Hacer ŞEN, Seyfettin KÖKLÜ, Erdem AKBAL, Fahri GÜNEŞ, Hikmetullah BATGİ, Tuğba CANATAN

Electrocardiogram Changes in Acute Carbon Monoxide Intoxication

Amaç: Karbonmonoksit (CO) zehirlenmeleri direkt olarak kardiyovasküler toksisite ile ilgilidir. Daha önceki çalış- malarda akut karbonmonoksit zehirlenmeleri ve QT dispersiyonu arasındaki ilişki rapor edilmiştir, ancak p dalga- sı değişikliği araştırılmamıştır. Bizim çalışmamızdaki amacımız, karbonmonoksit zehirlenmelerinde QT aralığı ve pdalgasındaki değişiklikleri değerlendirmektir. Yöntem ve Gereçler: Çalışmaya CO zehirlenmesi tanısı almış 20 hasta dahil edildi. CO intoksikasyonu tanısı arte- riel kan gazı analizi ile doğrulandı. Kontrol grubu olarak, benzer yaş ve cinsiyette sağlıklı 22 kişi alındı. Bütün has- talarda QT, QTc, QTd, QTdc, p maximum, p minumum ve p dalga dispersiyonu 12 kanallı EKG ile değerlendirildi.Kardiak enzimleri içeren laboratuvar testleri ölçüldü. Sonuç: CO intoksikasyonu olan grupta QTc maxium, QTc dispersiyonu ve beyaz küre sayıları, kontrol grubundan an- lamlı olarak yüksekti. Nötrofil sayıları, QTc maksimum ve QTc minimum değerleri arasında pozitif korelasyon var- dı. Lökosit sayısı ile kalp hızı arasında ise pozitif korelasyon mevcuttu. Tartışma: Bu çalışmada p dalga değişikliği saptanmamıştır. CO intoksikasyonlarında kan lökosit ve nötrofil sayısı ileQT dalga değişikliği arasında korelasyon saptanmıştır.

Akut Karbonmonoksit Zehirlenmelerinde Elektrokardiografik Değişiklikler

Objective: Carbon monoxide (CO) intoxication is associated with direct cardiovascular toxicity. Previous studies re- ported the association between acute CO intoxication and QT dispersion, but did not investigate p wave changes. Ouraim was to evaluate electrocardiographic changes including QT interval and p wave in patients with CO intoxication.Material And Methods: Twenty patients who had been diagnosed as CO intoxication were included in the study. COintoxication was confirmed by arterial blood gas analysis. Twenty two age and gender matched healthy subjects wereenrolled as control group. In all patients QT, QTc, QTd, QTdc, p maximum, p minimum and p wave dispersion inter- vals were evaluated with 12 leads of the surface ECG. Laboratory tests including cardiac enzymes were measured.Results: The QTc maximum, QTc dispersion, and white bloods were significantly higher in CO intoxication groupthan control group. There was a positive correlation between neutrohil counts and QTc maximum and Qtc minimum.Leukocyte counts had positive correlation with heart rate at admission.Conclusion: P wave changes have not been detected in the present study. There is a correlation between blood leu- kocyte and neutrophil number and QT changes in CO intoxication.

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