The Correlation of Carbon Monoxide Level, Lactate, Creatine Kinase Myocardial Band, Troponin T, Magnetic Resonance Imaging and Clinical Results in Acute Carbon Monoxide Poisoning
1University of Health Sciences Turkey, İstanbul Okmeydanı Training and Research Hospital, Clinic of Anesthesiology and Intensive Care, İstanbul, Turkey
2University of Health Sciences Turkey, İstanbul Okmeydanı Training and Research Hospital, Clinic of Emergency Medicine, İstanbul, Turkey
3University of Health Sciences Turkey, İstanbul Okmeydanı Training and Research Hospital, Clinic of Radiology, İstanbul, Turkey
Eur Arch Med Res 2020; 36(1): 12-16 DOI: 10.4274/eamr.galenos.2018.48039
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Abstract

Objective: In this study, it was aimed to investigate the correlation between arrival-carboxyl hemoglobin (COHb) levels, lactate, creatine kinase-myocardial band (CK-MB), troponin T and radiological findings in patients who were admitted to emergency service with a pre-diagnosis of carbon monoxide (CO) poisoning between the years 2014-2016.

Methods: The patients who were admitted to emergency service with a pre-diagnosis of CO poisoning between the years 2014-2016 were screened retrospectively. Demographic data, arrival-COHb levels, lactate, CK-MB, troponin T, and if available, computed tomography or magnetic resonance (MR) imaging of the patients, their clinical treatment, and results were compared.

Results: While COHb values of the patients at emergency department arrival were 14.536±13.047%, they were found as 4.536±3.698% at discharge from the hospital. A correlation was not observed statistically between arrival-COHb, lactate, troponin T, and CK-MB. Arrival-lactate level was found as >2.1 mmol/L in 47 patients (36.90%). Cranial MR findings that suggest CO poisoning were determined in four cases who underwent hyperbaric oxygen treatment; millimetric signal enhancements being concordant with chronic microangiopathic ischemic gliotic foci in white matter were determined in the level of the periventricular field, bilateral corona radiata and centrum semiovale in MRI.

Conclusion: There is no correlation between arrival-COHb levels of the patients and lactate, CK-MB and troponin T in CO poisoning. Radiological evaluation should be used for excluding the reasons for a neurological disorder, not for diagnostic reasons.