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...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | deu |
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German Medical Science GMS Publishing House
2021-11-01
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| Series: | GMS German Medical Science |
| Subjects: | |
| Online Access: | http://www.egms.de/static/en/journals/gms/2021-19/000300.shtml |
| _version_ | 1818394711765811200 |
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| 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 |
| collection | DOAJ |
| 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). |
| first_indexed | 2024-12-14T06:05:33Z |
| format | Article |
| id | doaj.art-4505e19de8264115b05982a60b2f3b8b |
| institution | Directory Open Access Journal |
| issn | 1612-3174 |
| language | deu |
| last_indexed | 2024-12-14T06:05:33Z |
| publishDate | 2021-11-01 |
| publisher | German Medical Science GMS Publishing House |
| record_format | Article |
| series | GMS German Medical Science |
| spelling | doaj.art-4505e19de8264115b05982a60b2f3b8b2022-12-21T23:14:18ZdeuGerman Medical Science GMS Publishing HouseGMS German Medical Science1612-31742021-11-0119Doc1310.3205/000300S2k guideline diagnosis and treatment of carbon monoxide poisoningJüttner, Björn0Busch, Hans-Jörg1Callies, Andreas2Dormann, Harald3Janisch, Thorsten4Kaiser, Guido5Körner-Göbel, Hella6Kluba, Karsten7Kluge, Stefan8Leidel, Bernd A.9Müller, Oliver10Naser, Johannes11Pohl, Carsten12Reiter, Karl13Schneider, Dietmar14Staps, Enrico15Welslau, Wilhelm16Wißuwa, Holger17Wöbker, Gabriele18Muche-Borowski, Cathleen19German Interdisciplinary Association of Critical Care and Emergency Medicine (DIVI)German Society of Medical Intensive Care and Emergency Medicine (DGIIN)Bundesvereinigung der Arbeitsgemeinschaften der Notärzte Deutschlands (BAND)German Association for Emergency Medicine (DGINA)German Society of Anaesthesiology and Intensive Care Medicine (DGAI)GIZ-Nord Poisons Center, University Medical Center Göttingen (GIZ-Nord)Bundesverband der Ärztlichen Leiter Rettungsdienst Deutschland (ÄLRD)The German Society of Anaesthesiology and Intensive Care Medicine (DGAI)German Respiratory Society (DGP)German Association for Emergency Medicine (DGINA)German Society for Diving and Hyperbaric Medicine (GTÜM)The German Society of Anaesthesiology and Intensive Care Medicine (DGAI)AMEOS Klinikum Bernburg, GermanySociety for Neonatology and Pediatric Intensive Care Medicine (GNPI)German Society of NeuroIntensive Care and Emergency Medicine (DGNI)Bundeswehrkrankenhaus Ulm, GermanyGerman Society for Diving and Hyperbaric Medicine (GTÜM)Bundesverband der Ärztlichen Leiter Rettungsdienst Deutschland (ÄLRD)German Society of NeuroIntensive Care and Emergency Medicine (DGNI)The Association of the Scientific Medical Societies in Germany (AWMF)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).http://www.egms.de/static/en/journals/gms/2021-19/000300.shtmlcarbon monoxide poisoningetiologypreventionprehospital managementoxygen breathinginitial in-hospital carehyperbaric oxygen therapyhbotco hemoglobindelayed neurological sequelae (dns)rehabilitation |
| spellingShingle | 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 GMS German Medical Science carbon monoxide poisoning etiology prevention prehospital management oxygen breathing initial in-hospital care hyperbaric oxygen therapy hbot co hemoglobin delayed neurological sequelae (dns) rehabilitation |
| title | 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_short | S2k guideline diagnosis and treatment of carbon monoxide poisoning |
| title_sort | s2k guideline diagnosis and treatment of carbon monoxide poisoning |
| 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 |
| url | http://www.egms.de/static/en/journals/gms/2021-19/000300.shtml |
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