S2k guideline diagnosis and treatment of carbon monoxide poisoning

Carbon monoxide (CO) can occur in numerous situations and ambient conditions, such as fire smoke, indoor fireplaces, silos containing large quantities of wood pellets, engine exhaust fumes, and when using hookahs.Symptoms of CO poisoning are nonspecific and can range from dizziness, headache, and an...

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Autores principales:	Jüttner, Björn, Busch, Hans-Jörg, Callies, Andreas, Dormann, Harald, Janisch, Thorsten, Kaiser, Guido, Körner-Göbel, Hella, Kluba, Karsten, Kluge, Stefan, Leidel, Bernd A., Müller, Oliver, Naser, Johannes, Pohl, Carsten, Reiter, Karl, Schneider, Dietmar, Staps, Enrico, Welslau, Wilhelm, Wißuwa, Holger, Wöbker, Gabriele, Muche-Borowski, Cathleen
Formato:	article
Lenguaje:	DE EN
Publicado:	German Medical Science GMS Publishing House 2021
Materias:	carbon monoxide poisoning etiology prevention prehospital management oxygen breathing initial in-hospital care hyperbaric oxygen therapy hbot co hemoglobin delayed neurological sequelae (dns) rehabilitation Medicine R
Acceso en línea:	https://doaj.org/article/4505e19de8264115b05982a60b2f3b8b
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spelling	oai:doaj.org-article:4505e19de8264115b05982a60b2f3b8b2021-11-25T07:14:07ZS2k guideline diagnosis and treatment of carbon monoxide poisoning1612-317410.3205/000300https://doaj.org/article/4505e19de8264115b05982a60b2f3b8b2021-11-01T00:00:00Zhttp://www.egms.de/static/en/journals/gms/2021-19/000300.shtmlhttps://doaj.org/toc/1612-3174Carbon monoxide (CO) can occur in numerous situations and ambient conditions, such as fire smoke, indoor fireplaces, silos containing large quantities of wood pellets, engine exhaust fumes, and when using hookahs.Symptoms of CO poisoning are nonspecific and can range from dizziness, headache, and angina pectoris to unconsciousness and death.This guideline presents the current state of knowledge and national recommendations on the diagnosis and treatment of patients with CO poisoning.The diagnosis of CO poisoning is based on clinical symptoms and proven or probable exposure to CO. Negative carboxyhemoglobin (COHb) levels should not rule out CO poisoning if the history and symptoms are consistent with this phenomenon. Reduced oxygen-carrying capacity, impairment of the cellular respiratory chain, and immunomodulatory processes may result in myocardial and central nervous tissue damage even after a reduction in COHb.If CO poisoning is suspected, 100% oxygen breathing should be immediately initiated in the prehospital setting.Clinical symptoms do not correlate with COHb elimination from the blood; therefore, COHb monitoring alone is unsuitable for treatment management. Especially in the absence of improvement despite treatment, a reevaluation for other possible differential diagnoses ought to be performed.Evidence regarding the benefit of hyperbaric oxygen therapy (HBOT) is scant and the subject of controversy due to the heterogeneity of studies.If required, HBOT should be initiated within 6 h.All patients with CO poisoning should be informed about the risk of delayed neurological sequelae (DNS).Jüttner, BjörnBusch, Hans-JörgCallies, AndreasDormann, HaraldJanisch, ThorstenKaiser, GuidoKörner-Göbel, HellaKluba, KarstenKluge, StefanLeidel, Bernd A.Müller, OliverNaser, JohannesPohl, CarstenReiter, KarlSchneider, DietmarStaps, EnricoWelslau, WilhelmWißuwa, HolgerWöbker, GabrieleMuche-Borowski, CathleenGerman Medical Science GMS Publishing Housearticlecarbon monoxide poisoningetiologypreventionprehospital managementoxygen breathinginitial in-hospital carehyperbaric oxygen therapyhbotco hemoglobindelayed neurological sequelae (dns)rehabilitationMedicineRDEENGMS German Medical Science, Vol 19, p Doc13 (2021)
institution	DOAJ
collection	DOAJ
language	DE EN
