The role of lactate levels in determining the severity of disease for carbon monoxide intoxications

Aim: It is aimed to investigate the role of lactate levels in determining severity of the disease in patients who attended to emergency service and were detected to have CO intoxication. Material and Methods: All CO intoxication cases who attended to emergency service of our hospital between 01.01.2014 and 01.12.2019 were investigated retrospectively and the patients who had CO exposure and above the age of 18 were detected and then 151 patients whose COHb and lactate levels were studied among them were included in the study. The duration of emergency service hospitalization, if they were taken to inpatient wards or intensive care units, the duration of their stays in these units, if advanced treatment methods such as hyperbaric oxygen treatment or intubation were performed, the duration of these and laboratory findings associated with these treatments were collected and evaluated. Findings: 63 male (%41.7), 88 female (%58.3), 151 patients in total who attended to our emergency service because of carbon monoxide intoxication were included in the study. When the symptoms were inspected, the most common was syncope with the rate of %14.7 and the following one was headache,nausea and vomiting with the rate of %13.3. When the cause of intoxication were investigated, %31.1 was because of stove smoke, %25.2 fire smoke,%40.4 was of unknown reason. It was detected that one unit of increase in CKMB value increases the probability of clinical severity by %29.5 and one unit of increase in CO Hb values increases the probability of clinical severity by %7.9. One unit of increase in COHb values increases the probability of clinical severity by %4.7 and one unit of increase in Troponin I value increases probability of clinical severity by %0.2. CKMB, troponin I values and lactate level changes after oxygen therapy of the patients were found to be statistically predictive for clinical severity of patients' conditions. The most important parameter for determining the clinical severity was detected as CKMB. The most effective factor in determining ICU or HBO treatment necessity was found as Troponin I. Conclusion : In conclusion we found that lactate levels were not effective in determining severity of the disease as much as we expected. However,we detected that CKMB and Troponin I have a close association with determining both ICU and HBO treatment necessity and clinical severity. In order to have more clear information, more studies with larger samples are required. Keywords: CO intoxication, Emergency service, CK MB, Troponin I