Sinem DOĞRUYOL, İlker AKBAŞ, Zeynep ÇAKIR

Demographic and Clinical Characteristics of Carbon Monoxide Poisoning: Data Between 2014 and 2018 in Erzurum

Amaç: Bu çalışma bir üniversite hastanesine, karbonmonoksit zehirlenmesi tanısı ile başvuran vakalarının klinik durumunu, tedavisini ve morbiditesini analiz etmeyi ve epidemiyolojik verilerini tanımlamayı amaçlamaktadır. Ek olarak, bu çalışmada belirtilen vakaların kan testlerinin sonuçları ayrıntılı olarak değerlendirilmiştir. Gereç ve Yöntem: Bu retrospektif çalışmada, 2014-2018 yılları arasında karbonmonoksitin toksik etkileri tanısı alan hastalar değerlendirildi. Hastaların dosyalarından elde edilen veriler arasında yaş, cinsiyet, altta yatan komorbiditeler, sigara kullanımı, alkol kötüye kullanımı öyküsü, vital bulgular, klinik belirtiler, laboratuvar ve görüntüleme sonuçları, tedavi, sonuç, zehirlenme kaynağı ve mevsimsel değişken yer alıyordu. Bulgular: Çalışmaya toplam 653 hasta dahil edildi. Kış mevsiminde yapılan başvuruların diğer mevsimlere anlamlı olarak daha yüksek olduğu tespit edildi (p <0.001). En sık görülen semptomlar baş ağrısı (% 62.3), bulantı (% 42.3), ani bilinç kaybı (% 15.9) ve baş dönmesi (% 12.1) idi. Laktat seviyeleri ile karboksihemoglobin değerleri (r = 0.257, p <0.001) ve troponin I düzeyleri (r = 0.267, p <0.001) arasında pozitif korelasyon gösterildi. > 2 mmol / L’lik bir kan laktat konsantrasyonu, hiperbarik oksijen tedavisi ihtiyacını öngörmek için% 40 hassasiyet ve% 75 özgüllük ile ilişkilendirildi. Hiperbarik oksijen tedavisi grubu daha uzun bir hastanede kalış süresine sahipti, bu durum istatistiksel olarak anlamlıydı (ortalama fark -0.98;% 95 CI = -1.38, -0.57) (p <0.001). Sonuç: Acil tıp klinikleri karbonmonoksit zehirlenmesi vakalarında neredeyse tek başına savaşmaktadır. Bu nedenle yeni bakış açılarına ihtiyaç vardır. Laktat, hastaların yönetiminde bir seçenek olarak güvenle kullanılabilir.

Anahtar Kelimeler:

karbonmonoksit, intoksikasyon, laktat, zehirlenme

Demographic and Clinical Characteristics of Carbon Monoxide Poisoning: Data Between 2014 and 2018 in Erzurum

Objective: This report describes the epidemiology and analyses the clinic status, treatment, morbidity of carbonmonoxide intoxication cases in a university hospital. Furthermore, the results of blood tests of cases mentioned in this study were evaluated in detail. Materials and Methods: In this retrospective study, patients diagnosed with toxic effects of carbonmonoxide were evaluated between years 2014-2018. The data extracted from the patients’ files included seasonal variation, age, gender, underlying comorbidities, smoking and alcohol abuse history, vital parameters, clinical manifestations and source of poisoning, laboratory and imaging records, treatment and outcome. Results: A total of 653 patients were included in the study. Admissions during the winter was found to be higher that other seasons with a significant difference (p < 0.001). The most frequent symptoms were headache (%62.3), nausea (%42.3), sudden loss of consciousness (%15.9) and dizziness (%12.1). Lactate levels were positively correlated with carboxyhemoglobin values (r= 0.257, p < 0.001) and troponin I levels (r=0.267, p<0.001). A blood lactate concentration >2 mmol/L was associated with %40 sensitivity and %75 specificity for predicting hyperbaric oxygen therapy requirement. Hyperbaric oxygen therapy group had a longer hospitalization period, which was statistically significant (mean difference -0.98; 95% CI = -1.38, -0.57) (p <0.001). Conclusion: Emergency medicine clinics are fighting almost alone in carbonmonoxide poisoning cases. Now it is required to develop new perspectives in these cases. Lactate can be used safely in the management of patients as an option.

Keywords:

Carbonmonoxide, Intoxication, Lactate, Poisoning,

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