Carbon Monoxide Intoxication: Experiences from Hungary

Carbon monoxide (CO) is odorless, colorless, tasteless, and nonirritating gas. Hence, mild CO poisoning often remains unrecognized and appears lethally. Carbon and gas systems, unfavorable architectural designs and machines may also cause intoxications. The prevalence rates in Hungary ranged from 2.37 to 3.80 cases per 100,000 people per year between 2013 and 2015; fatality rates have been decreased from 5.96 in 2013 to 3.38 in 2015. Given the vagueness and the broad spectrum of complaints, misdiagnosis of CO toxicity is common. The gold standard diagnosis is detecting the level of circulating carboxyhemoglobin (CO-Hgb). The measurement of CO-Hgb can be performed via blood-gas analyses or by spectrophotometry. Treatment protocol should follow the ACBDE rule. Administration of 100% oxygen should be performed as soon as possible. Later in-hospital management includes evaluation, treatment and prevention of further peripheral organ damage and long-term neurological complications. Fetuses and children are prone to suffer more severe intoxication due to higher oxygen demand. Though hyperbaric oxygen is the mainstay therapy, a prompt cesarean section is effective in preventing further intoxication. In conclusion, fatal CO intoxication can occur due to plain early signs and symptoms. Hyperbaric oxygen therapy should be considered in severe intoxication, in fetal and children