Clin Exp Emerg Med.  2016 Jun;3(2):100-104. 10.15441/ceem.15.034.

Treatment of acute carbon monoxide poisoning with induced hypothermia

• Oh BJ
• Im YG
• Park E
• Min YG
• Choi SC

• KMID: 2360984
• DOI: http://doi.org/10.15441/ceem.15.034

Abstract

OBJECTIVE
The effect of induced hypothermia on severe acute carbon monoxide (CO) poisoning remains to be addressed further. We investigated the effect of induced hypothermia on severe acute CO poisoning.
METHODS
Retrospective chart review was conducted for patients who diagnosed as severe acute CO poisoning in emergency department and underwent induced hypothermia from May 2013 to May 2014. Hospital courses with critical medication and major laboratory results were investigated through the chart review.
RESULTS
Among total 227 patients with acute CO poisoning during the period of study, patients with severe acute CO poisoning were 15. All patients underwent induced hypothermia with a temperature goal 33°C. Initial and follow-up levels of S100B protein after induced hypothermia were 0.47 μg/L (interquartile range, 0.11 to 0.71) and 0.10 μg/L (interquartile range, 0.06 to 0.37), respectively (P = 0.01). The mean Glasgow Coma Scales at emergency department admission was 6.87 ± 3.36. Except 1 patient who expired after cardiopulmonary resuscitation, Glasgow Coma Scales at 30-day of hospital discharge were 15 in 10 patients (71.4%), 14 in 1 patient (7.1%), 13 in 1 patient (7.1%), and 6 in 2 patients (14.2%). Seven patients (46.7%) developed delayed neurologic sequelae. Four patients showed mild types of delayed neurologic sequelae and 3 showed moderate to severe types of delayed neurologic sequelae.
CONCLUSION
Most of patients underwent induced hypothermia had a good recovery from severe acute CO poisoning. Therefore, induced hypothermia may be considered as a possible treatment in severe acute CO poisoning.

Keyword

Carbon monoxide; Poisoning; Targeted temperature management; Delayed neurologic sequelae; Complications

MeSH Terms

Carbon Monoxide Poisoning*
Carbon Monoxide*
Carbon*
Cardiopulmonary Resuscitation
Coma
Emergency Service, Hospital
Follow-Up Studies
Humans
Hypothermia, Induced*
Poisoning
Retrospective Studies
Weights and Measures
Carbon
Carbon Monoxide