Karbonmonoksit Zehirlenmesi

Yıl 2019, Cilt: 6 Sayı: 1, 52 - 55, 20.03.2019

Egemen Kaya Serkan Ergözen

Öz

Karbonmonoksit, hidrokarbonların tam olarak
yanmaması sonucu oluşan tatsız, renksiz ve kokusuz, toksik bir gazdır.
Karbonmonoksit zehirlenmesi Türkiye’de her yıl yüzlerce kişinin ölümüne sebep
olan önemli bir halk sağlığı sorunudur. Karbonmonoksit zehirlenmesi tedavisinde
güncel yaklaşım, hastaya %100 normobarik oksijen solutulması veya hiperbarik
oksijen tedavisi uygulanmasıdır. Tedavide amaç karbonmonoksidin vücuttan
eliminasyonunu sağlayarak akut etkileri ve gecikmiş nöropsikiyatrik sekel
gelişimini engellemektir.

Anahtar Kelimeler

Hiperbarik Oksijen Tedavisi, Karbonmonoksit, Zehirlenme

Carbon Monoxide Poisoning

Öz

Carbon monoxide, which is produced from
incomplete combustion of hydrocarbons, is a tasteless, colorless and odorless,
toxic gas. Carbon monoxide poisoning is a severe public health problem that
causes hundreds of deaths each year in Turkey. The current approach to the
treatment of carbon monoxide intoxication is 100% normobaric oxygen inhalation
or hyperbaric oxygen therapy. The aim of the treatment is to prevent the acute
effects and delayed neuropsychiatric sequelae by the elimination of carbon
monoxide from the body.

Anahtar Kelimeler

Carbon Monoxide, Hyperbaric Oxygen Treatment, Poisoning

Kaynakça

• 1. Gupta RC. Handbook of Toxicology of Chemical Warfare Agents, 2nd edn. Elsevier Inc, 2015.
• 2. Lascaratos JG, Marketos SG. The carbon monoxide poisoning of two Byzantine Emperors. J Toxicol - Clin Toxicol. 1998;36(1-2):103-7.
• 3. Dobbs MR. Clinical Neurotoxicology: Syndromes, Substances, Environments. Clinical Neurotoxicology: Syndromes, Substances, Environments. Elsevier Inc, 2009.
• 4. Can G, Sayılı U, Aksu Sayman Ö, et al. Mapping of carbon monoxide related death risk in Turkey: A ten-year analysis based on news agency records. BMC Public Health. 2019;19(1):9.
• 5. Guyton AC, Hall E J. Guyton and Hall Textbook of Medical Physiology, 13th edn. Elseiver, 2016.
• 6. Wald G. The equilibrium between cytochrome oxidase and carbon monoxide. J Gen Physiol. 2004;40(4):593-608.
• 7. Hampson NB, Rudd RA, Hauff NM. Increased long-term mortality among survivors of acute carbon monoxide poisoning. Crit Care Med. 2009;37(6):1941-47.
• 8. 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.
• 9. Brown SD, Piantadosi CA. Recovery of energy metabolism in rat brain after carbon monoxide hypoxia. J Clin Invest. 1992;89(2):666-72.
• 10. Shiva S, Huang Z, Grubina R, et al. Deoxymyoglobin is a nitrite reductase that generates nitric oxide and regulates mitochondrial respiration. Circ Res. 2007;100(5):654-61.
• 11. Meyer G, Andre L, Kleindienst A, et al. Carbon monoxide increases inducible NOS expression that mediates CO-induced myocardial damage during ischemia-reperfusion. Am J Physiol Heart Circ Physiol. 2015;308(7): 759-67.
• 12. Thom SR, Ohnishi ST, Ischiropoulos H. Nitric oxide released by platelets inhibits neutrophil b2 integrin function following acute carbon monoxide poisoning. Toxicol Appl Pharmacol. 1994;128(1):105-10.
• 13. 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.
• 14. Kuroda H, Fujihara K, Kushimoto S, Aoki M. Novel clinical grading of delayed neurologic sequelae after carbon monoxide poisoning and factors associated with outcome. Neurotoxicology. 2015;48:35-43.
• 15. Doyle KP, Simon RP, Stenzel-Poore MP. Mechanisms of ischemic brain damage. Neuropharmacology. 2008;55(3):310-18.
• 16. Piantadosi CA, Zhang J, Levin ED, Folz RJ, Schmechel DE. Apoptosis and delayed neuronal damage after carbon monoxide poisoning in the rat. Exp Neurol. 1997;147(1): 103-14.
• 17. Parkinson RB, Hopkins RO, Cleavinger HB, et al. White matter hyperintensities and neuropsychological outcome following carbon monoxide poisoning. Neurology. 2002;58(10):1525-32.
• 18. Lim PJ, Shikhare SN, Peh WC. Clinics in diagnostic imaging (154). Carbon monoxide (CO) poisoning. Singapore Med J. 2014;55(8):405-10.
• 19. O’donnell P, Buxton PJ, Pitkin A, Jarvis LJ. The magnetic resonance imaging appearances of the brain in acute carbon monoxide poisoning. Clin Radiol. 2000;55(4): 273-80.
• 20. Lippi G, Rastelli G, Meschi T, Borghi L, Cervellin G. Pathophysiology, clinics, diagnosis and treatment of heart involvement in carbon monoxide poisoning. Clinical Biochemistry. 2012;45(16-17):1278-85.
• 21. Dallas ML, Yang Z, Boyle JP, et al. Carbon monoxide induces cardiac arrhythmia via induction of the late Na+current. Am J Respir Crit Care Med. 2012;186(7):648-56.
• 22. Henry CR, Satran D, Lindgren B, Adkinson C, Nicholson CI, Henry TD. Myocardial injury and long-term mortality following moderate to severe carbon monoxide poisoning. J Am Med Assoc. 2006;295(4):398-402.
• 23. Kaya H, Coşkun A, Beton O, et al. COHgb levels predict the long-term development of acute myocardial infarction in CO poisoning. Am J Emerg Med. 2016;34(5):840-44.
• 24. Weaver LK. Clinical practice carbon monoxide poisoning. N Engl J Med. 2009; 360(12):1217-25.
• 25. Hampson NB, Hauff NM. Risk factors for short-term mortality from carbon monoxide poisoning treated with hyperbaric oxygen. Crit Care Med. 2008;36(9):2523-27.
• 26. Eichhorn L, Thudium M, Jüttner B. The diagnosis and treatment of carbon monoxide poisoning. Dtsch Arztebl Int. 2018;115(51-52):863-70.
• 27. 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.
• 28. Lin C-H, Wong CS, Ong J-R, et al. Treatment with normobaric or hyperbaric oxygen and its effect on neuropsychometric dysfunction after carbon monoxide poisoning. Medicine (Baltimore). 2018; 97(39):e12456.
• 29. Jain KK. Textbook of Hyperbaric Medicine, 6th edn. Springer International Publishing, 2016.
• 30. Mathieu D. Handbook on hyperbaric medicine. Springer Netherlands, 2006.
• 31. Jerome B. Buboltz; Marc Robins Hyperbaric, Carbon Monoxide Toxicity, Statpearls Publishing, 2018.