topic	carbon monoxide poisoning etiology prevention prehospital management oxygen breathing initial in-hospital care hyperbaric oxygen therapy hbot co hemoglobin delayed neurological sequelae (dns) rehabilitation Medicine R
spellingShingle	carbon monoxide poisoning etiology prevention prehospital management oxygen breathing initial in-hospital care hyperbaric oxygen therapy hbot co hemoglobin delayed neurological sequelae (dns) rehabilitation Medicine R Jüttner, Björn Busch, Hans-Jörg Callies, Andreas Dormann, Harald Janisch, Thorsten Kaiser, Guido Körner-Göbel, Hella Kluba, Karsten Kluge, Stefan Leidel, Bernd A. Müller, Oliver Naser, Johannes Pohl, Carsten Reiter, Karl Schneider, Dietmar Staps, Enrico Welslau, Wilhelm Wißuwa, Holger Wöbker, Gabriele Muche-Borowski, Cathleen S2k guideline diagnosis and treatment of carbon monoxide poisoning
description	Carbon monoxide (CO) can occur in numerous situations and ambient conditions, such as fire smoke, indoor fireplaces, silos containing large quantities of wood pellets, engine exhaust fumes, and when using hookahs.Symptoms of CO poisoning are nonspecific and can range from dizziness, headache, and angina pectoris to unconsciousness and death.This guideline presents the current state of knowledge and national recommendations on the diagnosis and treatment of patients with CO poisoning.The diagnosis of CO poisoning is based on clinical symptoms and proven or probable exposure to CO. Negative carboxyhemoglobin (COHb) levels should not rule out CO poisoning if the history and symptoms are consistent with this phenomenon. Reduced oxygen-carrying capacity, impairment of the cellular respiratory chain, and immunomodulatory processes may result in myocardial and central nervous tissue damage even after a reduction in COHb.If CO poisoning is suspected, 100% oxygen breathing should be immediately initiated in the prehospital setting.Clinical symptoms do not correlate with COHb elimination from the blood; therefore, COHb monitoring alone is unsuitable for treatment management. Especially in the absence of improvement despite treatment, a reevaluation for other possible differential diagnoses ought to be performed.Evidence regarding the benefit of hyperbaric oxygen therapy (HBOT) is scant and the subject of controversy due to the heterogeneity of studies.If required, HBOT should be initiated within 6 h.All patients with CO poisoning should be informed about the risk of delayed neurological sequelae (DNS).
format	article
author	Jüttner, Björn Busch, Hans-Jörg Callies, Andreas Dormann, Harald Janisch, Thorsten Kaiser, Guido Körner-Göbel, Hella Kluba, Karsten Kluge, Stefan Leidel, Bernd A. Müller, Oliver Naser, Johannes Pohl, Carsten Reiter, Karl Schneider, Dietmar Staps, Enrico Welslau, Wilhelm Wißuwa, Holger Wöbker, Gabriele Muche-Borowski, Cathleen
author_facet	Jüttner, Björn Busch, Hans-Jörg Callies, Andreas Dormann, Harald Janisch, Thorsten Kaiser, Guido Körner-Göbel, Hella Kluba, Karsten Kluge, Stefan Leidel, Bernd A. Müller, Oliver Naser, Johannes Pohl, Carsten Reiter, Karl Schneider, Dietmar Staps, Enrico Welslau, Wilhelm Wißuwa, Holger Wöbker, Gabriele Muche-Borowski, Cathleen
author_sort	Jüttner, Björn
title	S2k guideline diagnosis and treatment of carbon monoxide poisoning
title_short	S2k guideline diagnosis and treatment of carbon monoxide poisoning
title_full	S2k guideline diagnosis and treatment of carbon monoxide poisoning
title_fullStr	S2k guideline diagnosis and treatment of carbon monoxide poisoning
title_full_unstemmed	S2k guideline diagnosis and treatment of carbon monoxide poisoning
title_sort	s2k guideline diagnosis and treatment of carbon monoxide poisoning
publisher	German Medical Science GMS Publishing House
publishDate	2021
url	https://doaj.org/article/4505e19de8264115b05982a60b2f3b8b
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S2k guideline diagnosis and treatment of carbon monoxide poisoning

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