In addition, patients were also excluded from the study if they were involved in any of the following: suicidal CO intoxication, drug abuse, metabolic acidosis (uremia, diabetic ketoacidosis, lactic acidosis, renal tubular acidosis, sepsis etc.), respiratory diseases (chronic obstructive pulmonary disease, asthma, pneumonia, pulmonary thromboembolism etc.), multiple traumas or being under 18 years of age. Patients with fire-associated smoke poisoning were excluded, because of the suspicion that they could have been exposed to toxic gases other than CO, e.g. Selection of subjects: Patients who were admitted to the emergency department on suspicion of CO poisoning and having a blood COHb level of ≥%10, and aged above 18 years were included in this study. This study was subsequently conducted over a 12-month period (January 20). The study protocol was approved by the Ethics Committee, Faculty of Medicine, Istanbul Medipol University, as a clinical trial (Session No: 2017/02, Decision No: 01). This department serves an average of 97,000 patients per year. This prospective observational study was conducted between January 2017 and January 2018 at the Emergency Department of the University Hospital, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey. To the best of our knowledge, such an investigation has not been conducted previously in patients with respiratory conditions. Īim of the study: The aim of this study was to investigate the relationship between the arterial and venous COHb levels versus the EtCO2 levels in patients with unintentional non-fire-related poisoning with CO. In addition, in patients with non-intubated spontaneous breathing, capnography is utilized for the quick evaluation of critical diseases, determination of response to treatment in acute respiratory distress syndrome, ventilation adequacy in unconscious or procedural sedoanalgesia patients, and to obtain a prognostic basis in patients in septic shock. Further, capnography is used for assessing the prognosis of trauma and adequacy of ventilation. It is also used to check the effectiveness of resuscitation during cardiac arrest and is a prognostic indicator of “return of spontaneous circulation (ROSC)” during chest compressions. endotracheal tube location in intubated patients, and to continually monitor tube placement during transport. Capnography may be used to confirm the status of a number of clinical tests, e.g. The end-tidal CO2 (EtCO2) level, which is the maximum fraction of CO2 at end expiration, measures the physiological state of patients continuously, non-invasively and indirectly. The term capnography refers to the non-invasive measurement of the partial pressure of CO2 in the inhalation air over time. However, preliminary observational studies question the accuracy of this method. A noninvasive pulse CO and oxygen meter to perform spectrophotometric measurements of COHb are in the process of being developed. The diagnosis of CO poisoning is based on a history consistent with a high COHb level and physical examinations. The half-life of CO is about 250 to 320 minutes in room air, approximately 90 minutes when inhaled with high flow oxygen via non-rebreathing face mask, and around 30 minutes with 100 percent hyperbaric oxygen (HBO) treatment. Carbon monoxide spreads rapidly through the pulmonary capillary membranes and binds the iron moiety of heme (and other porphyrins) about 240 times stronger than the affinity of oxygen. It binds hemoglobin with stronger affinity than oxygen, where carboxyhemoglobin (COHb) is formed and interferes with oxygen transport and utilization in the body. Carbon monoxide (CO) is an odorless, tasteless, colorless, and non-irritating gas formed by the combustion of hydrocarbons.
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