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Revista Médica del Uruguay
versão impressa ISSN 0303-3295versão On-line ISSN 1688-0390
Resumo
CAIRUS, Andrea et al. Characteristics of acute carbon monoxide poisoning in a comprehensive public health provider. Rev. Méd. Urug. [online]. 2024, vol.40, n.4, e301. Epub 26-Nov-2024. ISSN 0303-3295. https://doi.org/10.29193/rmu.40.4.6.
Introduction:
Carbon monoxide (CO) poisoning is a common and preventable condition, especially during the fall and winter months. Public environmental education on CO sources, proper usage, and potential harms, both during the acute phase and possible long-term effects, should be prioritized.
Objective:
To describe the epidemiological, clinical, therapeutic, and evolutionary characteristics of children under 15 years of age poisoned by CO and treated at a healthcare provider between April and December 2022.
Methodology:
Retrospective observational study. Variables: age, sex, source of exposure, month of the year, symptoms, severity, carboxyhemoglobin (COHb) levels, latency between exposure and COHb detection, paraclinical tests, treatment, and evolution.
Results:
Eleven cases were identified, 6 of which were female, with a mean age of 7.9 years. Sources of exposure: gas water heater 4, stoves 3, braseros 3, exhaust pipe 1. Poisoning was severe in 5 cases, moderate in 4, and mild in 2. Most frequent symptoms: neurological and gastrointestinal. Mean initial COHb was 5.4% (range 0.9–15.6). Mean latency between symptom onset and sample collection was 9.8 hours. Seven patients received oxygen therapy before sample collection. Oxygen therapy was hyperbaric in 6 cases and normobaric in 5. Eight patients were admitted to moderate care and 1 to intensive care. Troponin levels were measured in 9 cases (elevated in 5), CK in 10 (elevated in 4). ECG was performed on 9 patients (altered in 2). Brain MRI was conducted in 8 (altered in 2). One patient was readmitted for late neurological manifestations. No deaths occurred.
Conclusions:
CO poisoning diagnosis requires a high index of suspicion as clinical manifestations are often nonspecific. COHb levels are not always useful for determining severity, as they are affected by multiple factors. Brain MRI and follow-up after discharge are essential for detecting neurological sequelae.
Palavras-chave : Poisoning; Carbon monoxide; Carboxyhemoglobin; Oxygen therapy; Hyperbaric oxygen therapy.