The Effect of Carbon Monoxide Poisoning on Platelet Volume in Children

Abstract

GirişKarbonmonoksit (CO), karbon içeren maddelerin tam yanmaması sonucu oluşan, renksiz, kokusuz, tatsız, irritan olmayan ve toksik bir gazdır. Özellikle kış aylarında sıklığı artan CO zehirlenmeleri, ülkemizde ve dünyada önemli bir toplum sağlığı sorunudur. Çocukluk çağında görülen zehirlenmeler arasında CO zehirlenmesi genellikle ilk üç sırada yer alır.1 CO zehirlenmesi önemli bir morbidite ve mortalite nedenidir. Birçok organ sistemi tutulabilir ve fark edilmeyen maruziyetler ölümle sonuçlanabilir. Ülkemizde ölümle sonuçlanan zehirlenmelerin en sık nedeni olarak bildirilmiştir. Bulgular: Çalışmaya alınan 228 hastanın (%49 erkek) ortalama yaşı 88±56 aydı. Kontrol grubu için benzer yaş aralığında olan 200 sağlıklı çocuk seçildi. MPV değeri çalışma grubunda 8,43±1,1 fL, kontrol grubunda 8,26±0,7 fL idi, arada anlamlı istatistiksel fark bulunamadı. Karboksihemoglobin (COHb) değeri ile MPV değeri ve trombosit sayısı arasında da korelasyon saptanmadı. Sonuç: Çalışmamızda çocukluk çağında MPV değerinin akut karbonmonoksit zehirlenmesi tanısını öngörmede yardımcı bir parametre olmadığı saptanmıştır. Hastaların MPV değerlerinin bulgulara göre karşılaştırıldığında anlamlı fark bulunmaması ve MPV değeri ile COHb seviyesi arasında korelasyon saptanmamış olması nedeniyle, MPV'nin hastalığın klinik şiddeti hakkında yol gösterici olmadığı sonucuna varılmıştır. Anahtar Kelimeler: Çocuk, karbonmonoksit zehirlenmesi, ortalama trombosit hacmi Introduction: Carbon monoxide poisoning is one of the most important causes of morbidity and mortality. There is increasing evidence supporting the important role of mean platelet volume (MPV) as a marker of hypoxia and inflammation. In this study, we aimed to determine changes in MPV values in pediatric patients with carbon monoxide poisoning. Methods: We retrospectively evaluated children who were diagnosed with carbon monoxide poisoning in our hospital between January 2005 and 2014. Results: We included 228 children with carbon monoxide poisoning (49% male) in this retrospective, controlled study. The mean age of the patients was 88±56 months. Control group consisted of 200 age-matched healthy children. There was no statistically significant difference in MPV levels between the study and control groups (8.43±1.1 fL and 8.26±0.7 fL, respectively). No correlation of MPV and platelet count with carboxyhemoglobin (COHb) was found. Conclusion: In our study, it was determined that MPV value was not a helpful parameter for predicting the diagnosis of acute carbon monoxide poisoning in childhood. The difference between the MPV values and the lack of significance and the absence of correlation between MPV value and COHb level led to the fact that MPV was not a guide indicating the clinical severity of the condition.

Clinical and Laboratory Characteristics Predicting the Severity of Carbon Monoxide Poisoning in Children

“…Marchewka et al 49 reported that MPV was significantly negatively correlated with disease severity in COP. Akça et al and Bağcı et al 19,40 found no statistically significant difference between the severe COP group and mild to moderate COP group in terms of platelet count and MPV. According to previous research, the platelet count was statistically significantly higher in the severe group than in the control group in our study.…”

“…Furthermore, free oxygen radicals produced by COP may promote platelet adhesion and aggregation. 19 According to Coşkun et al, 38 MPV levels were significantly higher in patients with CO intoxication. 18 Karabacak et al 47 discovered a high prevalence of COP and platelet count in adults, as well as the possibility that MPV could be a useful diagnostic tool for predicting prognosis.…”

“…This is explained by the fact that hypoxia caused by COHb elevation increases megakaryocyte production in the bone marrow, and the size and enzymatic activity of the newly formed platelets is greater than that of older platelets. Furthermore, free oxygen radicals produced by COP may promote platelet adhesion and aggregation 19 . According to Coşkun et al, 38 MPV levels were significantly higher in patients with CO intoxication 18 .…”

“…[14][15][16] In literature, there have been very few studies, particularly on COP in children and the evaluation of hematological parameters such as NLR, PLR, RDW, and MPV in children with COP. [17][18][19] The aim of this study is to assess the demographic, clinical, and laboratory characteristics predicting the severity of COP in children as well as to determine if scores based on peripheral CBC counts can predict COP severity during the acute period.…”

The Effect of Temperature on The Emissions of Shale Gas Combustion

“…CO as toxic gas causes mortal poisoning. CO and NOx emissions of USA in 2017 are reported as 60109 and 10776 in thousands of tons [6][7][8][9][10][11][12][13].…”