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Sartori A, Tiberio M, Gottardo R, Del Balzo G, Vermiglio E, Raniero D, De Leo D. Carbon monoxide related deaths: A Verona case series. When cooperation becomes compulsory. Leg Med (Tokyo) 2024; 67:102375. [PMID: 38154312 DOI: 10.1016/j.legalmed.2023.102375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023]
Abstract
INTRODUCTION Carbon monoxide (CO) poisoning is a significant concern in forensic medicine, as it often presents unique challenges in terms of diagnosis, investigation, and determination of the cause of death. CO is a colourless, odourless, and tasteless gas that can be lethal when inhaled in high concentrations. It binds strongly to haemoglobin, forming carboxyhaemoglobin (COHb), which reduces the oxygen-carrying capacity of the blood, leading to tissue hypoxia and ultimately death. MATERIALS AND METHODS Circumstantial data, medical history information, autopsy findings, and toxicological analysis results related to 24 CO poisoning cases at the Institute of Legal Medicine in Verona were collected and analysed. The data were examined in an integrated manner to identify correlations and common patterns. A comparison was also made with the data available in the literature. RESULTS The male gender was confirmed to be the most frequently involved. COHb levels were found to be less than 50% in 6 cases. Three individuals had concurrent cardiovascular pathologies, while 11 subjects tested positive for various substances, including alcohol, benzodiazepines, and morphine. In most cases, the manner of fatal intoxication was accidental, although 6 suicides and 1 homicide are reported. CONCLUSIONS The Verona case series demonstrates that deaths due to CO poisoning require a multidisciplinary approach. The integration of diverse expertise is essential for assessing the manner of death. This approach enables a comprehensive evaluation of the available data, aids in distinguishing between accidental, suicidal, and homicidal deaths, and ensures accurate and reliable forensic conclusions.
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Affiliation(s)
- Alessandro Sartori
- Department of Diagnostic and Public Health, Section of Forensic Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy.
| | - Maurizia Tiberio
- Department of Diagnostic and Public Health, Section of Forensic Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Rossella Gottardo
- Department of Diagnostic and Public Health, Section of Forensic Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Giovanna Del Balzo
- Department of Diagnostic and Public Health, Section of Forensic Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Elisa Vermiglio
- Department of Diagnostic and Public Health, Section of Forensic Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Dario Raniero
- Department of Diagnostic and Public Health, Section of Forensic Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Domenico De Leo
- Department of Diagnostic and Public Health, Section of Forensic Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
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Parker AL, Johnstone TC. Carbon monoxide poisoning: A problem uniquely suited to a medicinal inorganic chemistry solution. J Inorg Biochem 2024; 251:112453. [PMID: 38100903 DOI: 10.1016/j.jinorgbio.2023.112453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 11/30/2023] [Accepted: 12/03/2023] [Indexed: 12/17/2023]
Abstract
Carbon monoxide poisoning is one of the most common forms of poisoning in the world. Although the primary mode of treatment, oxygen therapy, is highly effective in many cases, there are instances in which it is inadequate or inappropriate. Whereas oxygen therapy relies on high levels of a low-affinity ligand (O2) to displace a high-affinity ligand (CO) from metalloproteins, an antidote strategy relies on introducing a molecule with a higher affinity for CO than native proteins (Kantidote,CO > Kprotein,CO). Based on the fundamental chemistry of CO, such an antidote is most likely required to be an inorganic compound featuring an electron-rich transition metal. A review is provided of the protein-, supramolecular complex-, and small molecule-based CO poisoning antidote platforms that are currently under investigation.
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Affiliation(s)
- A Leila Parker
- Department of Chemistry and Biochemistry, University of California Santa Cruz, Santa Cruz, California 95064, United States
| | - Timothy C Johnstone
- Department of Chemistry and Biochemistry, University of California Santa Cruz, Santa Cruz, California 95064, United States..
