Carbon monoxide poisoning: clinical, neurophysiological, and brain imaging observations in acute disease and follow-up

1989 ◽  
Vol 236 (8) ◽  
pp. 478-481 ◽  
Author(s):  
P. Vieregge ◽  
W. Klostermann ◽  
R. G. Bl�mm ◽  
K. J. Borgis
2018 ◽  
Vol 31 (3) ◽  
pp. 146 ◽  
Author(s):  
Luís Ramos dos Santos ◽  
Magna Alves-Correia ◽  
Margarida Câmara ◽  
Manuela Lélis ◽  
Carmo Caldeira ◽  
...  

Introduction: Carbon monoxide poisoning may occur in several contexts.Material and Methods: Retrospective of 37 carbon monoxide poisoning cases that underwent hyperbaric oxygen during wildfires in Funchal in August 2016.Results: The studied sample included 37 patients, mean age of 38 years, 78% males. Ten were firefighters, four children and two pregnant victims. Neurological symptoms were the most reported. Median carboxyhemoglobin level was 3.7% (IQR 2.7). All received high-flow oxygen from admission to delivery of hyperbaric oxygen. Persistence of symptoms was the main indication for hyperbaric oxygen. Median time to hyperbaric oxygen was 4.8 hours (IQR 9.5), at 2.5 ATA for 90 minutes, without major complications. Discharge in less than 24 hours occurred in 92% of the cases. Thirty days follow-up: five patients presented clinical symptoms of late neurological syndrome; twelve patients were lost to follow-up. Carboxyhemoglobin levels on admission and mean time to hyperbaric oxygen were no different between those who did and did not develop the syndrome at 30 days (p = 0.44 and p = 0.58, respectively).Discussion: Late neurological syndrome at 30 days occurred in 20% and no new cases were reported at 12 months.Conclusion: Use of hyperbaric oxygen appears to have reduced the incidence of the syndrome. This seems to be the first Portuguese series reporting use of hyperbaric oxygen in carbon monoxide poisoning due to wildfires. The authors intend to alert to the importance of referral of these patients because the indications and benefits of this treatment are well documented. This is especially important given the ever-growing issue of wildfires in Portugal.


1950 ◽  
Vol 96 (405) ◽  
pp. 1015-1023 ◽  
Author(s):  
G. D. F. Steele ◽  
A. B. Hegarty

Suicidal attempts by coal-gas poisoning are very common. Carbon monoxide is a principal constituent of this gas, and can produce severe and permanent brain damage. It is surprising, therefore, to find so few cases of chronic organic psychosis attributed to this cause in mental hospital practice. Rosseter (1928) found only one example of permanent psychosis in 2,000 cases of carbon monoxide asphyxiation. Shillito, Drinker and Shaughnessy (1936) made a follow-up study of 21,000 cases of acute carbon monoxide poisoning. In only 43 of these were the after-effects sufficiently severe to warrant their admission to a mental hospital. Twenty-three subsequently recovered, 11 died, and 9 suffered permanent nervous and mental sequelae. They found that the ratio of psychosis following carbon monoxide poisoning to other psychoses was 1 in 2,000. Henderson and Gillespie (1944) could find only one such case in 5,000 consecutive admissions.


1999 ◽  
Vol 6 (4) ◽  
pp. 331-336 ◽  
Author(s):  
L. D. NUYTTEN ◽  
E. L.E. DHONDT ◽  
M. B. SABBE ◽  
A. I. MEULEMANS ◽  
D. M. CROLS ◽  
...  

Author(s):  
Chien-Cheng Huang ◽  
Tzu-Hao Chen ◽  
Chung-Han Ho ◽  
Yi-Chen Chen ◽  
Chien-Chin Hsu ◽  
...  

Background: Carbon monoxide poisoning (COP) is an important public health issue around the world. It may increase the risk of myocardial injury, but the association between COP and congestive heart failure (CHF) remains unclear. We conducted a study incorporating data from epidemiological and animal studies to clarify this issue. Methods: Using the National Health Insurance Database of Taiwan, we identified patients with COP diagnosed between 1999 and 2012 and compared them with patients without COP (non-COP cohort) matched by age and the index date at a 1:3 ratio. The comparison for the risk of CHF between the COP and non-COP cohorts was made using Cox proportional hazards regression. We also established a rat model to evaluate cardiac function using echocardiography and studied the pathological changes following COP. Results: The 20 942 patients in the COP cohort had a higher risk for CHF than the 62 826 members in the non-COP cohort after adjusting for sex and underlying comorbidities (adjusted hazard ratio, 2.01 [95% CI, 1.74–2.32]). The increased risk of CHF persisted even after 2 years of follow-up (adjusted hazard ratio, 1.85 [95% CI, 1.55–2.21]). In the animal model, COP led to a decreased left ventricular ejection fraction on echocardiography and damage to cardiac cells with remarkable fibrotic changes. Conclusions: Our epidemiological data showed an increased risk of CHF was associated with COP, which was supported by the animal study. We suggest close follow-up of cardiac function for patients with COP to facilitate early intervention and further studies to identify other long-term effects that have not been reported in the literature.


2019 ◽  
Author(s):  
Meixian Zhang ◽  
Ho-Shan Wei ◽  
Ching-Wen Chien ◽  
Tao-Hsin Tung

Abstract Background It has long been known that carbon monoxide poisoning is associated with cognitive dysfunction but whether carbon monoxide poisoning is a risk factor for incident dementia is still inconclusive. Our objective was to assess whether carbon monoxide poisoning increases the incidence of dementia. Methods We conducted a systematic review and meta analysis of cohort studies examining the risk of dementia in people with carbon monoxide poisoning. We searched the Cochrane Library, PubMed, and EMBASE from inception to 31 March 2019. Two authors independently selected studies, assessed the quality of included studies, and extracted data. Any disagreement was resolved by discussion with a third author. Only cohort study with an enough follow-up period was included, which reported the association between carbon monoxide poisoning and incidence of dementia in adults. Exposure was carbon monoxide poisoning; primary outcomes were incident all-cause dementia, Alzheimer’s disease and cognitive disorder. Summary estimates were obtained using random effects meta-analysis. Results Thirty-three full texts were initially searched, but only three studies met our inclusion criteria, and they were comprised of 134,563 participants who were initially free of dementia. The follow-up period ranged from 9 to 12 years. We found that CO poisoning increased the risk of dementia incidence [adjusted hazard ratio 2.61, 95% confidence interval (CI) 1.56 to 4.36, P = 0.0003]. Subgroup analysis showed that the increased dementia risk was significant in males but not in females, and the highest risk was in young age group, followed by in middle age group, but not in the old one (P > 0.05). Conclusions This meta-analysis suggests that overall the evidence from prospective cohort studies supported a link between carbon monoxide exposure and an increased dementia risk, although all the included studies were limited to Taiwanese population. Further studies that provide data for different ethnic groups are needed to clarify whether a subgroup of patients with carbon monoxide exposure has an elevated risk of dementia.


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