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Carbon monoxide poisoning.

S R Mehta1, M Niyogi, A S Kasthuri

  • 1Department of Medicine, AFMC, Pune.

The Journal of the Association of Physicians of India
|October 5, 2001
PubMed
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Carbon monoxide (CO) poisoning can be misdiagnosed, especially at high altitudes. Early diagnosis and prompt 100% oxygen treatment are crucial for reducing CO poisoning morbidity and mortality.

Area of Science:

  • Environmental Health
  • Toxicology
  • Clinical Medicine

Background:

  • Carbon monoxide (CO) poisoning is a significant public health concern, particularly in regions with specific heating practices.
  • Accidental CO poisoning can present with diverse symptoms, often mimicking other serious conditions.
  • High-altitude environments may present unique challenges in managing CO poisoning.

Purpose of the Study:

  • To investigate the clinical and autopsy findings of carbon monoxide poisoning at an altitude of 5,000 ft.
  • To identify common misdiagnoses and assess the effectiveness of diagnostic methods.
  • To evaluate the outcomes and delayed sequelae in CO poisoning patients.

Main Methods:

  • Evaluation of clinical and postmortem findings in 25 and 15 cases of accidental CO poisoning.

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  • Diagnosis based on circumstantial evidence, history of indoor burning, and positive carboxyhaemoglobin (COHb) tests.
  • Routine investigations included pulse oximetry, chest X-ray, and electrocardiography; treatment with 100% oxygen.

    • Main Results:

    • Neurological and respiratory symptoms were prevalent (19/25 and 18/25 patients, respectively).
    • Pulse oximetry readings were normal in all cases, highlighting limitations in SpO2 monitoring for CO poisoning.
    • Autopsy findings included pulmonary edema (100%), cerebral edema with hemorrhages (40%), and skin discoloration (80%).

    Conclusions:

    • A high index of suspicion and thorough history of indoor heating practices are essential for early CO poisoning diagnosis.
    • Prompt administration of 100% oxygen is vital to reduce morbidity and mortality.
    • Delayed neurological sequelae were not observed in this cohort, but autopsy confirmed significant internal damage.