Oxidant/antioxidant and oxidative stress index levels in patients with carbon monoxide poisoning

Among patients with intoxication, carbon monoxide (CO) poisoning constitutes one of the major causes of mortality and morbidity. In this study, by investigating the effects of total oxidant levels (TOS), total antioxidant levels (TAS), and oxidative stress index (OSI) parameters in CO intoxication cases, we aimed to obtain more information about the pathophysiology of CO poisoning. This prospective study was conducted at the Gaziantep University Medical Faculty Hospital Emergency Department between February 2012 and March 2012. During this time, 113 patients were admitted with a diagnosis of CO poisoning; 50 healthy patients were included as a control group for a total of 163 patients. Levels of carboxyhemoglobin (COHb) were measured for all of the patients during admission and at 90 and 180 minutes after admission with the use of a fingertip signal capture COpulse oximeter. In addition, blood samples were taken during admission and at 90 and 180 minutes after admission to measure levels of TAS and TOS. Blood samples were centrifuged, and the separated plasma was preserved at -80°C until the run time. TAS and TOS measurements were performed with a fully automated colorimetric method. For statistical analysis, the SPSS Windows 18.0 (SPSS Inc, Chicago, Illinois, USA) software package was used. For all comparisons, p < 0.05 was considered significant. The average application time spent in the emergency department for patients with CO poisoning was 31.70 ± 12.46 minutes. There were no significant statistical correlations found (p > 0.05) between TAS, TOS, OSI levels, and age in either the patient group or the control group. In the patient group, there was no significant correlation (p > 0.05) between the COHb levels and the TAS, TOS, and OSI levels taken at admission and at 90 and 180 minutes after admission. The average differences in TAS, TOS, and OSI levels between men and women were not statistically significant (p > 0.05). TOS and OSI levels at the time of initial presentation were higher in the patient group as compared with the control group; this elevation was statistically significant (p < 0.001 for all patients). The TAS levels at admission of the patient group and the control group did not show any differences that were statistically significant (p > 0.05). The levels of TOS and OSI that were measured 90 minutes after admission were higher and statistically significant (p < 0.001 for all patients) in the patient group as compared with the control group. The TAS, TOS, and OSI levels of the patient group that were measured 180 minutes after admission were close to the levels of the control group for the same point in time and were not statistically significant (p > 0.05). Oxidative stress plays a role in the pathophysiology of CO poisoning. For this reason, TOS and OSI levels may be used as early biochemical markers for the evaluation of the severity and prognosis of CO poisoning. Keywords: Carbon monoxide poisoning, oxidative stres, total antioxidant status, total oxidant status, oxidative stress index