CF, Shiva S, Tejero J, et al. Carbon Monoxide Poisoning: Pathogenesis, Management, and Future Directions of Therapy. Am J Respir Crit Care Med. 2017;195(5):596-606.
• Gözübüyük AA, Dag H, Kacar A, Karakurt Y, Arica V. Epidemiology, pathophysiology, clinical evaluation, and treatment of carbon monoxide poisoning in child, infant, and fetus. North Clin Istanb. 2017;4(1):100-7.
• Wu L, Wang R. Carbon monoxide: endogenous production, physiological functions, and pharmacological applications. Pharmacol Rev. 2005;57(4):585-630.
• Kao LW, Nanagas KA. Carbon monoxide poisoning. Emerg Med Clin North Am. 2004;22(4):985-1018. Gorman D, Drewry A, Huang YL, Sames C. The clinical toxicology of carbon monoxide. Toxicology. 2003;187(1):25-38.
• Huzar TF, George T, Cross JM. Carbon monoxide and cyanide toxicity: etiology, pathophysiology and treatment in inhalation injury. Expert Rev Respir Med. 2013;7(2):159-70.
• Wattel F, Favory R, Lancel S, Neviere R, Mathieu D. Carbon monoxide and the heart: unequivocal effects?. Bull Acad Natl Med. 2006;190(9):1961-74-5.
• Geocadin RG, Koenig MA, Jia X, Stevens RD, Peberdy MA. Management of brain injury after resuscitation from cardiac arrest. Neurol Clin. 2008;26(2):487-506.
• Doyle KP, Simon RP, Stenzel-Poore MP. Mechanisms of ischemic brain damage. Neuropharmacology. 2008;55(3):310-8.
• Thom SR, Bhopale VM, Han ST, Clark JM, Hardy KR. Intravascular neutrophil activation due to carbon monoxide poisoning. Am J Respir Crit Care Med. 2006;174(11):1239-48.
• Naik JS, O’Donaughy TL, Walker BR. Endogenous carbon monoxide is an endothelial-derived vasodilator factor in the mesenteric circulation. Am J Physiol Heart Circ Physiol. 2003;284:838–45.
• Hampson NB, Piantadosi CA, Thom SR, Weaver LK. Practice recommendations in the diagnosis, management, and prevention of carbon monoxide poisoning. Diving Hyperb Med. 2013;186(11):1095-101.
• Doherty S. History, pathophysiology, clinical presentation and role of hyperbaric oxygen in acute carbon monoxide poisoning. Emergency Medicine. 2000;12(1):55-61.
• Kandiş H, Katırcı Y, Karapolat B. Karbonmonoksit zehirlenmesi. Düzce Üniversitesi Tıp Fakültesi Dergisi. 2009;11(3):54-60.
• Shimazu T. Pathophysiology, myths and mysteries of acute carbon monoxide poisoning, Chudoku Kenkyu 2006;19:23–33.
• Kao LW, Nanagas KA. Toxicity associated with carbon monoxide. Clin Lab Med. 2006;26(1):99-125.
• Garg J, Krishnamoorthy P, Palaniswamy C, Khera S, Ahmad H, Jain D, et al. Cardiovascular Abnormalities in Carbon Monoxide Poisoning. Am J Ther. 2018;25(3):e339-e48.
• Yelken B, Tanriverdi B, Cetinbas F, Memis D, Sut N. The assessment of QT intervals in acute carbon monoxide poisoning. Anadolu Kardiyol Derg. 2009;9(5):397-400.
• Weaver LK. Clinical practice: carbon monoxide poisoning. N Engl J Med 2009;360:1217–25.
• Akça H, Tuygun N, Polat E, Karacan CD. Acute carbon monoxide poisoning: experience of eight years. Eurasian J Emerg Med 2015;14:189-91.
