PREVALENCE AND PROGNOSTIC IMPLICATION OF CARBOXYHEMOGLOBIN IN CRITICALLY ILL PATIENT
Amir Samy Yakoub;
Abstract
arbon monoxide is the most common and serious by-product of combustion and responsible for smoke-related morbidity and mortality.As it is colorless, odorless, tasteless and non-irritating gas, the exposed person is usually unaware of its effect until serious disorders occur. It has the toxic effects of tissue hypoxia and produces various systemic and neurological complications.
The main clinical magnifications of acute CO poisoning consist of symptoms caused by alterations of the cardiovascular system such as initial tachycardia and hypertension, and CNS symptoms such as headache, dizziness, paresis, convulsions and unconsciousness.Carbon monoxide poisoning also produces myocardial ischemia, atrial fibrillation, pneumonia, pulmonary edema, erythrocytosis, leucocytosis, hyperglycemia, muscle necrosis, acute renal failure, skin lesions and changes in perception of the visual and auditory systems.
Of considerable clinical interest, severe neurological manifestations may occur days or weeks after acute CO poisoning. Delayed sequelae of CO poisoning are not rare, usually occur in middle or older ages, and are clinically characterized by symptom triad of mental deterioration, urinary incontinence and gait disturbance.Occasionally, movement disorders, particularly parkinsonism, are observed. In addition, peripheral neuropathy following CO poisoning usually occurs in young adults.
Carbon monoxide one of three gasses (the other two being nitric oxide and hydrogen sulfide) which naturally modulate inflammatory responses in the body, all three gases are known to act as anti-inflammatories, vasodilators and encouragers of neovascular growth.
Despite the known toxicity of CO at high concentration, recent research has revealed that low concentrations of CO may influence intracellular signal transduction pathways. CO can exert vasoregulatory properties, as well as modulate inflammation, apoptosis, and cell proliferation. Researches was done to carbon monoxide all over the world for its anti inflammatory and cell protection properties and use these properties in preventing and treating some diseases as vascular insufficiency ,graft rejection,atherosclerosis,malaria and immunologic diseases.
Diagnosis of CO poisoning can be based upon general symptoms of toxicity,pulse oximeter measurement andLab diagnosis which is promising marker (serum S100B).
Treatment of the CO poisoned patient begins with supplemental O2 and aggressive supportive care, including airway management, blood pressure support, and stabilization of cardiovascular status.Oxygen enhances dissociation of COHb and clearance from the blood by competing CO at the binding sites of hemoglobin and improving tissue oxygenation.
The levels of carbon monoxide in the body might be reduced by using both oxygen and carbon dioxide (Resiratory centers stimulant). This potential new treatment is called NormoCapnic hyperpnea.
Controversy is present as regard hyperbaric oxygen as the main standard treatment of CO poisoning. HOT increasing oxygen delivery to tissues Thus prevention remains a vital public health issue, requiring public education on the safe operation of appliances, heaters, fireplaces, and internal-combustion engines.
The main clinical magnifications of acute CO poisoning consist of symptoms caused by alterations of the cardiovascular system such as initial tachycardia and hypertension, and CNS symptoms such as headache, dizziness, paresis, convulsions and unconsciousness.Carbon monoxide poisoning also produces myocardial ischemia, atrial fibrillation, pneumonia, pulmonary edema, erythrocytosis, leucocytosis, hyperglycemia, muscle necrosis, acute renal failure, skin lesions and changes in perception of the visual and auditory systems.
Of considerable clinical interest, severe neurological manifestations may occur days or weeks after acute CO poisoning. Delayed sequelae of CO poisoning are not rare, usually occur in middle or older ages, and are clinically characterized by symptom triad of mental deterioration, urinary incontinence and gait disturbance.Occasionally, movement disorders, particularly parkinsonism, are observed. In addition, peripheral neuropathy following CO poisoning usually occurs in young adults.
Carbon monoxide one of three gasses (the other two being nitric oxide and hydrogen sulfide) which naturally modulate inflammatory responses in the body, all three gases are known to act as anti-inflammatories, vasodilators and encouragers of neovascular growth.
Despite the known toxicity of CO at high concentration, recent research has revealed that low concentrations of CO may influence intracellular signal transduction pathways. CO can exert vasoregulatory properties, as well as modulate inflammation, apoptosis, and cell proliferation. Researches was done to carbon monoxide all over the world for its anti inflammatory and cell protection properties and use these properties in preventing and treating some diseases as vascular insufficiency ,graft rejection,atherosclerosis,malaria and immunologic diseases.
Diagnosis of CO poisoning can be based upon general symptoms of toxicity,pulse oximeter measurement andLab diagnosis which is promising marker (serum S100B).
Treatment of the CO poisoned patient begins with supplemental O2 and aggressive supportive care, including airway management, blood pressure support, and stabilization of cardiovascular status.Oxygen enhances dissociation of COHb and clearance from the blood by competing CO at the binding sites of hemoglobin and improving tissue oxygenation.
The levels of carbon monoxide in the body might be reduced by using both oxygen and carbon dioxide (Resiratory centers stimulant). This potential new treatment is called NormoCapnic hyperpnea.
Controversy is present as regard hyperbaric oxygen as the main standard treatment of CO poisoning. HOT increasing oxygen delivery to tissues Thus prevention remains a vital public health issue, requiring public education on the safe operation of appliances, heaters, fireplaces, and internal-combustion engines.
Other data
| Title | PREVALENCE AND PROGNOSTIC IMPLICATION OF CARBOXYHEMOGLOBIN IN CRITICALLY ILL PATIENT | Other Titles | دراسة معدل انتشار مادة الكربوكسى هيموجلوبين فى مرضى الحالات الحرجة وعلاقة ذلك بتطور الحالة المرضية | Authors | Amir Samy Yakoub | Issue Date | 2014 |
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