Yenidoğan Döneminde Karbonmonoksit İntoksikasyonu: Vaka Sunumu

Öz

Karbonmonoksit gazı ülkemizde hâlâ yüksek mortalite ve morbiditeye yol açan, kış mevsiminde sık görülen önemli bir zehirlenme nedenidir. Her yaş grubunu etkileyebileceği öngörülse de neonatal dönemde literatürde bildirilmiş bir vaka sunumu yoktur. Bu makalede 3 günlük yenidoğan bir bebekte karbonmonoksit zehirlenme vakası literatür bilgileri eşliğinde sunuldu. Yakınları tarafından annesi ile birlikte evde derin uyku halinde bulunan 3 günlük erkek bebeğin karbonmonoksite maruziyeti düşünülerek bakılan karboksihemoglobin düzeyi % 15 bulundu. Muayenesinde taşipne dışında başka bir özellik yoktu. Normobarik oksijen ile 48. saatinde karboksihemoglobin düzeyi % 3’e düştü. Karbonmonoksit intoksikasyonu öntanılı yenidoğanlarda karboksihemoglobin düzeyi istenmeli ve erken oksijen tedavisine başlanmalıdır

Anahtar Kelimeler

• Karbonmonoksit,yenidoğan,tedavi,izlem

Carbonmonoxide Intoxication During Neonatal Period: A Case Report

Öz

Carbonmonoxide poisoning still carries a high level of mortality and morbidity. To our knowledge there has been no prior presentation of a case of carbonmonoxide intoxication during neonatal period. In this case report, a newborn with carbonmonoxide intoxication will be discussed. A 3-days old male newborn and his mother were discovered to be in deep sleep. The carboxyhemoglobin level of the baby was found to be 15%. Physical examination revealed only tachypnea. With 100% normobaric oxygen treatment, CO-Hb level decreased to 3% in the 48th hour. Neonates with carbonmonoxide intoxication should be screened for carboxyhemoglobin levels and treated immediately with oxygen therapy.

Anahtar Kelimeler

• Carbonmonoxide,neonate,treatment,observation

Kaynakça

1. 1. Cobb N, Etzel RA. Unintentional carbon monoxide-related deaths in the United States, 1979 through 1988. JAMA 1991; 266:659-63.
2. 2. Andiran N, Sarikayalar F. Pattern of acute poisonings in childhood in Ankara: what has changed in twenty years?. Turk J Pediatr 2004; 46:147-52.
3. 3. Asirdizer M, Yavuz MS, Albek E, Canturk G. Infant and adolescent deaths in Istanbul due to home accidents. Turk J Pediatr 2005; 47:141-9.
4. 4. Kim JK, Coe CJ. Clinical study on carbon monoxide intoxication in children. Yonsei MeJ 1987; 28:266-73.
5. 5. Chou KJ, Fisher JL, Silver EJ. Characteristics and outcome of children with carbon monoxide poisoning with and without smoke exposure referred for hyperbaric oxygen therapy. Pediatr Emerg Care 2000; 16:151-5.
6. 6. Salam MT, Millstein J, Li YF, Lurmann FW, Margolis HG, Gilliland FD. Birth Outcomes and Prenatal Exposure to Ozone, Carbon Monoxide, and Particulate Matter: Results from the Children’s Health Study. Environ Health Perspect 2005; 113:1638-44.
7. 7. Saraçel M, Özen H, Özçelik UT. Karbon monoksit zehirlenmesi. Katkı Pediatri Dergisi 1990; 11:327-33.
8. 8. El Khashab M, Nejat F. Hemorrhagic cerebral infarction in carbon monoxide poisoning: a case report. Cases J 2009; 2:96.

9. 9. 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; 45:1513-6.
10. 10. Ernst A, Zibrak JD. Carbon monoxide poisoning. N Engl J Med 1998; 339:1603-8.
11. 11. Meert KL, Heidemann SM, Sarnaik AP. Outcome of children with carbon monoxide poisoning treated with normobaric oxygen. J Trauma 1998; 44:149-54.
12. 12. Thom SR. Hyperbaric-oxygen therapy for acute carbon monoxide poisoning. N Engl J Med 2002; 347:1105-6.
13. 13. Myers RA, Snyder SK, Emhoff TA. Subacute sequelae of carbon monoxide poisoning. Ann Emerg Med 1985; 14:1163-7.
14. 14. Etzel RA. Indoor air pollutants in homes and schools. Pediatr Clin North Am 2001; 48:1153-65.
15. 15. Knight L, Levin A, Mendenhall C. Candles and Incense as Potential Sources of Indoor Air Pollution: Market Analysis and Literature. VA: National Technical Information Service 2001.