• Altintop I, Akcin ME, Tatli M, Ilbasmis MS. Factors that influence the decision for hyperbaric oxygen therapy (HBOT) in cases of carbonmonoxide poisoning: a retrospective study. Ann Burns Fire Disasters 2018;31:168-73.
• Lopez DM, Weingarten-Arams JS, Singer LP, Conway Jr EE. Relationship between arterial, mixed venous, and internal jugular carboxyhemoglobin concentrations at low, medium, and high concentrations in a piglet model of carbon monoxide toxicity. Crit Care Med. 2000;28:1998–2001.
• Hampson NB, Piantadosi CA, Thom SR, Weaver LK. Practice recommendations in the diagnosis, management, and prevention of carbon monoxide poisoning. Am J Respir Crit Care Med 2012;186(11):1095–101.
• Moriya F. Poisoning due to carbon monoxide and cyanide gas generated in the occurrence of fire, Chudoku Kenkyu 2015;28:339–45.
• Kuo YM, Nussbaum RL. Prolongation of chemically-induced methemoglobinemia in mice lacking α-synuclein: a novel pharmacologic and toxicologic phenotype, Toxicol. Rep. 2016;3:295–305.
• Katırcı Y. Karbonmonoksitle zehirlenen hastalarda nöropsikiyatrik bozuklukların sıklığı ve ilişkili etmenler. Uzmanlık Tezi; Erzurum 2005
• Hegde AN, Mohan S, Lath N, Lim CC. Differential diagnosis for bilateral abnormalities of the basal ganglia and thalamus. Radiographics. 2011;31(1):5-30.
• O'donnell P, Buxton P, Pitkin A, Jarvis L. The magnetic resonance imaging appearances of the brain in acute carbon monoxide poisoning. Clinical radiology. 2000;55(4):273-80.
• Lo CP, Chen SY, Lee KW, Chen WL, Chen CY, Hsueh CJ, et al. Brain injury after acute carbon monoxide poisoning: early and late complications. AJR Am J Roentgenol. 2007;189(4):205-11.
• Lin CH, Su WH, Chen YC, Feng PH, Shen WC, Ong JR et al. Treatment with normobaric or hyperbaric oxygen and its effect on neuropsychometric dysfunction after carbon monoxide poisoning. Medicine (Baltimore). 2018; 97(39):e12456.
• Eichhorn L, Thudium M, Jüttner B. The diagnosis and treatment of carbon monoxide poisoning. Dtsch Arztebl Int. 2018;115(51-52):863-70.
• Drinhaus H, Nüsgen S, Hinkelbein J. Guidelines desirable for treatment of carbon monoxide poisoning. Anaesthesist. 2016;65(4):301-2.
• Chavouzis N, Pneumatikos I. Carbonmonoxide inhalation poisoning. Pneumon 2014;27(1):16.
• Kuo SC, Hsu CK, Tsai CT, Chieh MJ. Hyperbaric Oxygen Therapy and Acute Carbon Monoxide Poisoning. Hu Li Za Zhi. 2018;65(4):11-17.
• Hampson NB, Hauff NM: Carboxyhemoglobin levels in carbon monoxide poisoning: do they correlate with the clinical picture? Am J Emerg Med 2008;26:665–6.
• Satran D, Henry CR, Adkinson C, Nicholson CI, Bracha Y, Henry TD. Cardiovascular manifestations of moderate to severe carbon monoxide poisoning. J Am Coll Cardiol 2005;45:1513–16.
• Hampson NB, Rudd RA, Hauff NM. Increased long-term mortality among survivors of acute carbon monoxide poisoning. Crit Care Med 2009;37:1941–47.
• Pages B, Planton M, Buys S, Lemesle B, Birmes P, Barbeau EJ, et al. Neuropsychological outcome after carbon monoxide exposure following a storm: a case–control study. BMC Neurol 2014;14:153. Kaya H. Carbon monoxide poisoning Turkiye Klinikleri J Emerg Med-Special Topics 2018;4(2):149-57.