Emergency Department, St. Mary's Hospital, Kurume, Japan.
Division of Cardiology and Emergency Department, St. Mary's Hospital, 422 Tsubuku-honmachi, Kurume, 830-8543, Japan.
BMC Emerg Med. 2021 Jan 15;21(1):7. doi: 10.1186/s12873-021-00405-7.
Carbon monoxide causes electrical, functional, and morphological changes in the heart. It is unclear, however, whether the indicators of myocardial damage can predict the patient's prognosis after carbon monoxide poisoning. This retrospective study aimed to investigate the relationship between the carboxyhemoglobin level and electrocardiographic (ECG) changes and whether the ECG changes and troponin I levels are related to the patient's prognosis after carbon monoxide poisoning.
Carboxyhemoglobin, troponin I, and ECG parameters were measured in 70 patients with carbon monoxide poisoning. The QT and RR intervals were measured for each ECG lead in all patients, and the corrected QT interval and corrected QT dispersion were calculated.
The correlation between the maximum corrected QT interval and the carboxyhemoglobin level was significant (P = 0.0072, R = 0.1017), as were the relationships between QT dispersion and carboxyhemoglobin (P < 0.001, R = 0.2358) and the corrected QT dispersion and carboxyhemoglobin (P < 0.001, R = 0.2613). The multivariate logistic analysis showed that the significant predictors of sequential disability were corrected QT dispersion (P = 0.0042), and troponin I level (P = 0.0021).
Patients' prognosis following carbon monoxide poisoning can be predicted based on corrected QT dispersion and the troponin I level. Patients with myocardial damage should be monitored not only for their cardiovascular outcome but also for their neurological outcome and their prognosis.
一氧化碳会导致心脏的电、功能和形态变化。然而，目前尚不清楚心肌损伤的指标是否可以预测一氧化碳中毒患者的预后。本回顾性研究旨在探讨碳氧血红蛋白水平与心电图（ECG）变化之间的关系，以及心电图变化和肌钙蛋白 I 水平是否与一氧化碳中毒患者的预后相关。
对 70 例一氧化碳中毒患者进行碳氧血红蛋白、肌钙蛋白 I 和心电图参数的测量。对所有患者的每个心电图导联进行 QT 和 RR 间期测量，并计算校正 QT 间期和校正 QT 离散度。
最大校正 QT 间期与碳氧血红蛋白水平之间存在显著相关性（P=0.0072，R=0.1017），QT 离散度与碳氧血红蛋白（P<0.001，R=0.2358）和校正 QT 离散度与碳氧血红蛋白（P<0.001，R=0.2613）之间也存在显著相关性。多变量逻辑分析显示，校正 QT 离散度（P=0.0042）和肌钙蛋白 I 水平（P=0.0021）是序贯残疾的显著预测因子。
可以根据校正 QT 离散度和肌钙蛋白 I 水平预测一氧化碳中毒患者的预后。心肌损伤患者不仅应监测其心血管结局，还应监测其神经结局和预后。
