Karbonmonoksit Zehirlenmelerinde Sistemik İnflamatuvar Parametrelerin Değerlendirilmesi

Yıl 2019, , 1 - 8, 30.04.2019

Emine Emektar , Seda Dağar , Şeref Kerem Çorbacıoğlu , Meral Tandoğan , Yavuz Katırcı , Yunsur Çevik

https://doi.org/10.24938/kutfd.429395

Cited By: 3

Öz

Amaç: Bu çalışmada karbonmonoksit (CO) zehirlenmesi olan hastalarda tam kan sayımında bakılan sistemik inflamatuvar kan parametrelerinin irdelenmesi ve bu parametreler ile zehirlenme ciddiyeti arasındaki ilişkinin değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntemler: Çalışmamız retrospektif vaka kontrol çalışmasıdır. Veriler hastane otomasyon sisteminden elde edildi. Karboksihemoglobin düzeyi %10 ve üzerinde saptanan hastalar çalışmaya dahil edildi. Hastaların tam kan sayımı parametreleri, kırmızı küre dağılım genişliği (RDW), nötrofil/lenfosit oranı (NLO), platelet/lenfosit oranı (PLO) ve tedavileri kaydedildi.

Bulgular: Hasta grubunda kontrol grubu ile karşılaştırıldığında WBC, lökosit, nötrofil, trombosit, NLO ve PLO değerleri daha yüksekti ve bu farklar, istatistiksel olarak anlamlıydı (p <0.05). Hastalar zehirlenme ciddiyetlerine göre iki gruba ayrıldı, gruplar arasında laboratuar sonuçları açısından anlamlı fark saptanmadı (p>0.05)

Sonuç: NLO, PLO, RDW; CO zehirlenmesi olan hastalarda, inflamasyonu göstermekte olup, zehirlenme ciddiyetini belirlemede ve tedaviyi şekillendirme de rolü olmadığını düşünmekteyiz.

Anahtar Kelimeler

Karbonmonoksit, zehirlenme, inflamasyon, acil servis

EVALUATION OF SYSTEMIC INFLAMMATORY PARAMETERS IN CARBON MONOXIDE POISONING

Öz

Objective: The objective of this study is to examine systemic inflammatory blood parameters measured in complete blood count of patients with carbon monoxide (CO) poisoning and to evaluate the relation between the parameters and the severity of poisoning.

Material and Methods: Our study is a retrospective case control study. Data was obtained through hospital automation system. Patients who were detected to have 10% and above carboxyhemoglobin levels were included in the study. Patients' complete blood count parameters, red cell distribution width (RDW), neutrophil/lymphocyte ratios (NLR), platelet/lymphocyte ratios (PLR) and treatments were recorded.

Results: When the control group was compared to patient group, WBC, leukocyte, neutrophil, platelet, NLR and PLR values were higher in the patient group and these differences were statistically significant (p <0.05). Patients were split into two groups in accordance with the severity of their poisoning. No significant differences were observed in terms of laboratory results (p >0.05).

Conclusion: In patients with CO poisoning, values of NLO, PLO and RDW indicate inflammation. We consider that these values do not assume a role in determination of poisoning severity and in shaping of the treatment to be administered.