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Yu J, Lee J, Cho Y, Oh J, Kang H, Lim TH, Ko BS. Correlation between Carboxyhemoglobin Levels Measured by Blood Gas Analysis and by Multiwave Pulse Oximetry. J Pers Med 2024; 14:168. [PMID: 38392600 PMCID: PMC10890311 DOI: 10.3390/jpm14020168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/17/2024] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
Carbon monoxide (CO) poisoning is difficult to diagnose owing to its nonspecific symptoms. Multiwave pulse oximetry can be used to quickly screen patients for CO poisoning. However, few studies have analyzed patients with CO poisoning who presented to the emergency department (ED). The primary aim of our study was to determine the correlation between COHb levels measured in blood gas analysis and COHb levels measured in multiwave pulse oximetry. Secondary aims were the sensitivity and specificity of the COHb level cutoff value using multiwave pulse oximetry to predict a 25% COHb level in blood gas analysis. This single-center retrospective observational study included patients with CO poisoning who visited the ED of a university-affiliated hospital in Seoul, Korea between July 2021 and June 2023. COHb poisoning was determined using blood gas analysis and multiwave pulse oximetry. The correlation of COHb levels between the two tests was evaluated using correlation analysis. The area under the receiver operating characteristic curve (AUC) of multiwave pulse oximetry was calculated to predict COHb levels from the blood gas analysis. The optimal cutoff values, sensitivity, and specificity of COHb were determined. A total of 224 patients who had COHb levels measured using both multiwave pulse oximetry and blood gas analysis were included in the analysis. In the correlation analysis, COHb showed a high positive correlation with COHb measured using blood gas analysis (Spearman correlation coefficient = 0.86, p < 0.001). The AUC of COHb measured by multiwave pulse oximetry to predict 25% of the COHb level (which can be an indication of hyperbaric oxygen treatment) measured by blood gas analysis was 0.916. When the COHb levels measured with multiwave pulse oximetry were 20% the sensitivity was 81% and the specificity was 83%, and when the COHb levels were 25% the sensitivity was 50% and the specificity was 95%. The COHb value measured using multiwave pulse oximetry blood gas analysis showed a high correlation. However, additional research using large-scale studies is required for validation.
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Affiliation(s)
- Jisu Yu
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Juncheol Lee
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Yongil Cho
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Jaehoon Oh
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Hyunggoo Kang
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Tae Ho Lim
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Byuk Sung Ko
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
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Camacho C, Pinto FS, Gouveia C, Chambino B, Rodrigues C. From Carbon Monoxide Poisoning to Myocardial Infarction. Cureus 2023; 15:e51201. [PMID: 38283462 PMCID: PMC10818092 DOI: 10.7759/cureus.51201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Myocardial injury is a known complication following acute carbon monoxide (CO) poisoning, yet there is little literature on this subject. Here, we present the case of a 56-year-old man admitted to the emergency room with severe CO poisoning. The electrocardiogram (ECG) at admission revealed an ST-segment elevation in leads II, III, and aVF, with an elevated troponin-T level. The patient was initially treated with hyperbaric oxygen, with improvement of symptoms and ECG normalization. He was later admitted for coronary angiography, which revealed an occlusion of the right coronary artery. This case aims to highlight an often-overlooked complication of CO intoxication and the need for more studies to better guide the treatment of these patients.
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Affiliation(s)
- Cristiana Camacho
- Internal Medicine, Centro Hospitalar de Lisboa Ocidental, Lisbon, PRT
| | - Fausto S Pinto
- Internal Medicine, Centro Hospitalar de Lisboa Ocidental, Lisbon, PRT
| | - Cláudio Gouveia
- Internal Medicine, Centro Hospitalar de Lisboa Ocidental, Lisbon, PRT
| | - Beatriz Chambino
- Internal Medicine, Centro Hospitalar de Lisboa Ocidental, Lisbon, PRT
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Mohsen G, Kemmerer M, Eichhorn L. Carbon monoxide intoxication with a CO-Hb of 30% while smoking waterpipe: a case report. Int J Emerg Med 2023; 16:83. [PMID: 37936075 PMCID: PMC10630999 DOI: 10.1186/s12245-023-00560-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/26/2023] [Indexed: 11/09/2023] Open
Abstract
Carbon monoxide (CO) poisoning is a significant public health issue and a considerable economic burden in developed countries. While the majority of non-fire-related CO poisonings are attributed to gas heating, there are several other less recognized sources that should be considered in the initial differential diagnosis.The patient in this case was a 21-year-old who experienced a brief episode of loss of consciousness and was subsequently admitted to the Emergency department. Upon evaluation, the patient was diagnosed with CO poisoning, which necessitated hyperbaric oxygen therapy to mitigate the effects of this toxic exposure.Despite exhibiting harmful symptoms initially, the patient stated in a phone interview two and a half years post-incident that they have not experienced any enduring effects such as cardiac arrhythmia or concentration deficits. While their understanding of the risks associated with waterpipe smoking has increased, it has not influenced any major changes in their waterpipe smoking habits.
