Plasma Lactate Levels in Carbon Monoxide Intoxication, Can be Used at First Step?

Year 2019, Volume: 1 Issue: 2, 57 - 60, 17.07.2019

Sinem Doğruyol , İlker Akbaş , Erdal Tekin

Abstract

Objectives: The
aim of this study was to determine whether there was a significant relationship
between carboxyhemoglobin levels and plasma lactate levels at the time of
admission in patients who had been admitted to the emergency department due to carbon monoxide intoxication.

Materials ad Methods: In
this retrospective-cross-sectional study, patients diagnosed with toxic effects
of carbon monoxide were evaluated among the patients admitted to the emergency
department between 01.01.2013-01.01.2017. Blood gas data obtained from the
peripheral artery in the first 30 minutes of patients’ admission to the
emergency department  were examined.
Patients were classified as Group 1 (10% -20%) and Group 2 (20% and above)
according to their carboxyhemoglobin levels.

Results: A
total of 404 patients were included in the study. The mean carboxyhemoglobin
level was 21.2 ± 8% for all cases and 14.6 ± 3% for Group 1 and 27.8 ± 6% for
Group 2. The difference between the two groups was statistically significant
(mean difference 13.2; 95% CI = 12,198-14,157) (p <0.001). The number of
patients with lactate levels above normal in Group 2 was higher than Group 1 (p
<0.001). There was a significant difference in lactate levels between two
exposure groups (p <0.001). At the same time, when all parameters were
evaluated, there was a correlation between carboxyhemoglobin levels and lactate
levels (r = 0,601, p <0,001). In the ROC analysis to determine the value of
lactate levels in the diagnosis of severe exposure (Group 2), AUC was
calculated as 0,791 (95% confidence interval, 0.748-0.835; p <0.001; Figure
1). The positive predictive value for lactate level 3 mmol/L was 88% and the
negative predictive value was 63% and this level could be used as cut-off
value.

Conclusion: In
the evaluation of cases of carbon monoxide poisoning, the question of whether
plasma lactate level can be used as a marker is still being discussed. Based on the significant results that we found in our
study, plasma lactate levels ,which is correlated with carboxyhemoglobin levels, may be
helpful in the classification and evaluation of patients with carbon monoxide
intoxication. 

Keywords

Carboxyhemoglobin, Carbon monoxide, Lactate, Poisoning

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