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Jornal Brasileiro de Pneumologia :... 2013In view of the tragic fire at a nightclub in the city of Santa Maria, Brazil, which culminated in the sudden death of 232 young people, we decided to review the... (Review)
Review
In view of the tragic fire at a nightclub in the city of Santa Maria, Brazil, which culminated in the sudden death of 232 young people, we decided to review the literature regarding smoke inhalation injury caused by enclosed-space fires, which can be divided into direct thermal damage, carbon monoxide poisoning, and cyanide poisoning. Such injuries often call for immediate orotracheal intubation, either due to acute airway obstruction or due to a reduced level of consciousness. The diagnosis and the severity of the thermal injury can be determined by fiberoptic bronchoscopy. The levels of gases and gas by-products in the bloodstream should be assessed as rapidly as possible, even while still at the scene of the incident. First responders can also treat carbon monoxide poisoning, with immediate administration of oxygen at 100%, as well as cyanide poisoning, with oxygen therapy and hydroxocobalamin injection.
Topics: Bronchoscopy; Burns; Carbon Monoxide Poisoning; Disasters; Fires; Humans; Hydrogen Cyanide; Particulate Matter; Severity of Illness Index; Smoke Inhalation Injury
PubMed: 23857686
DOI: 10.1590/S1806-37132013000300016 -
Medicine Sep 2022Intentional or unintentional exposure to asphyxiating gases is a significant public health concern worldwide. Argon poisoning is fatal, and its onset is primarily due to...
RATIONALE
Intentional or unintentional exposure to asphyxiating gases is a significant public health concern worldwide. Argon poisoning is fatal, and its onset is primarily due to neurological damage.
PATIENT CONCERNS
A 22-year-old man was admitted to the hospital for argon gas poisoning. While working in a plant containing argon gas, he suddenly lost consciousness, recovered consciousness slightly after on-site treatment, answered questions, and had impaired memory, sensory dullness, normal cognition, and symptoms of dizziness and headache.
DIAGNOSIS
Asphyxiating gas poisoning (argon gas poisoning), metabolic encephalopathy, and hepatic insufficiency.
INTERVENTIONS
Immediately after admission, the patient was treated with nasal cannula oxygen 3 L/min and hyperbaric oxygen therapy once a day. Mecobalamin tablets 500 μg were given orally 3 times a day. Oral Ginkgo biloba extract tablets 40 mg 3 times a day.
OUTCOME
The patient was discharged after treatment with hyperbaric oxygen therapy and nerve-nourishing drugs, with no discomfort, clear consciousness, and good memory, and was followed up by telephone for 2 consecutive months, and the patient is now in good condition with no discomfort.
LESSON
This case describes the pathogenesis, neurological damage, and rescue process of argon gas poisoning. Argon poisoning was found to damage bilateral cerebellar hemispheres and bilateral hippocampal regions, affecting the patient's consciousness and memory, and was found to cause abnormal liver function and heart rate disorders.
Topics: Adult; Argon; Carbon Monoxide Poisoning; Gas Poisoning; Humans; Hyperbaric Oxygenation; Male; Oxygen; Young Adult
PubMed: 36086783
DOI: 10.1097/MD.0000000000030491 -
JPMA. the Journal of the Pakistan... Oct 2022To evaluate the Saudi campers' knowledge and the applied safety practices regarding carbon monoxide poisoning during camping activities.
OBJECTIVE
To evaluate the Saudi campers' knowledge and the applied safety practices regarding carbon monoxide poisoning during camping activities.
METHODS
The cross-sectional questionnaire-based study was conducted from December 1, 2018, to February 1, 2019, in Riyadh, Saudi Arabia, and comprised young male campers from recreational camps in the northern parts of the city. Data was collected from the participants regarding socio-demographic characteristics, knowledge regarding carbon monoxide poisoning, the applied safety measures to prevent carbon monoxide poisoning and the dealing with carbon monoxide poisoning during camping activities. Data was analysed using SPSS 22.
RESULTS
There were 235 male subjects with mean age 24.47±1.139 years (range: 21-32 years). Of the total, 50(21.3%) participants had received civil defence education or training. Overall, 137(58.3%) participants had a good mean knowledge score, and 157(66.8%) participants had a good mean practice score for applying healthy measures in preventing and managing carbon monoxide poisoning. As a preventive measure against carbon monoxide poisoning, the use of carbon monoxide detectors was valued by 107(45.5%) participants. Having civil defence training, having a monthly income >10,000 Saudi Riyals, and having a good knowledge score were the elements that had significant association with the choice related to carbon monoxide detector usage.
CONCLUSIONS
The campers had relatively high knowledge regarding carbon monoxide poisoning, but this knowledge was not fully translated into good health practice.
