AI Summary & Key Takeaways
AI InsightCardiac and neuroimaging findings should be interpreted within the selected subgroups.
📌 3 Key Takeaways
Abstract
Aims: To evaluate the association between fractional carboxyhemoglobin (FCOHb) levels and biochemical markers of poisoning severity, and to describe cardiac and neuroimaging findings in a pediatric cohort affected by a single-source mass carbon monoxide (CO) exposure. Methods: This retrospective cross-sectional study included pediatric patients exposed during a single-source mass CO exposure event. Of 64 screened patients, 6 were excluded from inferential analyses because their initial FCOHb levels were <5%, leaving 58 patients in the analytical cohort. All blood gas analyses were venous. Age- and sex-adjusted multiple linear regression was used to examine associations between FCOHb and biochemical parameters. Cardiac and neuroimaging findings were evaluated descriptively in clinically selected subgroups. Results: Higher FCOHb levels were associated with increased lactate (B=0.089, p=0.001) and lactate dehydrogenase (B=3.631; p=0.005), and decreased bicarbonate (B=-0.096; p=0.005), venous pO2 (B=-0.701; p=0.044) and base excess (B=-0.112; p=0.026). No significant age- and sex-adjusted association was found between FCOHb and cardiac troponin-I (cTnI) (p=0.433). cTnI elevation was observed in 17 patients (29.3%); however, echocardiography in the selected subgroup showed no major acute systolic dysfunction. In the MRI-evaluated subgroup, no CO-specific central nervous system injury pattern was identified; findings consisted predominantly of nonspecific sinonasal and mastoid mucosal changes. Conclusion: FCOHb was associated with biochemical indicators of tissue hypoxia and metabolic disturbance, but did not reliably reflect cardiac involvement. Cardiac and neuroimaging findings should be interpreted within the selected subgroups.