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. 2024 Aug 30;19(8):e0301399.
doi: 10.1371/journal.pone.0301399. eCollection 2024.

Early and late adverse clinical outcomes of severe carbon monoxide intoxication: A cross-sectional retrospective study

Abdussamed Vural  1 , Turgut Dolanbay  1
Affiliations

Early and late adverse clinical outcomes of severe carbon monoxide intoxication: A cross-sectional retrospective study

Abdussamed Vural et al. PLoS One. .

Abstract

Background: Carbon monoxide (CO) results from incomplete combustion of carbon-based materials, causing symptoms such as headaches, dizziness, nausea, chest pain, confusion, and, in severe cases, unconsciousness. Normobaric oxygen therapy (NBOT) is the standard therapy, whereas hyperbaric oxygen therapy (HBOT) is recommended in severe cases of organ damage. This study examined the early and late adverse outcomes in patients with severe CO poisoning.

Materials and methods: This study analyzed severe cases of CO poisoning among patients admitted to the emergency department between January 2020 and May 2022. The demographic, clinical, and laboratory data of symptomatic individuals and those requiring HBOT were examined. The study recorded early outcomes, such as intubation and in-hospital mortality, and late outcomes, such as delayed neurological sequelae and 1-year mortality. Chi-square tests, Spearman's rho correlation tests, and logistic regression analyses were performed to identify factors affecting these outcomes.

Results: Patients who received HBOT showed a significant difference in delayed neurological sequelae (DNS) compared to those who received NBOT (p = 0.037). Significant differences were observed in the need for intubation, in-hospital mortality, and 1-year mortality between patients based on COHb levels, but no significant differences were found in DNS. The 1-year mortality probability was significantly influenced by COHb level (odds ratio = 1.159, 95% CI [1.056-1.273]). Patients receiving NBOT had a higher odds ratio for DNS risk than those receiving HBOT (odds ratio = 8.464, 95% [1.755-40.817], p = 0.008).

Conclusion: The study showed no differences in intubation, in-hospital mortality, and 1-year mortality rates between the HBOT and NBOT groups. However, significant differences in DNS suggest that treatment modalities have different effects on neurological outcomes. High COHb levels are associated with an increased risk of intubation, and mortality underscores the significance of monitoring COHb levels in clinical evaluations.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Early adverse outcomes (in-hospital mortality and needing intubation) of CO poisoning depending on the applied treatment and COHB level.
Fig 2
Fig 2. Late adverse outcomes (DNS and 1-year mortality) of CO poisoning depending on the applied treatment and COHB level.
See this image and copyright information in PMC

References

    1. Raub JA, Mathieu-Nolf M, Hampson NB, Thom SR. Carbon monoxide poisoning—a public health perspective. Toxicology. 2000;145(1):1–14. doi: 10.1016/s0300-483x(99)00217-6 - DOI - PubMed
    1. Kinoshita H, Türkan H, Vucinic S, Naqvi S, Bedair R, Rezaee R, et al. Carbon monoxide poisoning. Toxicol Rep. 2020;7:169–73. doi: 10.1016/j.toxrep.2020.01.005 - DOI - PMC - PubMed
    1. Hampson NB, Piantadosi CA, Thom SR, Weaver LK. Practice recommendations in the diagnosis, management, and prevention of carbon monoxide poisoning. Am J Respir Crit Care Med. 2012;186(11):1095–101. doi: 10.1164/rccm.201207-1284CI - DOI - PubMed
    1. Eichhorn L, Thudium M, Jüttner B. The Diagnosis and Treatment of Carbon Monoxide Poisoning. Dtsch Arztebl Int. 2018;115(51–52):863–70. doi: 10.3238/arztebl.2018.0863 - DOI - PMC - PubMed
    1. Casillas S, Galindo A, Camarillo-Reyes LA, Varon J, Surani SR. Effectiveness of Hyperbaric Oxygenation Versus Normobaric Oxygenation Therapy in Carbon Monoxide Poisoning: A Systematic Review. Cureus. 2019;11(10):e5916. doi: 10.7759/cureus.5916 - DOI - PMC - PubMed