Status epilepticus and cardiopulmonary arrest in a patient with carbon monoxide poisoning with full recovery after using a neuroprotective strategy: a case report

Journal of Medical Case Reports

Imad Hassan²  Suleiman Kojan¹  Yaseen Arabi⁴  Ousama Dabbagh³  Salman Abdulaziz² 

[1] Department of Neuroscience, King Abdulaziz Medical City, King Fahad National Guard Hospital, Box 22490, Riyadh, 11426, Kingdom of Saudi Arabia;Department of Medicine, King Abdulaziz Medical City, King Fahad National Guard Hospital, PO Box 22490, Riyadh, 11426, Kingdom of Saudi Arabia;Division of Pulmonary, Critical Care and Environmental Medicine, University of Missouri -Columbia, 5 Hospital Drive CE 428, Columbia, MO, 65212, USA;Department of Intensive Care, King Fahad National Guard Hospital, Box 22490, Riyadh, 11426, Kingdom of Saudi Arabia

关键词: Status epilepticus;    Seizure;    Neuroprotective strategy;    Carbon monoxide poisoning;    Cardiac arrest;   

Others  :  1195183
DOI  :  10.1186/1752-1947-6-421

 received in 2012-07-29, accepted in 2012-11-16,  发布年份 2012

【 摘 要 】

Introduction

Carbon monoxide poisoning can be associated with life-threatening complications, including significant and disabling cardiovascular and neurological sequelae.

Case presentation

We report a case of carbon monoxide poisoning in a 25-year-old Saudi woman who presented to our facility with status epilepticus and cardiopulmonary arrest. Her carboxyhemoglobin level was 21.4 percent. She made a full recovery after we utilized a neuroprotective strategy and normobaric oxygen therapy, with no delayed neurological sequelae.

Conclusions

Brain protective modalities are very important for the treatment of complicated cases of carbon monoxide poisoning when they present with neurological toxicities or cardiac arrest. They can be adjunctive to normobaric oxygen therapy when the use of hyperbaric oxygen is not feasible.

【 授权许可】

   
2012 Abdulaziz et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Ernst A, Zibrak JD: Carbon monoxide poisoning. N Engl J Med 1998, 339:1603-1608.
• [2]Arabi YM, Haddad S, Tamim HM, Al-Dawood A, Al-Qahtani S, Ferayan A, Al-Abdulmughni I, Al-Oweis J, Rugaan A: Mortality reduction after implementing a clinical practice guidelines-based management protocol for severe traumatic brain injury. J Crit Care 2010, 25:190-195.
• [3]Touger M, Gallagher EJ, Tyrell J: Relationship between venous and arterial carboxyhemoglobin levels in patients with suspected carbon monoxide poisoning. Ann Emerg Med 1995, 25:481-483.
• [4]Peterson JE, Stewart RD: Absorption and elimination of carbon monoxide by inactive young men. Arch Environ Health 1970, 21:165-171.
• [5]Hee J, Callais F, Momas I, Laurent AM, Min S, Molinier P, Chastagnier M, Claude JR, Festv B: Smokers’ behaviour and exposure according to cigarette yield and smoking experience. Pharmacol Biochem Behav 1995, 52:195-203.
• [6]Jay GD, McKindley DS: Alterations in pharmacokinetics of carboxyhemoglobin produced by oxygen under pressure. Undersea Hyperb Med 1997, 24:165-173.
• [7]Pracyk JB, Stolp BW, Fife CE, Gray L, Piantadosi CA: Brain computerized tomography after hyperbaric oxygen therapy for carbon monoxide poisoning. Undersea Hyperb Med 1995, 22:1-7.
• [8]Gale SD, Hopkins RO, Weaver LK, Bigler ED, Booth EJ, Blatter DD: MRI, quantitative MRI, SPECT, and neuropsychological findings following carbon monoxide poisoning. Brain Inj 1999, 13:229-243.
• [9]Hopkins RO, Fearing MA, Weaver LK, Foley JF: Basal ganglia lesions following carbon monoxide poisoning. Brain Inj 2006, 20:273-281.
• [10]Bennetto L, Powter L, Scolding NJ: Accidental carbon monoxide poisoning presenting without a history of exposure: a case report. J Med Case Rep 2008, 22:2-118.
• [11]Brown KI, Wilson RF, White MT: Carbon monoxide induced status epilepticus in an adult. J Burn Care Res 2007, 28:533-536.
• [12]Gesell LB: (Ed): Hyperbaric Oxygen 2009: Indications and Results: The Hyperbaric Oxygen Therapy Committee Report. Durham, NC: Undersea and Hyperbaric Medical Society; 2008.
• [13]Mori T, Nagai K: Carbon-monoxide poisoning presenting as an isolated afebrile seizure. Pediatr Neurol 2000, 22:330-331.
• [14]Bentur Y: Hyperbaric oxygen for carbon monoxide poisoning. Toxicol Rev 2005, 24:153-154.
• [15]Myers RAM, Thom SR: Carbon monoxide and cyanide poisoning. In Hyperbaric Medicine Practice. Edited by Kindwall EP. Flagstaff, AZ: Best Publishing; 1994:357. [Myers RAM, Thom SR]
• [16]Raphael JD, Elkharrat D, Jars-Guincestre MC: Trial of normobaric and hyperbaric oxygen for acute carbon monoxide intoxication. Lancet 1989, 2:414-419.
• [17]Scheinkestel CD, Bailey M, Myles PS, Jones K, Cooper DJ, Millar IL, Tuxen DV: Hyperbaric or normobaric oxygen for acute carbon monoxide poisoning: a randomized, controlled clinical trial. Med J Aust 1999, 170:203-210.
• [18]Weaver LK, Hopkins RO, Chan KJ, Churchill S, Elliott CG, Clemmer TP, Orme JF Jr, Thomas FO, Morris AH: Hyperbaric oxygen for acute carbon monoxide poisoning. New Engl J Med 2002, 347:1057-1067.
• [19]Buckley NA, Juurlink DN, Isbister G, Bennett MH, Lavonas EJ: Hyperbaric oxygen for carbon monoxide poisoning. Cochrane Database Syst Rev 2011, 13:CD002041.
• [20]Weaver LK, Valentine KJ, Hopkins RO: Carbon monoxide poisoning: risk factors for cognitive sequelae and the role of hyperbaric oxygen. Am J Respir Crit Care Med 2007, 176:491-497.
• [21]Haddad SH, Arabi YM: Critical care management of severe traumatic brain injury in adults. Scand J Trauma Resusc Emerg Med 2012, 3:12.
• [22]Busl KM, Greer DM: Hypoxic-ischemic brain injury: pathophysiology, neuropathology and mechanisms. NeuroRehabilitation 2010, 26:5-13.
• [23]Kamijo Soma K: Severe carbon monoxide poisoning complicated by hypothermia: a case report. Am J Emerg Med 2011, 29:357. e5-7.