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Affiliation(s)
- Ghaith Mohsen
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
| | | | - Lars Eichhorn
- Department of Anaesthesiology and Intensive Care Medicine, Helios Hospital Bonn/Rhein-Sieg, Bonn, Germany
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Tuoni C, Nuzzi G, Scaramuzzo RT, Fiori S, Filippi L. Neonatal hypoxic-ischemic encephalopathy after acute carbon monoxide intoxication during pregnancy. A case report and brief review of the literature. Front Pediatr 2023; 11:1264855. [PMID: 38027275 PMCID: PMC10655077 DOI: 10.3389/fped.2023.1264855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Carbon monoxide (CO) poisoning during pregnancy is a rare occurrence, associated with high maternal and fetal mortality rates. As CO can cross the placenta, leading to intrauterine hypoxia, CO intoxication can result in neurological sequelae and neurologic complications in fetuses who survive. We report a case of a preterm newborn acutely exposed to CO in-utero and delivered by emergent cesarean section at the 31st week of gestation due to the severe burns suffered by the mother following an indoor boiler explosion. As CO has serious adverse effects both on the mother and fetus, it is important to recognize and treat poisoning in a timely manner. Despite maternal blood CO levels, CO intoxication at critical stage of central nervous system development can lead to hypoxic-ischemic lesions, thus interdisciplinary care and follow up for these patients are mandatory.
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Affiliation(s)
- Cristina Tuoni
- Neonatology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Giulia Nuzzi
- Neonatology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | | | - Simona Fiori
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Luca Filippi
- Division of Neonatology and NICU, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Moberg ME, Hamilton EB, Zeng SM, Bryazka D, Zhao JT, Feldman R, Abate YH, Abbasi-Kangevari M, Abdurehman AM, Abedi A, Abu-Gharbieh E, Addo IY, Adepoju AV, Adnani QES, Afzal S, Ahinkorah BO, Ahmad S, Ahmed D, Ahmed H, Alem DT, Al-Gheethi AAS, Alimohamadi Y, Ameyaw EK, Amrollahi-Sharifabadi M, Anagaw TF, Anyasodor AE, Arabloo J, Aravkin AY, Athari SS, Atreya A, Azari Jafari A, Badiye AD, Baghcheghi N, Bagherieh S, Bansal H, Barrow A, Bashiri A, Bayileyegn NS, Berhie AY, Bhagavathula AS, Bhardwaj P, Boloor A, Cámera LA, Carvalho F, Carvalho M, Chandrasekar EK, Chang JC, Chattu VK, Chu DT, Coberly K, Cruz-Martins N, Dadras O, Dai X, Darvishi Cheshmeh Soltani R, Das S, Das S, Debela SA, Demessa BH, Deng X, Desta AA, Desye B, Dhimal M, Dibas M, Dsouza HL, Ekholuenetale M, El Sayed I, El-Huneidi W, Enyew DB, Fagbamigbe AF, Fatehizadeh A, Fatima SAF, Fischer F, Franklin RC, Garg T, Gebi TG, Gerema U, Getachew M, Getachew ME, Ghamari F, Golechha M, Goleij P, Gupta S, Gupta VB, Gupta VK, Harorani M, Hasani H, Hassan AM, Hassanian-Moghaddam H, Hassen MB, Hay SI, Hayat K, Heidari M, Heidari-Foroozan M, Heyi DZ, Holla R, Hoogar P, Hossain MS, Hosseini MS, Hostiuc S, Hoveidamanesh S, Ilesanmi OS, Ilic IM, Immurana M, Iwu CCD, Jayarajah U, Joseph N, Joshua CE, Kadashetti V, Kanchan T, Kandel H, Kantar RS, Kapoor N, Karaye IM, Katoto PDMC, Khajuria H, Khan EA, Khateri S, Khodamoradi F, Khormali M, Khubchandani J, Kim G, Kisa A, Koohestani HR, Krishan K, Kumar N, Laflamme L, Landires I, Larijani B, Lauriola P, Le TTT, Ledda C, Lee SW, Lim SS, Lobo SW, Lunevicius R, Maharaj SB, Menezes RG, Mentis AFA, Mestrovic T, Miller TR, Mirmoeeni S, Misganaw A, Mishra M, Misra S, Mittal C, Mohammadi E, Mokdad AH, Moni MA, Mostafavi