Clin Exp Emerg Med.  2018 Sep;5(3):185-191. 10.15441/ceem.17.217.

Serum markers and development of delayed neuropsychological sequelae after acute carbon monoxide poisoning: anion gap, lactate, osmolarity, S100B protein, and interleukin-6

• Kim H
• Choi S
• Park E
• Yoon E
• Min Y
• Lampotang

• KMID: 2422661
• DOI: http://doi.org/10.15441/ceem.17.217

Abstract

OBJECTIVE
Reliable biomarkers of delayed neuropsychological sequelae (DNS) after acute carbon monoxide (CO) poisoning are lacking. This study investigated the associations between potential serum markers and the development of DNS after acute CO poisoning.
METHODS
Retrospective chart reviews were conducted for patients diagnosed with acute CO poisoning during a 28-month period. The patients were divided into two groups according to the presence or absence of having developed DNS. Multivariate analysis was performed to identify predictors of DNS after CO poisoning.
RESULTS
Of a total of 102 patients, 10 (9.8%) developed DNS. The levels of serum osmolarity, S100B protein, and serum lactate, as well as serum anion gap, were statistically significant in univariate analysis. Multiple logistic regression analysis showed that anion gap (adjusted odds ratio [AOR], 1.36; 95% confidence interval [CI], 1.11 to 1.88), serum lactate level (AOR, 1.74; 95% CI, 1.26 to 2.75), and serum S100B protein level ([AOR, 7.02×10⁵; 95% CI, 4.56×10² to 9.00×10¹â°] in model 1, [AOR, 3.69×10⁵; 95% CI, 2.49×10² to 2.71×10¹¹] in model 2) were independently associated with DNS development.
CONCLUSION
Based on our preliminary results, serum lactate level, serum anion gap, and serum S100B protein level in the emergency department could be informative predictors of DNS development in patients with acute CO poisoning. These markers might have the potential to improve early recognition of DNS in patients with acute CO poisoning.

Keyword

Acid-base equilibrium; Lactic acid; Carbon monoxide poisoning; Neurotoxicity syndromes; Osmolar concentration

MeSH Terms

Acid-Base Equilibrium
Biomarkers*
Carbon Monoxide Poisoning*
Carbon Monoxide*
Carbon*
Emergency Service, Hospital
Humans
Interleukin-6*
Lactic Acid*
Logistic Models
Multivariate Analysis
Neurotoxicity Syndromes
Odds Ratio
Osmolar Concentration*
Poisoning
Retrospective Studies
Biomarkers
Carbon
Carbon Monoxide
Interleukin-6
Lactic Acid