The relationship between carbonmonoxide level and lactate level and the prognosis level of lactate level in patients applied to dicle university faculty of medicine adult emergency department due to carbonmonoxide exposure

Purpose: Carbon monoxide (CO) is one of the most common causes of death from acute poisoning and fire in developed countries. CO toxicity can cause irreversible injury to hypoxia-sensitive tissues. Although the blood carboxyhemoglobin (COHb) level of patients with carbon monoxide (CO) poisoning is sufficient in the diagnosis, it is not used as a prognostic factor alone. There is a need to use markers that predict acute and chronic complications in carbon monoxide poisoning. The aim of this study; The aim of this study is to examine the relationship between carbon monoxide level and lactate level and the effect of lactate level on prognosis in patients who applied to Dicle University Medical Faculty Emergency Medicine Clinic between 2015-2021 due to carbon monoxide exposure. Materials and methods: This retrospective cross-sectional study was created by selecting patients aged 18 and over who applied to the Adult Emergency Service of Dicle University Medical Faculty Hospital between 01.01.2015-31.01.2021. In this retrospective, descriptive study, the files of approximately 200 patients were scanned and their demographic characteristics (age, sex, application date and season), vital signs (respiratory rate, pulse rate, saturation, blood pressure, fever), admission complaints, ECG findings, laboratory parameters ( lactate, carboxyhemoglobin, troponin, alt, ast, urea, creatine, sodium, potassium, chlorine, anion gap, white blood cell count, hemoglobin, pH, PCO2, PO2, HCO3) were examined. Among these parameters, the relationship between carboxyhemoglobin level and lactate level and the effect of lactate level on prognosis were investigated. Observation, clinical hospitalization, intensive care admission, discharge and ex status of the patients were obtained from hospital records. Results: In the comparison made according to carboxyhemoglobin, the median carboxyhemoglobin value was found to be 8.45 in the patient group poisoned by stove smoke and 2.30 in the patient group poisoned by fire smoke. (p=0.001). It was determined that there was a significant positive correlation between lactate value and COHb value (rs=0.27, p=0.004). A possible increase in lactate value is expected to occur as an increase in COHb value. Again, it is predicted that a possible decrease in the lactate value will cause a decrease in the COHb value. There was no significant relationship between lactate value and Troponin I value (p=0.121). There was no significant relationship between lactate value and BE value (p=0.440). No significant correlation was found between COHb value and Troponin I value (p=0.051). There was no significant relationship between COHb value and BE value (p=0.703). In the comparison made according to the lactate value, the median lactate value was found to be 1.50 in the inpatient group in the ward and 5.70 in the patient group hospitalized in the intensive care unit. was determined to be high (p=0.007). In the comparison made according to the COHb value, the median COHb value was found to be 4.95 in the inpatient group in the ward, and the median COHb value was found to be 25 in the patient group hospitalized in the intensive care unit, and the median COHb value was found to be higher in the patient group hospitalized in the intensive care unit compared to the patient outcome group. determined (p=0.003). Conclusion: While there was a positive and moderate correlation between the COHb level and lactate level of the patients who applied to the emergency department and were diagnosed with carbon monoxide poisoning, the lactate level was measured higher in cases that resulted in hospitalization or death compared to the patients who were discharged as a result. Key words: Carbon Monoxide, Lactate, Prognosis, Mortality