Biochemical parameters and clinical outcomes of carbon monoxide poisoning in special groups: children, pregnant women, and the elderly

A. Vural, T. Dolanbay, M. Ozçelik, Z.Y. Oztorun, N. Ardıc, A.B. Vural, M.C. Altay

Emergency Medicine, Niğde Ömer Halisdemir University School of Medicine, Niğde, Turkey. abdussamedvural@gmail.com

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• Toxicology

OBJECTIVE: Carbon monoxide (CO), a toxic gas, poses a significant threat to human health. Children, pregnant women, and elderly individuals are particularly vulnerable to this toxicity. This study aims to evaluate the demographic and clinical characteristics of pediatric, pregnant, and geriatric patients.

PATIENTS AND METHODS: The study included pediatric, pregnant, and geriatric patients with a confirmed diagnosis of CO poisoning, excluding those with complete file data and those with carboxyhemoglobin (COHb) levels below 5% (for children and pregnant patients) and 10% (for elderly patients). Patients aged < 18 years, > 65 years, and pregnant patients admitted to the adult and pediatric emergency departments were included in the study; statistical analyses were conducted using SPSS Inc., with a p-value of < 0.05 considered statistically significant.

RESULTS: For pediatric patients, a statistically significant difference was observed between the two groups in terms of their main complaints, which were primarily attributed to neurological and general symptoms. A positive correlation was found between follow-up time and several factors, including white blood cell (WBC) count and troponin, lactate, lactate dehydrogenase (LDH), and COHb levels. For pregnant patients, no in-hospital mortality was observed in the patients included in this study. A significant negative correlation was identified between age and both COHb and hemoglobin (Hb) levels. A strong positive correlation was found between the COHb levels and hospital follow-up time. For elderly patients, no significant differences were found between the two treatment modalities. Notably, higher COHb levels on admission were associated with a more fatal in-hospital course, with COHb levels > 40% of all patients requiring intubation.

CONCLUSIONS: Vulnerable populations are at increased risk of exposure to CO, and the study results emphasize the necessity of heightened awareness and preventive measures to safeguard these individuals from CO poisoning.

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