Topics: Humans; Male; Young Adult; Adult; Carbon Monoxide Poisoning; Camping; Carbon Monoxide; Cross-Sectional Studies; Saudi Arabia; Risk-Taking
PubMed: 36660971
DOI: 10.47391/JPMA.4524 -
Actas Espanolas de Psiquiatria Jan 2022arbon monoxide (CO) is an odorless, tasteless, colorless and nonirritating gas 1. In Spain, most of the accidents due to CO poisoning are caused by water heaters2,3,4....
arbon monoxide (CO) is an odorless, tasteless, colorless and nonirritating gas 1. In Spain, most of the accidents due to CO poisoning are caused by water heaters2,3,4. CO binds to hemoglobin with much greater affinity than oxygen, for- ming carboxyhemoglobin (COHb) and resulting in impaired oxygen transport and utilization.XS In up to 40 percent of patients with significant CO exposure, a delayed neuropsy- chiatric syndrome (DNS) can arise 3 to 240 days after appa- rent recovery, characterized by cognitive deficits, personality changes, movement disorders, and focal neurologic deficits, which may persist for a year or longer.
Topics: Carbon Monoxide Poisoning; Carboxyhemoglobin; Cognitive Dysfunction; Humans; Spain; Syndrome
PubMed: 35103300
DOI: No ID Found -
Scientific Reports Sep 2022Carbon monoxide poisoning may damage the brain and adrenal glands, but it is unclear whether it is associated with adrenal insufficiency. We identified all COP patients...
Carbon monoxide poisoning may damage the brain and adrenal glands, but it is unclear whether it is associated with adrenal insufficiency. We identified all COP patients diagnosed between 1999 and 2012 in Taiwan using the Nationwide Poisoning Database and selected a reference cohort (participants without COP) from the same database by exact matching of age and index date at a 1:2 ratio. Participants with a history of adrenal insufficiency or steroid use of more than 14 days were excluded. We followed up participants until 2013 and compared the risk of developing adrenal insufficiency between the two cohorts. The 21,842 COP patients had a higher risk for adrenal insufficiency than the 43,684 reference participants (adjusted hazard ratio [AHR] = 2.5; 95% confidence interval [CI]: 1.8-3.5) after adjustment for sex and underlying comorbidities (liver disease, thyroid disease, mental disorder). The risk continued to elevate even after 1 year (AHR = 2.1; 95% CI: 1.4-3.4). The COP patients who had acute respiratory failure had an even higher risk for adrenal insufficiency than those without acute respiratory failure, which may indicate a dose-response relationship. Stratified analyses showed that female patients had an elevated risk (AHR = 3.5; 95% CI: 2.1-6.0), but not male patients. Younger patients (< 50 years) had higher risks, and the AHR reached statistical significance in the age groups 20-34 (AHR = 5.5; 95% CI: 1.5-20.6) and 35-49 (AHR = 4.9; 95% CI: 2.3-10.6) years old. The risk for developing adrenal insufficiency elevated after COP, especially in female and younger patients. Carbon monoxide is the most common gaseous agent causing acute intoxication worldwide. Results of the current study call for monitoring adrenal function of patients with COP.
Topics: Adrenal Insufficiency; Carbon Monoxide; Carbon Monoxide Poisoning; Child; Child, Preschool; Cohort Studies; Female; Humans; Incidence; Respiratory Insufficiency; Retrospective Studies; Risk Factors; Steroids; Taiwan
PubMed: 36171402
DOI: 10.1038/s41598-022-20584-y -
Deutsches Arzteblatt International Mar 2015
Topics: Carbon Monoxide Poisoning; Critical Care; Emergency Medical Services; Female; Humans; Male; Smoking; Syncope
PubMed: 25869342
DOI: 10.3238/arztebl.2015.0221a -
Irish Journal of Medical Science Oct 2023In this study, cardiac biomarkers, blood parameters, electrocardiography (ECG), and echocardiography were investigated in children with carbon monoxide (CO) poisoning,...
AIMS
In this study, cardiac biomarkers, blood parameters, electrocardiography (ECG), and echocardiography were investigated in children with carbon monoxide (CO) poisoning, and the diagnostic value of these parameters was investigated.
METHODS
The demographical, clinical, and laboratory data of children aged 0-18 years who were admitted to the pediatric emergency department due to CO poisoning between January 2019 and January 2022 were retrospectively scanned from medical records. The patients were divided into two groups as troponin-I positive and troponin-I negative.
RESULTS
There were 107 children aged 0-18 years (average age, 10.46 ± 5.77 years; 51% female) with CO poisoning. There were 13 patients with troponin-I positive myocardial injury. Troponin-I was positive in 3 patients whose carboxyhemoglobin (COHb) level was below 2% at the time of admission. In one patient, troponin-I, which was normal at admission, increased by the 24th hour of hospitalization. Hyperbaric oxygen therapy was given due to headache in one patient, although the COHb level of that patient was below 25%. An NT-proBNP level of ≥ 219.5 ng/L predicted the development of troponin-I positivity with a sensitivity of 70% and a specificity of 86.7% (AUC, 0.967 (0.58-0.994); p = 0.017). White blood cell (WBC), neutrophil, neutrophil-to-lymphocyte ratio (NLR), immature granulocyte (IG), and IG% levels were found to be significantly higher in the troponin-positive patient group. DISCUSSION AND CONCLUSION: NT-proBNP has been shown to be an early diagnostic marker for myocardial dysfunction. Additionally, when cardiac markers are not available, full blood parameters may assist clinicians for patient treatment and referral.
