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Is Asymmetric Dimethylarginine a Useful Biomarker in Children With Carbon Monoxide Poisoning?

Abdullah Yazar, Fatih Akin, Ahmet Sert1

  • 1Department of Pediatric Cardiology, Medical Faculty, Selcuk University.

Pediatric Emergency Care
|February 13, 2019
PubMed

Insights

Asymmetric dimethylarginine (ADMA) levels remain elevated in children with carbon monoxide poisoning (COP) even after treatment. ADMA may serve as a valuable biomarker for predicting treatment duration and outcomes in pediatric COP cases.

Area of Science:

  • Pediatric Emergency Medicine
  • Toxicology
  • Biomarker Discovery

Background:

  • Carbon monoxide poisoning (COP) is a leading cause of poisoning deaths globally.
  • Children experience more severe effects from COP, potentially requiring prolonged treatment.
  • Current biomarkers like carboxyhemoglobin (CO-Hb) and lactate may not fully predict treatment duration or outcomes in pediatric COP.

Purpose of the Study:

  • To investigate asymmetric dimethylarginine (ADMA) as a potential biomarker for predicting treatment duration and outcomes in pediatric carbon monoxide poisoning.
  • To compare ADMA levels in children with COP to healthy controls.
  • To assess the correlation between ADMA, CO-Hb, and lactate levels in pediatric COP patients.

Main Methods:

  • A case-control study involving 32 pediatric patients with COP and 30 healthy children.
  • Analysis of blood samples for arterial blood gases, CO-Hb, methemoglobin, lactate, and ADMA.
  • Comparison of ADMA levels at admission and 6 hours post-treatment between COP patients and controls.

Main Results:

  • ADMA levels were significantly higher in COP patients on admission and post-treatment compared to controls.
  • No significant correlation was found between CO-Hb and ADMA levels at admission or 6 hours.
  • A positive correlation was observed between lactate and CO-Hb levels on admission.

Conclusions:

  • ADMA levels remain elevated in children with COP for at least 6 hours after 100% oxygen therapy, irrespective of normalized CO-Hb or lactate levels.
  • ADMA shows potential as a useful biomarker for assessing severity and predicting outcomes in pediatric COP.
  • Further research is warranted to establish ADMA's role in managing pediatric carbon monoxide poisoning.
Abstract

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