Is Asymotomatic Low-Dose Carbonmonoxide Poisoning Harmless at Emergency Department Presentation?

Abstract

Aim: Carbon monoxide (CO) poisoning is a common inhalation poisoning in emergency department (ED) admissions. In this study, we aimed to determine the negligible biochemical and electrocardiogram (ECG) pathological findings of this group of patients with CO poisoning and asymptomatic clinical cases with a CO level below 15% at first admission who are frequently discharged from the ED. Materials and Methods: A total of 68 patients who were exposed to CO poisoning who did not have any clinical complaints or symptoms at the first examination and whose carboxyhemoglobin (COHb) level was between 5% and 15% were included in the study. The group with a COHb level of 5-10% was considered to have a very low level, whereas the group with a COHb level of 10-15% was considered to have a low level. Among the laboratory findings at the time of admission, the COHb level measured at the time of admission to the ED, troponin a cardiac marker, potential of hydrogen and lactate measurements, and white blood cell (WBC) and neutrophil levels were recorded. ECG data were recorded. Results: With regard to COHb levels of low-dose and very low-dose CO poisoning, ECG parameters showed a significant difference, but not in heart rate (p=0.001) between the groups. Regression analysis was performed between ECG heart rate and COHb level, and the linear regression equation was found to be y=2.38x+58.32 (r2=0.68). Conclusion: It should be kept in mind that patients may sometimes present with low COHb levels at ED presentation. If patients have available ECGs, they should definitely be compared with their previous ECGs, and blood parameters, especially lactate, troponin, WBC, and neutrophil levels, should be evaluated. It should not be forgotten that tissue and organ damage can occur with low-dose poisoning.

Keywords

• carbon monoxide
• electrocardiogram
• emergency department
• blood parameters
• heart rate