Sinus Tachycardia as a Predictor of Severe Carbonmonoxide Poisoning
Keywords:Carbonmonoxide poisoning, electrocardiogram, hypoxia, Emergency Department
Introduction: Carbonmonoxide (CO) poisoning is one of the most frequent intoxications in the world. The
heart is one vital organ affected in CO intoxication. In this study, we aimed to investigate characterstics and
electrocardiographic abnormalities of patients with CO poisoning.
Material and Methods: In a two-year period, we analyzed patient records admitted to our Emergency
Department (ED), retrospectively. Demographical characteristics (age, gender, monthly distribution, sources
of poisoning, etc), vital signs, laboratory findings, Glasgow Coma Scale (GCS) scores and ECG findings
were investigated. Additionally, treatment method, source of exposure and length of stay (LOS) in the ED
were investigated. Then, patients were divided into 2 groups as to normobaric oxygen therapy (NBO) and
hyperbaric oxygen therapy (HBO) groups according to the treatment methods. Two groups were compared
in terms of electrocardiographic abnormalities.
Results: Atotal of 75 patients were involved. The most common source of CO poisoning was stoves (n=71,
94.6%). The most common complaint was found to be nausea and vomiting (n=24, 32%). Mean GCS score
of the patients was 14. Mean carboxyhemoglobin levels were found to be 15%, mean saturation was 95.9%.
Five (6.6%) of the patients have undergone HBO in addition to NBO. The most common ECG finding was
found to be normal sinus rythm in 52 patients (69.3%), followed by sinus tachycardia in 10 patients (13.3%),
bradycardia in 4 patients (5.3%), ST depression in 2 patients (2.6%). Four of 5 patients who underwent HBO
had tachycardia on ECG.
Conclusion: Use of stoves for heating purposes increases the risk for poisoning particularly in winter
months. Although physicians must be aware of its ischemic effects of CO poisoning on cardiovascular
system, sinus tachycardia may be a predictor of CO poisoning severity.
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