Öz
Giriş: Karbon monoksit (CO) zehirlenmesi dünya çapında en yaygın zehirlenmelerden biridir. CO zehirlenmesi ile zehirlenme şiddetini tahmin edecek parametreleri araştırmak için birçok çalışma bulunmaktadır. Bu çalışmada kan parametre değerleri ile kanda ölçülen CO değerleri ve zehirlenmenin sonlanımı arasındaki ilişkiyi araştırmayı amaçladık.
Metod: Çalışmamız retrospektif bir çalışmadır. Kan gazında CO düzeyi ≥ %10 olan hastalar çalışmaya dahil edildi. Hastalar hiperbarik oksijen ihtiyacı olanlar ve olmayanlar olarak 2 gruba ayrıldı. Hastaların yaş, cinsiyet gibi demografik verileri ile kan gazlarındaki CO düzeyleri, hemoglobin, lökosit, nötrofil, kan sayımı trombosit sayıları, MPV ve PDW değerleri kaydedildi. Ayrıca kreatinin, troponin, CRP, ALT değerleri de kaydedildi.
Bulgular: Çalışmaya 110 hasta dahil edildi Hastaların yaş ortalaması 46,80±18,18 idi. Parametreler incelendiğinde HBO tedavisi gereken hastaların WBC sayımı ortancası 8,73 [7,54-11,83], HBO tedavisi gerektirmeyen hastaların WBC sayısı ortancası 8,01 [6,96-9,72] (p=0,038) idi. Benzer şekilde HBO tedavisi gereken hastaların lenfosit sayısı ortancası 2,73 [1,85-3.36] olarak belirlendi ve bu değer HBO tedavisi gerektirmeyen hastalara göre daha yüksek bulundu (p=0,026).
Sonuç: Hiperbarik oksijen tedavisi gerektiren CO zehirlenmesi olgularında WBC ve lenfosit sayıları daha yüksektir. Ancak bu iki değer hiperbarik oksijen tedavisini öngörmede bağımsız risk faktörleri değillerdir.
Anahtar Kelimeler
Kaynakça
- Cervellin G, Comelli I, Rastelli G, et al. Initial blood lactate correlates with carboxyhemoglobin and clinical severity in carbon monoxide poisoned patients. Clin Biochem. 2014;47(18):298-301.
- Weaver LK. Carbon monoxide poisoning. Undersea Hyperb Med. 2020;47(1):151-69.
- 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.
- Ozturk B, Arihan O, Coskun F, Dikmenoglu-Falkmarken NH. Acute carbon monoxide poisoning alters hemorheological parameters in human. Clin Hemorheol Microcirc. 2016;61(4):591-7.
- Coşkun A, Eren FA, Eren ŞH, Korkmaz İ. Predicting of neuropsychosis in carbon monoxide poisoning according to the plasma troponin, COHb, RDW and MPV levels: Neuropsychoses in carbon monoxide poisoning. Am J Emerg Med. 2019;37(7):1254-9.
- Karabacak M, Varol E, Türkdogan KA, et al. Mean platelet volume in patients with carbon monoxide poisoning. Angiology. 2014;65(3):252-6.
- Liu Q, Xiao Q, Han Y, et al. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2021;33(9):1088-93.
- Moon JM, Chun BJ, Cho YS. The predictive value of scores based on peripheral complete blood cell count for long-term neurological outcome in acute carbon monoxide intoxication. Basic Clin Pharmacol Toxicol. 2019;124(4):500-10.
- Gao H, Sun L, Wu H, Chen J, Cheng Y, Zhang Y. The predictive value of neutrophil-lymphocyte ratio at presentation for delayed neurological sequelae in carbon monoxide poisoning. Inhal Toxicol. 2021;33(4):121-7.
- Moon JM, Chun BJ, Cho YS, Lee SM. Diagnostic Value of Parameters Related to White Blood Cell Counts for Troponin I Elevation in CO Poisoning. Cardiovasc Toxicol. 2019;19(4):334-43.
- Bağcı Z, Arslan A, Arslan D. The Value of Neutrophil:Lymphocyte Ratio and Platelet:Lymphocyte Ratio in Predicting Clinical Severity in Children with Carbon Monoxide Poisoning. Indian J Pediatr. 2021;88(11):1121-6.
- Coşkun A, Eren FA, Eren ŞH, Korkmaz İ. Predicting of neuropsychosis in carbon monoxide poisoning according to the plasma troponin, COHb, RDW and MPV levels: Neuropsychoses in carbon monoxide poisoning. Am J Emerg Med. 2019;37(7):1254-9.
- Liao SC, Mao YC, Hung YM, Lee CH, Yang CC. Predictive Role of QTc Prolongation in Carbon Monoxide Poisoning-Related Delayed Neuropsychiatric Sequelae. Biomed Res Int. 2018;2018:2543018.
- Cha YS, Kim H, Do HH, et al. Serum neuron-specific enolase as an early predictor of delayed neuropsychiatric sequelae in patients with acute carbon monoxide poisoning. Hum Exp Toxicol. 2018;37(3):240-6.
- Temrel TA, Bilge S. Myocardial Repolarization Parameters and Neutrophil-to-Lymphocyte Ratio are Associated with Cardiotoxicity in Carbon Monoxide Poisoning. Cardiovasc Toxicol. 2020;20(2):190-6.
- Karaman K, Armagan HH. Predictive value of platelet lymphocyte ratio in carbon monoxide poisoning Ann Med Res 2021;28(9):1754-7.
