Main Article Content
Carbon monoxide poisoning is one of the common causes of poisoning in patients. However, few studies have focused on the pediatric group. We performed this study in order to clarify the clinical characteristics of pediatric patients with Carbon monoxidepoisoning.
Methods: We retrospectively reviewed the medical records of pediatric patients (age < 14 years) diagnosed with CO intoxication and admited in the Hyperbaric Oxygen chamber of the military hospital MOHAMED V of RABAT between January 2018 and March 2020, epidemiologic and clinical data were collected, analyzed and compared with literature.
Results: A total of 112 children with CO poisoning were identified. Their ages ranged from one to 14 years, symptoms were nausea and vomiting (31%), headache (23%), altred consciousness (19%), dizziness (15%) and seizure (8%). Most events (67.8%) occurred during winter, (100%) of cases were recorded as accidental poisoning. Only one child developed delayed neurologic sequelae, with no death enregistred in our series.
The most common cause of intoxication was improperly vented exhaust produced by gas, hot water heaters (98%).(And) (20%) of patients needed two or more sessions of Hyperbaric Oxygen therapy.
Conclusion: The treatment of Carbon monoxide poisoning is a race against time. Patients requiringHyperbaric Oxygen therapy must be carefully selected within the first few hours, and kept under close observation. Children with Carbon monoxide poisoning had good outcomes in this series.
Chang YC, et al. Risk factors and outcome analysis in children with carbon monoxide poisoning. Pediatrics and Neonatology; 2016.
Liebelt EL. Hyperbaric oxygen therapy in childhood carbon monoxide poisoning. Curr Opin Pediatr. 1999;11(3):259-64.
Theodore E, Mark L W. Carbon monoxide poisoning in children: Diagnosis and management in the emergency Department. Pediatr Emerg Med Pract. 2016;13(9):1-24.
Altintop I, Akcin ME, Tatli M, Ilbasmis MS. Factors that influence the decision for Hyperbaric Oxygen Therapy (HBOT) in cases of carbon monoxide poisoning: a retrospective study. Annals of Burns and Fire Disasters. 2018;31(3):168-73
Turner M, Hamilton-Farrel MR, Clark RJ. Carbon monoxide poisoning: An update. J Accid Emerg Med. 1999;16(2):92.
Levasseur L, Galliot-Guilley M, Richter F, Scherrmann JM, Baud FJ. Effects of mode of inhalation of carbon monoxide and of normobaric oxygen administration on carbon monoxide elimination from the blood. Hum ExpToxicol. 1996;15(11):898–903.
Tibbles PM, Perrotta PL. Treatment of carbon monoxide poisoning: A critical review of human outcome studies comparing normobaric oxygen with hyperbaric oxygen. Ann Emerg Med 1994; 24:269-76
Ernst A, Zibrak JD. Carbon monoxide poisoning. N Engl J Med. 1998;339(22): 1603–8
Cervellin G, Comelli I, Rastelli G, Picanza A, Lippi G. Initial blood lactate correlates with carboxyhemoglobin and clinical severity in carbon monoxide poisoned patients. Clin Biochem. 2014;47(18):298-301.
Damlapinar R, Arikan FI, Sahin S, Dallar Y. Lactate level is more significant than carboxihemoglobin level in determining prognosis of carbon monoxide intoxication of childhood. 2016;32(6):377–83.
Cohn JE, Pfeiffer M, Patel N, Sataloff RT, Mckinnon BJ. Identifying eustachian tube dysfunction prior to hyperbaric oxygen therapy: who is at risk for intolerance. Am J Otolaryngol. 2018;39(1):14-9
Hampson NB, Weaver LK. Carbon monoxide poisoning: a new incidence for an old disease. Undersea Hyperb Med. 2007;34:163-8.
Keles A, Demircan A, Kurtoglu G. Carbon monoxide poisoning: how many patients do we miss. Eur J Emerg Med. 2008; 15(3):154–7.
Weaver LK, Hopkins RO, Chan KJ, Churchill S. Hyperbaric oxygen for acute carbon monoxide poisoning. N Engl J Med. 2002;347(14):1057–67.
Choi IS. Delayed neurologic sequelae in carbon monoxide intoxication. Arch Neurol. 1983;40:433−5.
Crocker PJ, Walker JS. Pediatric carbon monoxide toxicity. J Emerg Med. 1985;3: 443−8.
Raphael JC, Elkharrat D, Jars-Guincestre MC, et al. Trial of normobaric and hyperbaric oxygen for acute carbon monoxide intoxication. Lancet. 1989;2: 414−9.