Diagnosis, Prognosis and Management of Illnesses Caused by Carbon Monoxide Poisoning

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 1882

Special Issue Editor


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Guest Editor
Department of Emergency Medicine, Research Institute of Hyperbaric Medicine and Science, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
Interests: carbon monoxide poisoning; hyperbaric medicine; clinical toxicology; emergency ultrasound

Special Issue Information

Dear Colleagues,

Carbon monoxide is a poisonous gas causing debilitating-to-lethal intoxication by binding hemoglobin and heme-containing proteins throughout the body. Carbon monoxide poisoning causes neurocognitive sequelae and various organ injuries, such as to the heart and kidney. Also, a diagnosis of carbon monoxide poisoning is often difficult due to the nonspecific symptoms and clinical signs and the normalized carboxyhemoglobin level after time passes. Once diagnosed, carbon monoxide poisoning is treated with normobaric oxygen and, in selected cases, with hyperbaric oxygen.

This Topic intends to gather updates on carbon monoxide poisoning, especially regarding its diagnosis, prognosis, and treatment, and various organ injuries caused by it. We will include both clinical and experimental research.

This Topic will evaluate original research and high-quality reviews focusing on the following fields: diagnosis (training of technical and healthcare personnel; prehospital diagnosis; new biomarkers; and triage); prognosis (neurological outcomes, mortality, other organ-injury-related outcomes, and long-term outcomes); treatment (normobaric vs. hyperbaric oxygen; early referral; prevention and follow-up of delayed neurologic sequelae; and other treatment modalities); various organ injuries (diagnosis, prognosis, treatment, and basic research).

Dr. Yong Sung Cha
Guest Editor

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Keywords

  • carbon monoxide
  • toxicology
  • emergency medicine
  • critical care
  • hyperbaric medicine
  • oxygen
  • epidemiology
  • mechanism

Published Papers (2 papers)

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Research

9 pages, 776 KiB  
Article
Correlation between Time to Hyperbaric Oxygen Therapy and Delayed Neurological Sequelae in Acute Carbon Monoxide Poisoning Patients
by Sungwoo Choi, Sangun Nah and Sangsoo Han
Diagnostics 2024, 14(2), 186; https://doi.org/10.3390/diagnostics14020186 - 15 Jan 2024
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Abstract
Carbon monoxide (CO) is one of the most common causes of intoxication. Delayed neurologic sequelae (DNS) have a major impact on prognosis of CO poisoning patients. Hyperbaric oxygen therapy (HBOT) is widely used to treat DNS. However, there is no consensus regarding the [...] Read more.
Carbon monoxide (CO) is one of the most common causes of intoxication. Delayed neurologic sequelae (DNS) have a major impact on prognosis of CO poisoning patients. Hyperbaric oxygen therapy (HBOT) is widely used to treat DNS. However, there is no consensus regarding the optimal timing of HBOT. This prospective study enrolled patients who visited the hospital from November 2019 to October 2022. The cutoff value for the latency to HBOT after CO exposure was determined, and the area under the receiver operating characteristic curve (AUC) was estimated. In total, 167 patients were divided into non-DNS and DNS groups. The initial Glasgow Coma Scale (GCS) score, CO exposure time, latency to HBOT after CO exposure, median length of hospital stay (p < 0.001) and creatine kinase (p = 0.016) showed significant differences. A GCS score ≤ 9 had an odds ratio (OR) of 5.059 (95% confidence interval [CI]: 1.602–15.976, p = 0.006), and latency to HBOT after CO exposure ≥ 200 min had an OR of 18.971 (95% CI: 4.310–83.508, p < 0.001). The AUC was 0.8235 (95% CI: 0.7504–0.8966). A GCS score ≤ 9 and latency to HBOT ≥ 200 min may be significant risk factors for DNS. Full article
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13 pages, 1386 KiB  
Article
Clinical and Echocardiographic Predictors for the Presence of Late Gadolinium Enhancement on Cardiac Magnetic Resonance Imaging in Patients with Carbon Monoxide Poisoning
by Dong-Hyuk Cho, Jung-Woo Son, Young In Kim, Jihye Lim, Ho-Sung Jeon, Sung Min Ko and Yong Sung Cha
Diagnostics 2024, 14(1), 60; https://doi.org/10.3390/diagnostics14010060 - 27 Dec 2023
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Abstract
Late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMRI) reflects the burden of myocardial damage in carbon monoxide (CO) poisoning. This study aimed to identify the clinical and echocardiographic parameters that can predict myocardial LGE on CMRI in CO poisoning. This prospective [...] Read more.
Late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMRI) reflects the burden of myocardial damage in carbon monoxide (CO) poisoning. This study aimed to identify the clinical and echocardiographic parameters that can predict myocardial LGE on CMRI in CO poisoning. This prospective observational study included patients who presented with acute CO poisoning and elevated troponin I and underwent echocardiography and CMRI to identify myocardial damage at a tertiary university hospital between August 2017 and May 2019 and August 2020 and July 2022. Based on the CMRI findings, participants were categorized into LGE and non-LGE groups. The median age of the 155 patients was 51.0 years, and 98 (63.2%) were males. Median times from emergency department arrival to either CMRI or echocardiography were 3.0 days each. The LGE group included 99 (63.9%) patients with LGE positivity on CMRIs. Time from rescue to hyperbaric oxygen therapy >4 h (odds ratio (OR): 3.31, 95% confidence interval (CI): 1.28–8.56, p = 0.01); serum lactate levels >2 mmol/L (OR: 2.62, 95% CI: 1.20–5.73, p = 0.02); and left ventricular global longitudinal strain >−16% (OR: 2.95, 95% CI: 1.35–6.47, p = 0.007) were significant predictors of LGE positivity. The area under the curve of these predictors was 0.711. Our prediction model, which combines the clinical parameters with left ventricular global longitudinal strain, may be helpful in the early detection of LGE positivity. Full article
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