Topics: Humans; Child; Female; Child, Preschool; Adolescent; Male; Carbon Monoxide Poisoning; Troponin I; Retrospective Studies; Prognosis; Biomarkers
PubMed: 36445626
DOI: 10.1007/s11845-022-03232-2 -
Journal of Korean Medical Science Jun 2001Carbon monoxide (CO) has the toxic effects of tissue hypoxia and produces various systemic and neurological complications. The main clinical manifestations of acute CO... (Review)
Review
Carbon monoxide (CO) has the toxic effects of tissue hypoxia and produces various systemic and neurological complications. The main clinical manifestations of acute CO poisoning consist of symptoms caused by alterations of the cardiovascular system such as initial tachycardia and hypertension, and central nervous system symptoms such as headache, dizziness, paresis, convulsion and unconsciousness. CO poisoning also produces myocardial ischemia, atrial fibrillation, pneumonia, pulmonary edema, erythrocytosis, leucocytosis, hyperglycemia, muscle necrosis, acute renal failure, skin lesion, and changes in perception of the visual and auditory systems. Of considerable clinical interest, severe neurological manifestations may occur days or weeks after acute CO poisoning. Delayed sequelae of CO poisoning are not rare, usually occur in middle or older, and are clinically characterized by symptom triad of mental deterioration, urinary incontinence, and gait disturbance. Occasionally, movement disorders, particularly parkinsonism, are observed. In addition, peripheral neuropathy following CO poisoning usually occurs in young adults.
Topics: Animals; Carbon Monoxide Poisoning; Humans
PubMed: 11410684
DOI: 10.3346/jkms.2001.16.3.253 -
Journal of Affective Disorders May 2023Suicide and mental health disorders are a recognized increasing public concern. Most suicide prevention rely on evidence from mortality data, although suicide attempts...
INTRODUCTION
Suicide and mental health disorders are a recognized increasing public concern. Most suicide prevention rely on evidence from mortality data, although suicide attempts are a better predictor for completed suicides. Understanding spatio-temporal patterns and demographic profiles of people at risk can improve suicide prevention schemes, including for carbon monoxide (CO) poisoning, a common method for gas-related suicides.
OBJECTIVE
Describe spatio-temporal patterns of intentional CO poisoning hospitalization rates in England between 2002 and 2016, and identify population sub-groups at risk.
METHODS
We used NHS Digital's Hospital Episode Statistics (HES) routinely collected data on hospital admissions for intentional CO poisoning. We estimated age-standardised rates (ASR) by year, gender and residential small-area characteristics, including rural/urban, deprivation and ethnic composition. Temporal trends were assessed through linear regression and joinpoint regression analysis. Regional differences were explored.
RESULTS
On average, we identified 178 hospital admissions for intentional CO poisoning per year. The ASR decreased substantially over the study period, particularly among males (average annual percent change of -7.8 % (95 % CI: -11.0; -4.6)), in comparison to 3.9 % (95%CI, -6.4; -1.4) among females. Most admissions (81 %) occurred in males. White men aged 35-44 years were particularly at risk. The ASR in London (0.08/100,000) was almost six times lower than in the South-West (0.47/100,000).
CONCLUSIONS
This study provides novel insights into attempted suicides by intentional CO poisoning. Further prevention interventions, targeting sub-groups at risk (i.e. white men in their 30s/40s), need to be developed and implemented to reduce the burden of suicides and of CO poisoning.
Topics: Male; Female; Humans; Carbon Monoxide Poisoning; Suicide, Attempted; Risk Factors; England; Hospitalization; Poisoning
PubMed: 36841308
DOI: 10.1016/j.jad.2023.02.036 -
The Neuroradiology Journal Oct 2017Carbon monoxide (CO) inhalation is nowadays the most common cause of fatal poisoning worldwide. CO binds to haemoglobin 230-270 times more avidly than oxygen, thus... (Review)
Review
Carbon monoxide (CO) inhalation is nowadays the most common cause of fatal poisoning worldwide. CO binds to haemoglobin 230-270 times more avidly than oxygen, thus leading to formation of carboxyhaemoglobin with subsequent reduction of tissue oxygenation. Brain is mainly affected due to its high oxygen requirement. Up to two-thirds of patients who survive the acute phase of this pathology present a delayed leukoencephalopathy, usually in a period ranging from two to 40 days. White matter damage closely relates to long-term prognosis of these patients. On the other hand CO seems to play a fundamental role as a possible neuro-protective agent in ischaemic stroke. Diagnostic imaging, with computed tomography and magnetic resonance imaging, especially magnetic resonance spectroscopy, is very useful to depict the presence and extension of this pathology, in both acute and late phase. Nevertheless, a correlation of imaging studies with clinical history and laboratory data is fundamental to perform the correct diagnosis. The purpose of this article is to highlight the imaging features of brain CO poisoning in acute and late phase, describing a case report of a 56-year-old man found unconscious at home.
Topics: Carbon Monoxide Poisoning; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neuroimaging; Tomography, X-Ray Computed
PubMed: 28643616
DOI: 10.1177/1971400916689342