Sinus Tachycardia as a Predictor of Severe Carbonmonoxide Poisoning

Abstract

Introduction: Carbonmonoxide (CO) poisoning is one of the most frequent intoxications in the world. Theheart is one vital organ affected in CO intoxication. In this study, we aimed to investigate characterstics andelectrocardiographic abnormalities of patients with CO poisoning.Material and Methods: In a two-year period, we analyzed patient records admitted to our EmergencyDepartment (ED), retrospectively. Demographical characteristics (age, gender, monthly distribution, sourcesof poisoning, etc), vital signs, laboratory findings, Glasgow Coma Scale (GCS) scores and ECG findingswere investigated. Additionally, treatment method, source of exposure and length of stay (LOS) in the EDwere investigated. Then, patients were divided into 2 groups as to normobaric oxygen therapy (NBO) andhyperbaric oxygen therapy (HBO) groups according to the treatment methods. Two groups were comparedin terms of electrocardiographic abnormalities.Results: Atotal of 75 patients were involved. The most common source of CO poisoning was stoves (n=71,94.6%). The most common complaint was found to be nausea and vomiting (n=24, 32%). Mean GCS scoreof the patients was 14. Mean carboxyhemoglobin levels were found to be 15%, mean saturation was 95.9%.Five (6.6%) of the patients have undergone HBO in addition to NBO. The most common ECG finding wasfound to be normal sinus rythm in 52 patients (69.3%), followed by sinus tachycardia in 10 patients (13.3%),bradycardia in 4 patients (5.3%), ST depression in 2 patients (2.6%). Four of 5 patients who underwent HBOhad tachycardia on ECG.Conclusion: Use of stoves for heating purposes increases the risk for poisoning particularly in wintermonths. Although physicians must be aware of its ischemic effects of CO poisoning on cardiovascularsystem, sinus tachycardia may be a predictor of CO poisoning severity.