RETREATED: Mini Review: Clicinal Strategies for Carbon monoxide Poisoning

Review

Abstract

Carbon monoxide is a type of tasteless, colorless, odorless gas that occurs as a result of incomplete combustion of organic/inorganic hydrocarbons. He is defined as the "silent killer" based on these three physical characteristics. Poisoning is seen especially in winter months due to chimney systems used in rural areas (poisoning caused by suicide and exhaust may also be seen). In a study conducted in our country, it was shown that most of the exposure to carbon monoxide gas between 1993 and 2006 was caused by stoves and water heaters without any suicidal intent. It has been stated that the affinity of carbon monoxide to the tetramer receptor region in hemoglobin is approximately 200-250 times higher than that of the oxygen molecule, resulting in hypoxia and relative anemia. Additionally, by binding to cardiac myoglobin, it causes myocardial depression and hypotension. It plays a role in the activation of platelets, causing myeloperoxidase release, high oxidative stress, inflammation, and deterioration of cellular respiration by binding and inactivating reduced cytochrome a3. Intoxication resulting from these mechanisms must be treated as soon as possible. Otherwise, life-threatening situations may occur. The first symptoms of carbon monoxide intoxication are non-specific. Physical examination findings have a limited place in diagnosis. The relationship between disease history and carboxyhemoglobin is the most reliable diagnostic tool. There is no chemical or physiological antidote for poisoning. In first aid, advanced life support steps must be applied depending on whether the patient is conscious or unconscious. Hyperbaric oxygen therapy dramatically increases patient survival and is now recommended as the gold standard treatment by separating carbon monoxide bound to hemoglobin.