Copeptin levels in carbon monoxide poisoning

Copeptin levels in carbon monoxide poisoning

Background/aim: The aim of this study is to identify the copeptin levels in patients presenting with carbon monoxide (CO) poisoning to the emergency department and to investigate its correlation with the neurological effects. Materials and methods: The study group consisted of patients presenting with CO poisoning and carboxyhemoglobin levels >10%. Blood samples for copeptin levels were obtained twice, first at presentation then at the fourth hour of observation. The data were analyzed using SPSS 16 for Windows. Results: The median copeptin levels of the patient group were identified as 0.63 (0.39 1.06) ng/mL at hour 0 and 0.41 (0.31 0.49) at hour 4. The copeptin levels of the control group were 0.34 (0.25 0.42) ng/mL and were significantly lower than those of the patient group (P < 0.000). According to our results, 0.345 ng/mL for plasma copeptin level as the best cut-off level may be used with sensitivity of 94.0% and specificity of 60%. The copeptin levels at hour 0 were statistically significantly higher in the neurologically affected patients than those not affected (P < 0.001). Conclusion: In this study it was shown that blood copeptin levels increase in patients presenting to the emergency department with CO poisoning.

___

  • 1. Akköse S, Türkmen N, Bulut M, Akgöz S, Işcimen R, Eren B. An analysis of carbon monoxide poisoning cases in Bursa, Turkey. East Mediterr Health J 2010; 16: 101-106.
  • 2. Bojakowski K, Gaciong Z, Grochowiecki T, Szmidt J. Carbon monoxide may reduce ischemia reperfusion injury: a case report of complicated kidney transplantation from a carbon monoxide poisoned donor. Transplant Proc 2007; 39: 2928-2929.
  • 3. Davutogu V, Gunay N, Kocaoglu H, Ekici Gunay N, Yildirim C, Cavdar M, Tarakcioglu M. Serum levels of NT-ProBNP as an early cardiac marker of carbon monoxide poisoning. Inhal Toxicol 2006; 18: 155-158.
  • 4. Katan M,  Christ-Crain M. The  stress  hormone  copeptin: a  new  prognostic biomarker in acute  illness. Swiss Med Wkly 2010; 140: 13101.
  • 5. Stolz D, Christ-Crain M, Morgenthaler NG, Leuppi J, Miedinger D, Bingisser R, Müller C, Struck J, Müller B, Tamm M. Copeptin, C-reactive protein, and procalcitonin as prognostic biomarkers in acute exacerbation of COPD. Chest 2007; 131: 1058-1067.
  • 6. Morgenthaler NG, Muller B, Struck J, Bergmann A, Redl H, Christ-Crain M. Copeptin, a stable peptide of the arginine vasopressin precursor, is elevated in hemorrhagic and septic shock. Shock 2007; 28: 219-226.
  • 7. De Marchis GM, Weck A, Audebert H, Benik S, Foerch C, Buhl D, Schuetz P, Jung S, Seiler M, Morgenthaler NG et al. Copeptin for the prediction of recurrent cerebrovascular events after transient ischemic attack: results from the CoRisk study. Stroke 2014; 45: 2918-2923.
  • 8. Katirci Y,  Kandis H,  Aslan S,  Kirpinar I. Neuropsychiatric disorders and risk factors in carbon monoxide intoxication. Toxicol Ind Health 2011; 27: 397-406.
  • 9. Yardan T, Cevik Y, Donderici O, Kavalci C, Yilmaz FM, Yilmaz G,  Vural K,  Yuzbasioglu Y,  Gunaydin YK,  Sezer AA. Elevated serum S100B protein and neuron-specific enolase levels in carbon monoxide poisoning. Am J Emerg Med  2009; 27: 838- 842.
  • 10. Brvar M, Mozina H, Osredkar J, Mozina M,  Noc M,  Brucan A, Bunc M. S100B protein in carbon monoxide poisoning: a pilot study. Resuscitation 2004; 61: 357-360.
  • 11. Akdemir HU, Yardan T, Kati C, Duran L, Alacam H, Yavuz Y, Okuyucu A. The role of S100B protein, neuron-specific enolase, and glial fibrillary acidic protein in the evaluation of hypoxic brain injury in acute carbon monoxide poisoning. Hum Exp Toxicol 2014; 33: 1113-1120.
  • 12. Nickel CH, Bingisser R, Morgenthaler NG. The role of copeptin as a diagnostic and prognostic biomarker for risk stratification in the emergency department. BMC Med 2012; 10: 7.
  • 13. Katan M, Fluri F, Morgenthaler NG, Schuetz P, Zweifel C, Bingisser R, Kappos L,  Steck A,  Engelter ST,  Müller B et al. Copeptin: a novel, independent prognostic marker in patients with ischemic stroke. Ann Neurol 2009; 66: 799-808.
  • 14. Urwyler SA,  Schuetz P,  Fluri F,  Morgenthaler NG,  Zweifel C, Bergmann A, Bingisser R, Kappos L, Steck A, Engelter S et al. Prognostic value of copeptin: one-year outcome in patients with acute stroke. Stroke 2010; 41: 1564-1567.
  • 15. Zweifel C, Katan M, Schuetz P, Siegemund M, Morgenthaler NG, Merlo A, Mueller B, Christ-Crain M. Copeptin is associated with mortality and outcome in patients with acute intracerebral hemorrhage. BMC Neurol 2010; 10: 34.
  • 16. Pang L, Wang HL, Wang ZH, Wu Y, Dong N, Xu DH, Wang DW, Xu H, Zhang N. Plasma copeptin as a predictor of intoxication severity and delayed neurological sequelae in acute carbon monoxide poisoning. Peptides 2014; 59: 89-93.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK