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Acute cardiac effects of carbon monoxide poisoning in children

Ozlem Teksam1, Pinar Gumus, Benan Bayrakci

  • 1Department of Pediatrics, Hacettepe University School of Medicine, Ihsan Dogramaci Children's Hospital, Sihhiye, Ankara 06100, Turkey. ozlemt@hacettepe.edu.tr

European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine
|March 3, 2010
PubMed

Insights

Carbon monoxide (CO) poisoning can cause heart damage in children, even without abnormal ECGs. Low Glasgow Coma Scale (GCS) scores and hypotension are linked to this myocardial injury.

Area of Science:

  • Pediatric Cardiology
  • Toxicology
  • Emergency Medicine

Background:

  • Carbon monoxide (CO) poisoning is a rare cause of cardiotoxicity in children.
  • Existing reports are limited to isolated case studies.
  • Acute cardiac effects and myocardial injury in pediatric CO poisoning require further investigation.

Purpose of the Study:

  • To describe the acute cardiac effects in children with CO poisoning.
  • To identify factors associated with myocardial injury in pediatric CO poisoning cases.

Main Methods:

  • Retrospective review of medical records for children (<17 years) with CO poisoning (carboxyhemoglobin ≥10%).
  • Analysis of cardiac biomarkers (creatine kinase-MB, troponin-t), ECG, and echocardiography findings.
  • Correlation of myocardial injury with clinical factors like Glasgow Coma Scale (GCS) and hypotension.

Main Results:

  • 15% (16/107) of pediatric CO poisoning patients showed myocardial injury via elevated cardiac biomarkers.
  • Sinus tachycardia was observed in 32% of patients; no ischemic ECG changes were noted.
  • Echocardiography revealed low ejection fraction and abnormal left ventricular function in 9 of 27 patients.

Conclusions:

  • Myocardial injury can occur in pediatric CO poisoning without abnormal ECG findings.
  • A Glasgow Coma Scale (GCS) score ≤14 and hypotension are significant risk factors for myocardial injury.
  • These findings highlight the importance of cardiac monitoring in children with CO poisoning.
Abstract

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