- Liao SC, Mao YC, Yang KJ, et al. Targeting optimal time for hyperbaric oxygen therapy following carbon monoxide poisoning for prevention of delayed neuropsychiatric sequelae: A retrospective study. J Neurol Sci. 2019;396:187-92.
Öz
Introduction: Carbon monoxide (CO) poisoning is one of the most common poisonings worldwide. Many studies have investigated the relationship between predictive parameters and CO poisoning severity. We aimed to investigate the relationship between blood parameter values with poor outcome in CO poisoning, and CO values measured in blood.
Methods: This is a retrospective study. Patients who had CO levels ≥ %10 in their blood gas were included in the study. Patients were divided into 2 groups as those who required hyperbaric oxygen and those who do not. Demographic data such as age, gender of the patients, as well as CO levels in the blood gases of the patients, hemoglobin, leukocyte, neutrophil, platelet counts of the blood count, and MPV and PDW values were recorded. Also, creatinine, troponin, CRP, ALT values were recorded as well.
Results: The study was conducted with 110 patients. The mean age of the patients was 46.80±18.18 years. When the parameters were examined, the median WBC count of patients with patients who required HBO therapy was 8.73[7.54-11.83], and the median WBC count of patients who did not require HBO therapy was 8.01[6.96-9.72] (p=0.038). The median lymphocyte count of patients who required HBO therapy was determined as 2.73[1.85-3.36], and this value was found to be higher than patients who did not require HBO therapy (p=0.026).
Conclusion: WBC and lymphocyte counts are higher in CO poisoning patients who required hyperbaric oxygen therapy. But these two values were not found to be independent risk factors in predicting hyperbaric oxygen therapy.
Anahtar Kelimeler
Kaynakça
- Cervellin G, Comelli I, Rastelli G, et al. Initial blood lactate correlates with carboxyhemoglobin and clinical severity in carbon monoxide poisoned patients. Clin Biochem. 2014;47(18):298-301.
- Weaver LK. Carbon monoxide poisoning. Undersea Hyperb Med. 2020;47(1):151-69.
- 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.
- Ozturk B, Arihan O, Coskun F, Dikmenoglu-Falkmarken NH. Acute carbon monoxide poisoning alters hemorheological parameters in human. Clin Hemorheol Microcirc. 2016;61(4):591-7.
- Coşkun A, Eren FA, Eren ŞH, Korkmaz İ. Predicting of neuropsychosis in carbon monoxide poisoning according to the plasma troponin, COHb, RDW and MPV levels: Neuropsychoses in carbon monoxide poisoning. Am J Emerg Med. 2019;37(7):1254-9.
- Karabacak M, Varol E, Türkdogan KA, et al. Mean platelet volume in patients with carbon monoxide poisoning. Angiology. 2014;65(3):252-6.
- Liu Q, Xiao Q, Han Y, et al. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2021;33(9):1088-93.
- Moon JM, Chun BJ, Cho YS. The predictive value of scores based on peripheral complete blood cell count for long-term neurological outcome in acute carbon monoxide intoxication. Basic Clin Pharmacol Toxicol. 2019;124(4):500-10.
- Gao H, Sun L, Wu H, Chen J, Cheng Y, Zhang Y. The predictive value of neutrophil-lymphocyte ratio at presentation for delayed neurological sequelae in carbon monoxide poisoning. Inhal Toxicol. 2021;33(4):121-7.
- Moon JM, Chun BJ, Cho YS, Lee SM. Diagnostic Value of Parameters Related to White Blood Cell Counts for Troponin I Elevation in CO Poisoning. Cardiovasc Toxicol. 2019;19(4):334-43.
- Bağcı Z, Arslan A, Arslan D. The Value of Neutrophil:Lymphocyte Ratio and Platelet:Lymphocyte Ratio in Predicting Clinical Severity in Children with Carbon Monoxide Poisoning. Indian J Pediatr. 2021;88(11):1121-6.
- Coşkun A, Eren FA, Eren ŞH, Korkmaz İ. Predicting of neuropsychosis in carbon monoxide poisoning according to the plasma troponin, COHb, RDW and MPV levels: Neuropsychoses in carbon monoxide poisoning. Am J Emerg Med. 2019;37(7):1254-9.
- Liao SC, Mao YC, Hung YM, Lee CH, Yang CC. Predictive Role of QTc Prolongation in Carbon Monoxide Poisoning-Related Delayed Neuropsychiatric Sequelae. Biomed Res Int. 2018;2018:2543018.
- Cha YS, Kim H, Do HH, et al. Serum neuron-specific enolase as an early predictor of delayed neuropsychiatric sequelae in patients with acute carbon monoxide poisoning. Hum Exp Toxicol. 2018;37(3):240-6.
- Temrel TA, Bilge S. Myocardial Repolarization Parameters and Neutrophil-to-Lymphocyte Ratio are Associated with Cardiotoxicity in Carbon Monoxide Poisoning. Cardiovasc Toxicol. 2020;20(2):190-6.
- Karaman K, Armagan HH. Predictive value of platelet lymphocyte ratio in carbon monoxide poisoning Ann Med Res 2021;28(9):1754-7.
- Liao SC, Mao YC, Yang KJ, et al. Targeting optimal time for hyperbaric oxygen therapy following carbon monoxide poisoning for prevention of delayed neuropsychiatric sequelae: A retrospective study. J Neurol Sci. 2019;396:187-92.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Orjinal Araştırma |
| Yazarlar | |
| Erken Görünüm Tarihi | 1 Haziran 2022 |
| Yayımlanma Tarihi | 31 Temmuz 2022 |
| Kabul Tarihi | 3 Nisan 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 12 Sayı: 4 |