E, Mubarik S, Mulita F, Mulualem JA, Mulugeta T, Murray CJL, Myers I, Nayak BP, Nayak VC, Nejadghaderi SA, Nguyen HLT, Nguyen VT, Nouraei H, Nzoputam OJ, Okati-Aliabad H, Olufadewa II, Ordak M, Padron-Monedero A, Padubidri JR, Pandey A, Pant S, Parekh U, Pawar S, Peden AE, Petcu IR, Piel FB, Piracha ZZ, Pourali G, Qattea I, Qureshi MF, Raghav PR, Rahman M, Rahmani S, Ramasubramani P, Ramazanu S, Rawaf S, Rezaei N, Rezaei N, Rezaeian M, Saddik B, Sadeghi M, Sadeghian F, Saeed U, Sahebkar A, Saif Z, Sakshaug JW, Salahi S, Salamati P, Samy AM, Sarmiento-Suárez R, Schwebel DC, Senthilkumaran S, Seylani A, Shaikh MA, Sham S, Shashamo BB, Sheikhi RA, Shetty BSK, Shetty PH, Sibhat MM, Singh H, Singh P, Sisay EA, Solomon Y, Taheri M, Ullah I, Ullah S, Violante FS, Vu LG, Wickramasinghe ND, Yigit A, Yonemoto N, Yousefi Z, Zaman M, Zastrozhin MS, Zhang ZJ, Zheng P, Zoladl M, Steinmetz JD, Vos T, Naghavi M, Ong KL. Global, regional, and national mortality due to unintentional carbon monoxide poisoning, 2000-2021: results from the Global Burden of Disease Study 2021. Lancet Public Health 2023; 8:e839-e849. [PMID: 37813118 PMCID: PMC10602911 DOI: 10.1016/s2468-2667(23)00185-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Unintentional carbon monoxide poisoning is a largely preventable cause of death that has received insufficient attention. We aimed to conduct a comprehensive global analysis of the demographic, temporal, and geographical patterns of fatal unintentional carbon monoxide poisoning from 2000 to 2021. METHODS As part of the latest Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), unintentional carbon monoxide poisoning mortality was quantified using the GBD cause of death ensemble modelling strategy. Vital registration data and covariates with an epidemiological link to unintentional carbon monoxide poisoning informed the estimates of death counts and mortality rates for all locations, sexes, ages, and years included in the GBD. Years of life lost (YLLs) were estimated by multiplying deaths by remaining standard life expectancy at age of death. Population attributable fractions (PAFs) for unintentional carbon monoxide poisoning deaths due to occupational injuries and high alcohol use were estimated. FINDINGS In 2021, the global mortality rate due to unintentional carbon monoxide poisoning was 0·366 per 100 000 (95% uncertainty interval 0·276-0·415), with 28 900 deaths (21 700-32 800) and 1·18 million YLLs (0·886-1·35) across all ages. Nearly 70% of deaths occurred in males (20 100 [15 800-24 000]), and the 50-54-year age group had the largest number of deaths (2210 [1660-2590]). The highest mortality rate was in those aged 85 years or older with 1·96 deaths (1·38-2·32) per 100 000. Eastern Europe had the highest age-standardised mortality rate at 2·12 deaths (1·98-2·30) per 100 000. Globally, there was a 53·5% (46·2-63·7) decrease in the age-standardised mortality rate from 2000 to 2021, although this decline was not uniform across regions. The overall PAFs for occupational injuries and high alcohol use were 13·6% (11·9-16·0) and 3·5% (1·4-6·2), respectively. INTERPRETATION Improvements in unintentional carbon monoxide poisoning mortality rates have been inconsistent across regions and over time since 2000. Given that unintentional carbon monoxide poisoning is almost entirely preventable, policy-level interventions that lower the risk of carbon monoxide poisoning events should be prioritised, such as those that increase access to improved heating and cooking devices, reduce carbon monoxide emissions from generators, and mandate use of carbon monoxide alarms. FUNDING Bill & Melinda Gates Foundation.
