Clinical and Laboratory Characteristics Predicting the Severity of Carbon Monoxide Poisoning in Children: A Single-Center Retrospective Study
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Published on: January 29, 2011
1From the Department of Pediatrics, University of Health Sciences, Ankara Atatürk Sanatorium Training and Research Hospital, Ankara, Turkey.
Insights
Carbon monoxide poisoning (COP) is common in children. Neurological symptoms, elevated red cell distribution width, and mean platelet volume predict severe COP. Early treatment leads to good outcomes even in severe cases.
Area of Science:
- Pediatrics
- Toxicology
- Emergency Medicine
Background:
- Carbon monoxide poisoning (COP) is a prevalent global health concern.
- Accidental exposure, often from domestic sources like coal stoves, affects children.
- Understanding predictors of severity is crucial for timely intervention.
Purpose of the Study:
- To identify demographic, clinical, and laboratory factors associated with severe carbon monoxide poisoning in children.
- To analyze characteristics that predict the severity of COP in pediatric patients.
Main Methods:
- A case-control study involving 380 children with COP and 380 healthy controls.
- COP diagnosis based on medical history and carboxyhemoglobin (COHb) levels >5%.
- Classification of severity: mild (COHb ≤10%), moderate (10%-25%), and severe (>25%).
Main Results:
- Neurological symptoms (syncope, confusion, seizures) were more frequent in the severe COP group.
- Elevated mean platelet volume and red cell distribution width were significant predictors of severity.
- Severe COP cases received hyperbaric oxygen therapy, intubation, or ICU transfer; no deaths or sequelae were reported.
Conclusions:
- Neurological symptoms and specific laboratory markers (RDW, MPV) indicate a higher risk of severe carbon monoxide poisoning in children.
- Prompt and appropriate medical management, including hyperbaric oxygen therapy, yields favorable outcomes even in severe pediatric COP cases.
Objectives:
Carbon monoxide poisoning (COP) is extremely common throughout the world. The purpose of this study was to assess the demographic, clinical, and laboratory characteristics predicting the severity COP in children.
Methods:
The study included 380 children diagnosed with COP between January 2017 and January 2021 and 380 healthy controls. Carbon monoxide poisoning was diagnosed based on the medical history and a carboxyhemoglobin (COHb) level of more than 5%. The patients were classified as mild (COHb 10%), moderate (COHb 10%-25%), or severely (COHb > 25%) poisoned.
Results:
The mean age of the severe group was 8.60 ± 6.30, for the moderate group was 9.50 ± 5.81, for the mild group was 8.79 ± 5.94, and for the control group was 8.95 ± 5.98. The most common place of exposure was at home and all cases were affected accidentally. The coal stove was the most common source of exposure, followed by natural gas. The most common symptoms were nausea/vomiting, vertigo, and headache. Neurologic symptoms such as syncope, confusion, dyspnea, and seizures were more common in the severe group. A total of 91.3% of the children had hyperbaric oxygen therapy, 3.8% were intubated, and 3.8% were transferred to intensive care in the severe group, whereas no death or sequela was observed. Mean platelet volume and red cell distribution width had the highest area under the curve in the receiver operating characteristic analysis (0.659; 0.379). A positive and low statistically significant relationship was found between COHb levels and troponin and lactate levels in the severe group ( P < 0.05).
Conclusions:
Carbon monoxide poisoning progressed more severely in children presented with neurological symptoms and have elevated red cell distribution width and mean platelet volume. Even in severe COP cases, satisfactory results have been obtained with early and appropriate treatment.
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