Kohlenmonxidvergiftung

The carbon monoxide poisoning (CO) produces acute symptoms such as headache, nausea, weakness, heart tightness, dyspnea, loss of consciousness, seizures and coma. Neuropsychiatric symptoms may occur even weeks later. The diagnosis is made based on the carboxy-hemoglobin concentration and arterial blood gas analysis, incl. The measured O2 saturation. The treatment is done by administering O2. Carbon monoxide poisoning can often be prevented by use of carbon monoxide detectors in homes.

Carbon monoxide poisoning, which are among the most common causes of death: poisoning, come about by inhalation. Carbon monoxide is a colorless, odorless gas produced by incomplete combustion of hydrocarbon compounds. Common sources of carbon monoxide to Vvergiftungenführen are fire, not sufficiently ventilated motor vehicles, water heaters, gas heaters, wood or coal and oil furnaces. Carbon monoxide is produced by the combustion of natural gas constituents such as methane or propane. Cigarette smoke also leads to the increase of carbon monoxide in the blood, but not enough to cause poisoning signs.

The carbon monoxide poisoning (CO) produces acute symptoms such as headache, nausea, weakness, heart tightness, dyspnea, loss of consciousness, seizures and coma. Neuropsychiatric symptoms may occur even weeks later. The diagnosis is made based on the carboxy-hemoglobin concentration and arterial blood gas analysis, incl. The measured O2 saturation. The treatment is done by administering O2. Carbon monoxide poisoning can often be prevented by use of carbon monoxide detectors in homes. Carbon monoxide poisoning, which are among the most common causes of death: poisoning, come about by inhalation. Carbon monoxide is a colorless, odorless gas produced by incomplete combustion of hydrocarbon compounds. Common sources of carbon monoxide to Vvergiftungenführen are fire, not sufficiently ventilated motor vehicles, water heaters, gas heaters, wood or coal and oil furnaces. Carbon monoxide is produced by the combustion of natural gas constituents such as methane or propane. Cigarette smoke also leads to the increase of carbon monoxide in the blood, but not enough to cause poisoning signs. Pathophysiology The elimination half-life of carbon monoxide is by inhalation of ambient air about 4.5 hours, shortened by inhalation of 100% O2 at 1.5 hours and at respiration of O2 (at 3 atm pressure, for example in a pressure chamber; Hyperbaric oxygen therapy ( HBO)) continued on 20 minutes. The mechanisms of carbon monoxide poisoning are not fully understood. The following is involved: displacement of O2 from Hb (because CO has a higher affinity for Hb than O2) shift of the O2-Hb dissociation curve to the left inhibition of mitochondrial (decreasing release of O2 from Hb to tissue oxyhemoglobin dissociation curve.) breathing may direct toxic effect on brain tissue symptoms and complaints symptoms of CO poisoning appear to correlate well with the maximum carboxy-hemoglobin levels of patients. Some symptoms are non-specific. Headache and nausea concentrations between 10 and 20% occur with CO-Hb. Values> 20% usually produce unclear dizziness, general weakness, poor concentration and impaired judgment. Values> 30% often lead to dyspnea during exercise, chest pain (esp. In patients with coronary artery disease) and confusion. Higher values ??can cause syncope, seizures and impaired consciousness. Hypotension, coma, respiratory arrest and death usually occur at COHb levels above 60%. In some patients, but other symptoms such as blurred vision, abdominal pain and limited neurologic deficits show. Severe poisoning neuropsychiatric symptoms (eg. As dementia, psychosis, Parkinson’s disease, chorea, amnesic syndrome) can develop even days to weeks after exposure and are then permanently. Since carbon monoxide poisoning often occur in the context of house or apartment fires occur accompanying damage to the respiratory tract, which still increase the risk of respiratory failure (burns: smoke inhalation). Diagnosis The diagnosis must be made when potentially exposed patients have non-specific symptoms or metabolic acidosis Venous carboxyhemoglobin concentration Since the symptoms of such poisoning can only be vague, nonspecific and variable, the diagnosis of CO poisoning is often overlooked. Many light poisoning with non-specific symptoms are often mistaken as unclear viral infections. therefore, a high degree of attention required by doctors. If several persons in a household, esp. When using floor boilers, develop non-specific flu-like symptoms should be considered a carbon monoxide exposure. Provided that a carbon monoxide poisoning is suspected, the CO-Hb value is measured using a CO-Oximeter. It can also be used venous blood samples, as the differences between arterial and venous samples are negligible. Arterial blood gas analysis should not be performed routinely. In addition, pulse oximeter can not differentiate between normal hemoglobin and carboxyhemoglobin and therefore give false-high Oxyhämoglobinwerte. Arterial blood gas analysis and pulse oximetry, alone or in combination, are not sufficient for diagnosis of carbon monoxide poisoning because the measured in arterial blood gases O2 saturation also includes the dissolved O2, which is independent of the carboxyhemoglobin. Noninvasive CO detectors could not show that they are accurate enough to be useful in the diagnosis of CO exposure or Toxicity. Although elevated carboxyhemoglobin provide a clear point of poisoning, the values ??can be false-low because they fall quickly after the end of exposure, was particularly if already given additional O2 z. As in the ambulance. Metabolic acidosis may be the key to diagnosis. Other studies may help clarify specific symptoms (eg. As ECG for chest pain, computed for clarification of neurological symptoms). Therapy 100% O2 may hyperbaric O2 patients need to be rescued from the CO atmosphere and stabilized if necessary. You should 100% of O2 are obtained (via breathing masks without rebreathing) and supportive treatment. Although the use is controversial, hyperbaric O2 therapy should (in a chamber at 2-3 atmospheres of 100% O2) will be considered for patients in those in which either of the following conditions: Life-threatening cardiopulmonary complications Continuing chest pain disturbances of consciousness loss of consciousness (regardless of duration) A carboxyhemoglobin concentration> 25% hyperbaric O2 therapy should also be considered for pregnant patients into consideration, possibly at lower serum COHb values ??than non-pregnant patients. Hyperbaric O2 therapy probably reduces the incidence of subsequent neuropsychiatric symptoms. Perhaps no hyperbaric chamber is located on site. This therapy can cause barotrauma and because it is not available in all hospitals, making the transfer of patients required even if they are not sufficiently stable. The efficacy of hyperbaric O2 therapy is becoming increasingly controversial, as some studies show damage to the patient. In cases where the hyperbaric O2 therapy is contemplated, consultation must be held with a poison center or appropriate experts. Prevention Prevention involves finding sources such as incinerators within the home to ensure that they are correctly installed and properly ventilated to the outside. Exhaust pipes must be checked regularly for leaks. Car engines should never be left running in a closed garage. The installation of carbon monoxide detectors is recommended because it early alert on the release of carbon monoxide in a heating atmosphere. When carbon monoxide is suspected in a boiler room, the windows were open, shut the heating system and the source of CO production are investigated. Summary The carbon monoxide poisoning (eg., Caused by house fires, not properly ventilated cars, gas heaters, furnaces, water heaters, wood, coal and gas stoves, heaters) is the most common fatal poisoning. Carbon monoxide poisoning should be considered in patients with non-specific symptoms (flu-like z. B. symptoms in winter) or unexplained metabolic acidosis into consideration. Measuring the CO content of a CO-oximeter. Toxicity should not be excluded on the basis of a normal CO value because the values ??decrease rapidly, especially after treatment with O2. Treatment with 100% O2. Severe poisoning an expert or a poison control center must be called to decide on a treatment with hyperbaric O2.

Health Life Media Team

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