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Obeso JL, Flores JG, Flores CV, Huxley MT, de Los Reyes JA, Peralta RA, Ibarra IA, Leyva C. MOF-based catalysts: insights into the chemical transformation of greenhouse and toxic gases. Chem Commun (Camb) 2023; 59:10226-10242. [PMID: 37554029 DOI: 10.1039/d3cc03148a] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
Metal-organic framework (MOF)-based catalysts are outstanding alternative materials for the chemical transformation of greenhouse and toxic gases into high-add-value products. MOF catalysts exhibit remarkable properties to host different active sites. The combination of catalytic properties of MOFs is mentioned in order to understand their application. Furthermore, the main catalytic reactions, which involve the chemical transformation of CH4, CO2, NOx, fluorinated gases, O3, CO, VOCs, and H2S, are highlighted. The main active centers and reaction conditions for these reactions are presented and discussed to understand the reaction mechanisms. Interestingly, implementing MOF materials as catalysts for toxic gas-phase reactions is a great opportunity to provide new alternatives to enhance the air quality of our planet.
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Affiliation(s)
- Juan L Obeso
- Instituto Politécnico Nacional, CICATA U. Legaria, Laboratorio Nacional de Ciencia, Tecnología y Gestión Integrada del Agua (LNAgua), Legaria 694, Col. Irrigación, Miguel Hidalgo, 11500, CDMX, Mexico.
- Laboratorio de Fisicoquímica y Reactividad de Superficies (LaFReS), Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México, Circuito Exterior s/n, CU, Coyoacán, 04510, Ciudad de México, Mexico.
| | - J Gabriel Flores
- Departamento de Ingeniería de Procesos e Hidráulica, División de Ciencias Básicas e Ingeniería, Universidad Autónoma Metropolitana-Iztapalapa, 09340, Ciudad de México, Mexico
| | - Catalina V Flores
- Instituto Politécnico Nacional, CICATA U. Legaria, Laboratorio Nacional de Ciencia, Tecnología y Gestión Integrada del Agua (LNAgua), Legaria 694, Col. Irrigación, Miguel Hidalgo, 11500, CDMX, Mexico.
- Laboratorio de Fisicoquímica y Reactividad de Superficies (LaFReS), Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México, Circuito Exterior s/n, CU, Coyoacán, 04510, Ciudad de México, Mexico.
| | - Michael T Huxley
- School of Physics, Chemistry and Earth Sciences, Faculty of Sciences, Engineering and Technology, The University of Adelaide, Adelaide, South Australia 5005, Australia
| | - José Antonio de Los Reyes
- Departamento de Ingeniería de Procesos e Hidráulica, División de Ciencias Básicas e Ingeniería, Universidad Autónoma Metropolitana-Iztapalapa, 09340, Ciudad de México, Mexico
| | - Ricardo A Peralta
- Departamento de Química, División de Ciencias Básicas e Ingeniería. Universidad Autónoma Metropolitana (UAM-I), 09340, Mexico.
| | - Ilich A Ibarra
- Laboratorio de Fisicoquímica y Reactividad de Superficies (LaFReS), Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México, Circuito Exterior s/n, CU, Coyoacán, 04510, Ciudad de México, Mexico.
| | - Carolina Leyva
- Instituto Politécnico Nacional, CICATA U. Legaria, Laboratorio Nacional de Ciencia, Tecnología y Gestión Integrada del Agua (LNAgua), Legaria 694, Col. Irrigación, Miguel Hidalgo, 11500, CDMX, Mexico.
