![]() Those at highest risk for mortality are those who: are of an older age are exposed to fire as a source of CO experience loss of consciousness and those with very high carboxyhemoglobin levels and respiratory failure. Mortality due to carbon monoxide poisoning, 1999-2014. Mortality of acute CO poisoning is approximately 1% to 3%. Symptoms can range from headache, nausea, and dizziness, to severe cardiovascular and neurologic symptoms, depending on the dose and duration of the exposure. The symptoms of CO poisoning vary widely and are mostly nonspecific. The increased affinity of CO with hemoglobin results in decreased systemic oxygen delivery and the effects of CO on cytochrome c oxidase results in impairment of cellular respiration. Carbon monoxide poisoning: pathogenesis, management, and future directions of therapy. 2012 Dec 1 186(11):1095-101.ĬO is formed by incomplete combustion, with fire smoke inhalation, motor vehicles, and other engine exhausts being the most prevalent sources of exposure. ![]() Practice recommendations in the diagnosis, management, and prevention of carbon monoxide poisoning. Hampson NB, Piantadosi CA, Thom SR, et al. DefinitionĬarbon monoxide (CO) poisoning is the most common human poisoning. Issues with hyperbaric treatment include difficulty caring for critically ill patients at some centers, and logistical barriers for timely transfer to facilities offering hyperbaric therapy.Ĭomplications of hyperbaric therapy include seizures related to oxygen toxicity, pulmonary edema, and ear barotrauma. High-flow oxygen therapy, hyperbaric oxygen, and supportive therapy are the key treatments. Up to 40% of survivors of CO poisoning suffer from delayed neurocognitive deficits that can become permanent.ĭiagnosis is based on a clinical triad: history of CO exposure, elevated carboxyhemoglobin levels, and symptoms consistent with CO poisoning. Neurologic symptoms include acute stroke-like symptoms, altered mental status, confusion, coma, and syncope. Patients with moderate to severe CO poisoning should be assessed for cardiac involvement with an ECG and measurement of cardiac biomarkers to identify acute myocardial injury, as this can predict poor long-term outcomes. More severe exposure results in cardiovascular manifestations that can include myocardial ischemia, myocardial infarction, cardiac dysfunction, dysrhythmias, and cardiac arrest. If symptoms of CO poisoning are suspected, individuals should leave the building or space immediately and call the emergency medical services. Poisoning can occur following exposure from incomplete combustion that includes smoke inhalation from fire, motor vehicle exhaust and other engine exhausts in poorly ventilated spaces, and various industrial sources.Įarly symptoms are nonspecific and include headache, dizziness, and nausea. Approximately 1% to 3% of all poisonings are fatal. ![]() ![]() Carbon monoxide (CO) is an odorless, colorless gas, and poisoning can cause hypoxia, cell damage, and death. ![]()
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