a Department of Anesthesiology and Intensive Care Medicine , University Hospital of Bonn , Bonn , North Rhine-Westphalia , Germany.
b Asklepios Paulinen Klinik Wiesbaden , Wiesbaden , Hessen , Germany.
Clin Toxicol (Phila). 2018 Apr;56(4):264-272. doi: 10.1080/15563650.2017.1375115. Epub 2017 Sep 14.
Waterpipe smoking may increasingly account for unintentional carbon monoxide poisoning, a serious health hazard with high morbidity and mortality. We aimed at identifying waterpipe smoking as a cause for carbon monoxide poisoning in a large critical care database of a specialty care referral center.
This retrospective cohort study included patients with a history of exposure to waterpipe smoking and carbon monoxide blood gas levels >10% or presence of clinical symptoms compatible with CO poisoning admitted between January 2013 and December 2016. Patients' initial symptoms and carbon monoxide blood levels were retrieved from records and neurologic status was assessed before and after hyperbaric oxygen treatment.
Sixty-one subjects with carbon monoxide poisoning were included [41 males, 20 females; mean age 23 (SD ± 6) years; range 13-45] with an initial mean carboxyhemoglobin of 26.93% (SD ± 9.72). Most common symptoms included syncope, dizziness, headache, and nausea; 75% had temporary syncope. Symptoms were not closely associated with blood COHb levels.
CO poisoning after waterpipe smoking may present in young adults with a wide variability of symptoms from none to unconsciousness. Therefore diagnosis should be suspected even in the absence of symptoms.
水烟可能会导致越来越多的非意愿性一氧化碳中毒，这是一种发病率和死亡率都很高的严重健康危害。我们旨在确定水烟是导致专业治疗转介中心的大型重症监护数据库中一氧化碳中毒的原因。
本回顾性队列研究纳入了 2013 年 1 月至 2016 年 12 月期间有过水烟暴露史且碳氧血红蛋白水平>10%或存在与 CO 中毒相符的临床症状的患者。从记录中获取患者的初始症状和碳氧血红蛋白水平，并在高压氧治疗前后评估神经状态。
共纳入 61 例一氧化碳中毒患者[41 名男性，20 名女性；平均年龄 23（SD±6）岁；范围 13-45]，初始平均碳氧血红蛋白为 26.93%（SD±9.72）。最常见的症状包括晕厥、头晕、头痛和恶心；75%的患者出现短暂性晕厥。症状与血 COHb 水平无密切相关性。
水烟吸食后的 CO 中毒可能发生在年轻成年人中，症状从无症状到无意识变化多样。因此，即使没有症状，也应怀疑存在 CO 中毒。
