Age as a predisposing factor of respiratory alkalosis in accidental carbon monoxide poisoning

Abstract

The purpose of this study was to determine the frequency of and identify the predisposing factors for respiratory alkalosis in patients with accidental carbon monoxide (CO) poisoning. Patients presenting to the emergency department with accidental CO poisoning were retrospectively identified and divided into Group A (no respiratory alkalosis) and Group B (respiratory alkalosis). Charts were reviewed for neurologic status, various demographic factors, and laboratory data. A total 96 patients, 37 (38.5%) men and 59 (61.5%) women, were identified. Of these, the 58 (60.4%) patients without respiratory alkalosis were placed in Group A and the 38 (39.6%) patients with respiratory alkalosis were placed in Group B. Independent multivariate predictors of CO poisoning presenting with respiratory alkalosis were age [odds ratio (OR), 1.04; 95% confidence interval (CI), 1.01–1.08] and respiratory rate (OR, 1.16; 95% CI, 1.01–1.33). The rates of respiratory alkalosis in patients younger than 15 years, 15–29 years, 30–44 years, 45–59 years, and older than 59 years were 17.4%, 32.4%, 51.9%, 75%, and 75%, respectively ( p < 0.01). Respiratory alkalosis in the patients with CO poisoning is not an uncommon finding, and as age increases, the percentage becomes higher. When emergency physicians are faced with patients presenting with respiratory alkalosis of undetermined cause, CO poisoning should be taken into consideration, especially in the elderly.