Can Naci KOCABAŞ, Tayfur GİNİŞ, Dibek Emine MISIROĞLU, Cüneyt GÜRSOY

Seki̇z Yıllık Dönemde Karbonmonoksi̇t Zehi̇rlenmeleri̇ni̇n Değerlendi̇ri̇lmesi̇

Amaç: Çocuklarda karbonmonoksit (CO) zehirlenmesinin sıklığı konusunda yapılan çalışmalar sınırlı sayıdadır. Buçalışmada, Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji Eğitim ve Araştırma Hastanesine başvuran COzehirlenmesinin görülme sıklığının belirlenmesi amaçlandı.Gereç ve Yöntemler: Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji Eğitim ve Araştırma Hastanesine03.01.2006 - 21.01.2014 tarihleri arasında başvuran ve CO zehirlenmesi tanısı alan hastalar değerlendirildi. Olgularınyaşları, cinsiyetleri, hastane yatışları, tedavi aldıkları bölümler ile zehirlenmelerin mevsim ve aylara göre dağılımı incelendi.Bulgular: Belirtilen tarihler arasında çocuk acil polikliniğine toplam 394.387 hastanın başvurduğu ve bu hastalar içinde1756 (%0,4) çocuğun CO zehirlenmesi tanısı aldığı saptandı. Olguların %51.5u kız (n=905) ve yaş ortalaması 8.14 ±4.86 yıl idi. Olguların %74.4ü (n=1307) ayaktan, %25.6sı (n=449) ise hastanede yatırılarak izlenmişti. Hastaların %0.4ü(n=7) yoğun bakım tedavisi gerektirmişti. Karbon monoksit zehirlenmelerinin en sık kış mevsiminde (%59.5) ve Ocakayında (% 22.9) görüldüğü saptandı.Sonuç: Karbonmonoksit zehirlenmesi ülkemizde çocuklarda özellikle kış aylarında sık görülen zehirlenme türüdür. Busorunun önlenmesine yönelik çalışmalar oldukça önemlidir.

The Evaluation of Carbon Monoxide Poisoning in a Tertiary Children s Hospital During an 8-Year Period

Objective: Studies on the frequency of carbonmonoxide (CO) poisoning in children are rare. The aim of this study wasto determine the frequency of the CO poisoning cases arriving at Ankara Children s Hematology Oncology Training andResearch Hospital. Material and Methods: Patients with a diagnosis of CO poisoning who had presented at Ankara Children sHematology Oncology Training and Research Hospital between the dates of 03.01.2006 and 21.01.2014 were searchedretrospectively. The age, sex and hospitalization rate of the patients, departments where the patients were treated, andseasonal and monthly distributions were evaluated. Results: A total of 394.387 patients presented at the emergency clinic during the study period and 1756 cases (0.4%,age range 0-18 years) were diagnosed as CO poisoning. The percentage of female patients was 51.5% (n=905) andthe mean age was 8.14 ± 4.86 years. The hospitalization rate was 25.6% (n=449) with 74.4% (n=1307) treated in theoutpatient emergency clinic and 0.4% (n=7) requiring intensive care therapy. Poisoning cases occurred mostly in thewinter (59.5%) and especially in January (22.9%)..Conclusion: Carbonmonoxide poisoning is a common type of poisoning in children especially during the winter monthsin our country. The measures taken to prevent this problem are extremely important.

PDF

___

1. Piantadosi CA. Carbon monoxide poisoning. Undersea Hyperb Med 2004;31:167-77.
2. Raub JA, Mathieu-Nolf M, Hampson NB, Thom SR. Carbon monoxide poisoning--a public health perspective. Toxicology 2000;145:1-14.
3. Weaver LK. Clinical practice. Carbon monoxide poisoning. N Engl J Med 2009;360:1217-25.
4. Guzman JA. Carbon monoxide poisoning. Crit Care Clin 2012;28:537-48.
5. Hampson NB, Weaver LK. Carbon monoxide poisoning: A new incidence for an old disease. Undersea Hyperb Med 2007;34: 163-8.
6. Centers for disease control and prevention (CDC).Unintentional poisoning deaths--United States, 1999-2004. MMWR Morb Mortal Wkly Rep 2007;56: 93-6.
7. Centers for disease control and prevention (CDC). Unintentional non-fire-related carbon monoxide exposures--United States, 2001-2003. MMWR Morb Mortal Wkly Rep 2005;54: 36-9.
8. Centers for disease control and prevention (CDC). Nonfatal, unintentional, non--fire-related carbon monoxide exposures- -United States, 2004-2006. MMWR Morb Mortal Wkly Rep 2008;57:896-9.
9. Kandiş H, Katırcı Y, Çakır Z, Aslan Ş, Uzkeser M, Bilir Ö. Acil servise karbonmonoksit entoksikasyonu ile başvuran olguların geriye dönük analizi. Akademik Acil Tıp Dergisi 2007;3:21-5.
10. Metin S, Yıldız Ş, Çakmak T, Demirbaş Ş. Frequency of carbon monoxide poisoning in Turkey in 2010. TAF Preventive Medicine Bulletin 2011;10:587-92.
11. Satar S, Seydaoglu G, Akpinar A, Sebe A, Karakoc E, Gumusay U, et al. Trends in acute adult poisoning in a ten-year period in Turkey: Factors affecting the hazardous outcome. Bratisl Lek Listy 2009;110:404-11.
12. Avsarogullari L, Senol V, Akdur O, Akin A, Durukan P, Ozkan S. Characteristics of acute adult poisonings in a university hospital emergency department in central Turkey: A three-year analysis. J Pak Med Assoc 2012;62:129-33.
13. Koylu R, Dundar ZD, Koylu O, Akinci E, Akilli NB, Gonen MO, et al. The experiences in a toxicology unit: A review of 623 cases. J Clin Med Res 2014;6:59-65.
14. Iqbal S, Law HZ, Clower JH, Yip FY, Elixhauser A. Hospital burden of unintentional carbon monoxide poisoning in the United States, 2007. Am J Emerg Med 2012;30:657-64.
15. Salameh S, Amitai Y, Antopolsky M, Rott D, Stalnicowicz R. Carbon monoxide poisoning in Jerusalem: Epidemiology and risk factors. Clin Toxicol (Phila) 2009;47:137-41.
16. Cho CH, Chiu NC, Ho CS, Peng CC. Carbon monoxide poisoning in children. Pediatr Neonatol 2008;49:121-5.
17. Kurt F, Bektas O, Kalkan G, Oncel MY, Yakut HI, Kocabas CN. Does age affect presenting symptoms in children with carbon monoxide poisoning? Pediatr Emerg Care 2013;29:916-21.
18. Iqbal S, Clower JH, Boehmer TK, Yip FY, Garbe P. Carbon monoxide-related hospitalizations in the U.S.: Evaluation of a web- based query system for public health surveillance. Public Health Rep 2010;125:423-32.
19. Centers for disease control and prevention (CDC).Carbon monoxide-related deaths-United States, 1999-2004. MMWR Morb Mortal Wkly Rep 2007;56:1309-12.