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Alarbi KMS, Baghi MA, Varikkodan I, Sirajudeen J, Al-Aani F, Purayil N, Naushad VA. Acute Cardiomyopathy and Delayed Neuropsychiatric Sequelae of Carbon Monoxide Poisoning: A Case Report. Cureus 2023; 15:e42701. [PMID: 37654911 PMCID: PMC10465715 DOI: 10.7759/cureus.42701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2023] [Indexed: 09/02/2023] Open
Abstract
Carbon monoxide (CO) is an odorless and colorless gas that is formed by the combustion of hydrocarbon. CO poisoning is not an uncommon phenomenon that can have serious consequences for morbidity and mortality. The most frequent causes of accidental poisoning include smoke inhalation from fires, malfunctioning heating devices, smoke from motor vehicles in a poorly ventilated or enclosed space, and electrical cable fires. CO has a higher affinity to hemoglobin than oxygen leading to the formation of carboxyhemoglobin. It impairs the oxygen transport and cytochrome chain which, therefore, leads to further cellular and immunological changes. Here, we present a case of CO poisoning resulting in combined cardiac and neuropsychiatric complications.
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Affiliation(s)
| | - Mohamed A Baghi
- Internal Medicine, Hamad General Hospital, Doha, QAT
- Clinical Medicine, Weill Cornell Medicine - Qatar, Doha, QAT
| | - Irfan Varikkodan
- Internal Medicine, Hamad Medical Corporation, Doha, QAT
- Clinical Department, College of Medicine, Qatar University, Doha, QAT
| | - Jaseem Sirajudeen
- Internal Medicine, Hamad Medical corporation, Doha, QAT
- Clinical Department, College of Medicine, Qatar University, Doha, QAT
| | - Fuad Al-Aani
- Internal Medicine, Hamad General Hospital, Doha, QAT
- Clinical Medicine, Weill Cornell Medicine - Qatar, Doha, QAT
| | - Nishan Purayil
- Internal Medicine, Hamad Medical Corporation, Doha, QAT
- Clinical Department, College of Medicine, Qatar University, Doha, QAT
- Clinical Medicine, Weill Cornell Medicine - Qatar, Doha, QAT
| | - Vamanjore A Naushad
- Internal Medicine, Hamad Medical Corporation, Doha, QAT
- Clinical Medicine, Weill Cornell Medicine - Qatar, Doha, QAT
- Clinical Department, College of Medicine, Qatar University, Doha, QAT
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10
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Hampson NB. Carbon monoxide poisoning mortality in the United States from 2015-2021. Clin Toxicol (Phila) 2023; 61:483-491. [PMID: 37535036 DOI: 10.1080/15563650.2023.2237667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023]
Abstract
INTRODUCTION Most carbon monoxide poisoning is preventable. Tracking of longitudinal trends in carbon monoxide-related mortality is needed to guide public health efforts. This study sought to describe mortality in the United States from carbon monoxide poisoning, examine the epidemiology of unintentional ("accidental") and intentional exposures, and identify trends in both. METHODS The Centers for Disease Control and Prevention's Wonder databases were utilized to extract online data from National Center for Health Statistics files containing mortality data in the United States from 2015-2021. Extracted were deaths, crude death rates, intent of exposure, and demographics of persons dying from carbon monoxide poisoning, excluding cases related to fires. Also extracted was the number of suicidal deaths of all types. Carbon monoxide deaths related to consumer products were obtained from the Consumer Product Safety Commission. Information on state legislation mandating residential carbon monoxide alarms was obtained from online resources. RESULTS Total carbon monoxide deaths decreased from 1,253 in 2015 to 1,067 in 2021. An increase in accidental poisoning deaths was offset by a larger decrease in intentional deaths, despite an increase in suicides of all types in the country. For the first time in the United States, accidental carbon monoxide deaths (543) outnumbered intentional deaths (524) in 2021. The increase in accidental deaths is consistent with those recently reported from carbon monoxide-emitting consumer products by the Consumer Product Safety Commission. Furthermore, even though over one-half of accidental deaths occurred at home, no evidence of a protective effect of state laws requiring residential carbon monoxide alarms was seen. CONCLUSIONS Accidental carbon monoxide poisoning deaths increased from 2015-2021 for the first time in four decades. Exploration of the possibility they are due to consumer products warrants attention and prevention efforts. We were unable to demonstrate the preventive effect of residential carbon monoxide alarm legislation.
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Affiliation(s)
- Neil B Hampson
- Virginia Mason Medical Center and University of WA, Seattle, WA, USA
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