Acil Servise Başvuran Hastaların Gizli Karbon Monoksit Zehirlenmesi Açısından Değerlendirilmesi

Öz

Amaç: Bu çalışmanın birincil amacı, acil servise atipik semptomlarla başvuran hastaları gizli karbonmonoksit (CO) zehirlenmesi açısından değerlendirmek, ikincil amacı ise yüksek CO düzeyi olan hastalarda Karboksihemoglobin (COHb) düzeylerinin invaziv ve non-invaziv değerlerini karşılaştırmaktır. Materyal ve Metot: Bu prospektif ve tanımlayıcı çalışma, 1 Ocak-31 Mart 2015 tarihleri arasında Acil Servise (AS) başvuran 2775 erişkin hasta üzerinde yapılmıştır. Acil servise non spesifik şikayetler ile başvuran bireylerin noninvaziv multidalga pulse oksimetre cihazı ile COHb düzeyleri ölçülmüş ve önceden oluşturulan ve başvuru tarihi, yaş, cinsiyet, şikayet, sigara öyküsü, gebelik durumu, pulse COHb, kan COHb ve kan metHb parametlerini içeren forma kaydedilmiştir. Sigara içenlerde %10’un, içmeyenlerde %6.6’nın altındaki değerler gizli COHb intoksikasyonu olarak kaydedildmiştir. Bulgular: %52.8’i erkek olan hastaların %34.4’ü sigara kullanıyordu. Kadın hastalar arasında gebe olanların oranı %13.4 idi. İlk üç şikayet nefes darlığı, göğüs ağrısı ve karın ağrısıydı. Hastaların COHb ortalaması arteriyal kan gazında 1.44±1.65, parmak ölçümünde 1.75±1.63 olarak belirlendi. İki ortalama arasında yüksek düzeyde anlamlı bir ilişki bulundu. Her iki teknikle ölçülen COHb değeri, erkek hastalarda, sigara içenlerde ve gebe olmayanlarda daha yüksekti. Gizli COHb zehirlenmesi oranı sigara içenlerde %1, içmeyenlerde %0.1 olarak belirlendi. Sonuç: Non-invaziv COHb ölçümünün gizli karbonmonoksit intoksikasyonlarının teşhisine olumlu katkılar sağlayabileceği kanaatine vardık.

Anahtar Kelimeler

• COHb değeri
• acil servis
• gizli CO intoksikasyonu
• gizli karbon monoksit zehirlenmesi

Secret Carbon Monoxide Intoxication Assessments of the Patients Who Presented to Emergency

Abstract

Aim: The primary aim of this study is to evaluate patients who present to the emergency department with atypical symptoms in terms of occult Carbon monoxide (CO) poisoning, and the secondary aim is to compare the invasive and non-invasive values of Carboxyhemglobin (COHb) levels in patients with high CO levels. Material and Method: This prospective and descriptive study was conducted on 2775 adult patients who visited the Emergency Department (ED) between January 1 and March 31, 2015. The COHb levels of the individuals who applied to the emergency department with non-specific complaints were measured with a non-invasive multiwave pulse oximeter device and the date of application, age, gender, complaint, smoking history, pregnancy status, pulse COHb, blood COHb and blood metHb parameters were recorded in the preformed form. Values under 10% in smokers and under 6.6% in non-smokers were recorded as secret COHb intoxication. Results: 52.8% of the patients were male and 34.4% were smokers. The rate of pregnant women among female patients was 13.4%. The first three complaints were shortness of breath, chest pain and stomach ache. It was determined that the mean COHb of the patients was 1.44±1.65 in arterial blood gas and 1.75±1.63 in finger measurement. A highly significant positive correlation was found between the two averages. The COHb value measured by both techniques was higher in male patients and in smokers and non-pregnant patients. The rate of latent COHb intoxication was determined as 1% in smokers and 0.1% in non-smokers. Conclusion: We came to the conclusion that non-invasive COHb measurement can make positive contributions to the diagnosis of secret carbonmonoxyde intoxications.

Keywords

• COHb value
• emergency department
• secret CO intoxication
• secret carbon monoxide intoxication

Kaynakça

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