Karbon monoksit zehirlenmesinde iyileştirici eritosit aferez ugulamasinin etkileri

ABSTRACTPurpose: Carbon monoxide poisoning is a significant reason of death and disability in Turkey as all over the world. The treatment of carbon monoxide poisoning is a race against time. While early treatment is highly effective; effect decreases in late treated patients. In our study, we aim to cure the patients who are diagnosed with carbon monoxide poisoning in our hospital?s Emergency Service and have indications of hyperbaric oxygen teraphy using therapeutic erythrocyte apheresis method because we don?t have hyperbaric oxygen therapy department in our hospital to compare the obtained treatment results to hyperbaric oxygen treatment which is current.Methods: We studied 17 patients ( 9 males and 8 females) who were diagnosed with carbon monoxide poisining in our hospital?s Emergency Service and who had indications of hyperbaric oxygen treatment between January 2007 and February 2009. The mean age of patients was measured between 41,6±20,8. During the patients application to Emergeny Service, in the blood samples taken prior to therapeutic erythrocyte apheresis, complete blood count, prothrombin time, activated partial thromboplastin time, blood gas values, biochemical values and carboxyhemoglobin blood levels were measured. In order to direct the treatment of patients and to make the follow-ups easy their states of consciousness were recorded with the Glaskow coma scale.Results: Before therapeutic erythrocyte apheresis, patients mean carboxyhemoglobin value was measured as 28,6±18,05 and Glaskow coma scale value as 10±3. All of the patients were taken to the therapeutic erytrocyte apheresis process. The process took nearly 81,88 ±24,3 minutes. After the treatment, the patients average blood carboxyhemoglobin value was measured as 6,13±4,18 and Glasgow coma value was measured as 14±1,0 It was statistically detected that there was a significant improvement between blood carboxyhemoglobin values and Glasgow coma scale values before and after the patients treatment (p<0,001) There was no death in patients. In 3 patients, neurological complications were observed secondary to carbon monoxide poisoning. 2 patients developed permanent hypoxic ischemic encephalopathy. 1 patient developed cortical blindness and recovered by the time.Conclusion: As a result there is a healing effect of therapeutic erythrocyte apheresis in carbon monoxide poisoning. To reduce the blood levels of karboxyhemoglobin in carbon monoxide poisoning is an effective treatment. The probability of disability increases in late treated patients. In the future, further studies should be done to be able to compare it to the hyperbaric oxygen treatment.Keywords : Carbon Monoxide Poisoning, Therapeutic Erythrocyte Apheresis