Anahtar Kelimeler

Carbon monoxide, poisoning, inflammation, emergency service

Kaynakça

• 1. Akca H, Tuygun N, Polat E, Karacan CD. Acute carbon monoxide poisoning: Experience of eight years. Eurasian J Emerg Med. 2015;14:189-91.
• 2. Emektar E, Ramadan H, Yuzbasioglu Y, Vural S, Coskun F. Use of lactate clearance in determining serum lactate levels and effectiveness of treatment in carbon monoxide poisonings Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2017;19(2):60-5.
• 3. Mannaioni PF, Vannacci A, Masini E. Carbonmonoxide: the bad and the good side of the coin, from neuronal death to anti-inflammatory activity. Inflamm Res. 2006;55(7):261-73.
• 4. Corbacioglu SK. New potential-treatment options in brain injury due to acute carbon monoxide poisoning in future. J Neurolog Sci. 2016;369:292-3.
• 5. Soylu K, Gedikli O, Ekşi A, Avcıoğlu Y, Soylu A, Yüksel S et al. Neutrophil-to-lymphocyte ratio for the assessment of hospital mortality in patients with acute pulmonary embolism. Arch Med Sci. 2016;1;12(1):95-100.
• 6. Lok U, Gulacti U. The predictive effect of the neutrophil-to-lymphocyte ratio (nlr) on the mortality of acute ischemic stroke and its subtypes: a retrospective cross-sectional study. Eurasian J Emerg Med. 2016;15:69-72.
• 7. Wasilewski J, Pyka L, Hawranek M, Osadnik T, Kurek A, Skrzypek M et al. Prognostic value of neutrophil to lymphocyte ratio in predicting long-term mortality in patients with ischemic and nonischemic heart failure. Pol Arch Med Wewn. 2016;126(3):166-73.
• 8. Emektar E, Corbacioglu SK, Dagar S, Uzunosmanoglu H, Safak T, Cevik Y. Prognostic value of the neutrophil-lymphocyte and platelet-lymphocyte ratios in predicting one-year mortality in patients with hip fractures and aged over 60 years. Eurasian J Emerg Med. 2017;16:165-70.
• 9. Toprak C, Tabakci MM, Simsek Z, Arslantas U, Durmus HI, Ocal L et al. Platelet/lymphocyte ratio was associated with impaired myocardial perfusion and both in-hospital and long-term adverse outcome in patients with ST-segment elevation acute myocardial infarction undergoing primary coronary intervention. Postepy Kardiol Interwencyjnej. 2015;11(4):288-97.
• 10. Dogan NO, Akinci E, Gumus H, Akilli NB, Aksel G. Predictors of in hospital mortality in geriatric patients presenting to the emergency department with ischemic stroke. Clin Appl Thromb Hemost. 2016;22(3):280-4.
• 11. Koh CH, Bhoo-Pathy N, Ng KL, Jabir RS, Tan GH, See MH et al. Utility of pre-treatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as prognostic factors in breast cancer. Br J Cancer. 2015;113(1):150-8.
• 12. Karabulut AE, Cevik Y, Emektar E, Corbacioglu SK, Dagar S, Yardim O. Analysis of mean platelet volume and red blood cell distribution width in recurrent epistaxis, Turk J Emerg Med. 2018;18:67-70.
• 13. Avci E, Kiris T, Demirtas AO, Kadi H. Relationship between high-density lipoprotein cholesterol and the red cell distribution width in patients with coronary artery disease. Lipids Health Dis. 2018;17(1):53.
• 14. Kim CH, Park JT, Kim EJ, Han JH, Han JS, Choi JY et al. An increase in red blood cell distribution width from baseline predicts mortality in patients with severe sepsis or septic shock. Crit Care. 2013;17(6):R282.
• 15. Das M, Cevik Y, Erel O, Corbacioglu SK. Ischemia-modified albumin levels in the prediction of acute critical neurological findings in carbon monoxide poisoning. The Kaohsiung J Med Sci. 2016;32(4):201-6.
• 16. Irem G, Cevik Y, Keskin AT, Emektar E, Demirci OL, Şafak T et al. Copeptin levels in carbon monoxide poisoning. Turk J Med Sci. 2017;47(2):653-7.
• 17. Cakir Z, Aslan S, Umudum Z, Acemoglu H, Akoz A, Turkyilmaz S et al. S-100beta and neuron-specific enolase levels in carbon monoxide-related brain injury. Am J Emerg Med. 2010;28(1):61-7.
• 18. Akyol S, Gulec MA, Erdemli HK, Akyol O. A new therapeutic approach for carbon monoxide poisoning: Antioxidants. Toxicology. 2015;336:34-5.
• 19. Zhang Y, Lu JJ, Du YP, Feng CX, Wang LQ, Chen MB. Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in gastric cancer. Medicine (Baltimore). 2018;97(12):e0144.
• 20. Günaydın YK, Vural K, MA Ok, Katırcı Y, Kocaşaban DÜ, Yiğit Y et al. Comparison of carbon monoxide poisonings originated from coal stove and natural gas and the evaluation of Neutrophil/Lymphocyte ratio. Dicle Med J. 2015;42(3):299-304.
• 21. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009;133(4):628-32.
• 22. Turkdogan KA, Eren SH, Sogut O, Karabacak M, Yigit M, Gülen B et al. Red cell distribution width in carbon monoxide poisoning: Relationship with markers of ineffective erythropoiesis, inflammation. Acta Medica Mediterranea. 2014;30(5):1075-9.