Carbon monoxide poisoning in children

Abstract

Background: Carbon monoxide (CO) is an important source of poisoning in children. We performed this study in order to clarify the clinical characteristics of pediatric patients with CO poisoning.

Methods: We identified and reviewed the medical records of pediatric patients diagnosed with CO intoxication and hospitalized in our department during a 10-year period. Epidemiologic and clinical data were collected and analyzed.

Results: A total of 30 children with CO poisoning were identified. Their ages ranged from 2 to 17 years, with a mean of 9.5 +/- 4.5 years. Improperly vented exhaust produced by gas hot water heaters was the most common cause of intoxication (53.3%), followed by house fires (26.7%). Intentional poisoning by charcoal burning by parents occurred in six patients (20.0%). The majority of events occurred during cool seasons (76.7%). The most common presenting symptom was consciousness disturbance (86.7%). Only one child died and the mortality was 0.03%. Five (16.7%) children developed delayed neurologic sequelae (DNS), but they all recovered completely within 2 months. Seizures during the acute stage, severe metabolic acidosis, significant hypotension, longer times for recovery to full consciousness, and longer hospital stays were observed in children with DNS.

Conclusion: Children with CO poisoning had good outcomes in this series. Although improperly vented exhaust from water heaters and house fires were the most common causes, intentional poisoning by parents through charcoal burning was also an important factor. Early identification of DNS risk factors might help to provide better care.