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Affiliation
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Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India. |
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Abstract
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Carbon monoxide (CO) poisoning in a neonate is an uncommon and unrecognized entity. It poses higher risk to neonates than adults and older children due to non-specific clinical presentation and higher levels of fetal hemoglobin (HbF) in neonates. We report an unusual case of CO poisoning in a neonate.
A 14-d-old, previously healthy boy was brought to emergency with complaints of decreased responsiveness, poor feeding and multiple episodes of vomiting for 4 h. There was a history of exposure to room heating coal furnace in a closed room for 4–5 h. Mother and grandmother also experienced headache and fell unconscious. They regained consciousness after 2–3 h and noticed that the baby is dull and unresponsive and brought him to the hospital. There was no history of seizures. Baby was hemodynamically stable and blood gas revealed pH – 7.24, pCO2–37.2, pO2–45.5, SO2−87.4%, carboxy hemoglobin (COHb) – 10.6% and lactate −10.6 mmol/L. In view of elevated COHb and h/o recent exposure, possibility of CO poisoning was considered and baby was started on 100% oxygen therapy and intravenous fluids. After 3–4 h he started regaining consciousness and by 8 h he became normal. Repeat blood gas at 8 h showed pH – 7.43, COHb – 0.1% and lactate – 4.5 mmol/L. Oxygen was stopped and breastfeeding was initiated. Baby was discharged after a total stay of 24 h.
CO poisoning is a sequel of fires and accidents with home heating appliances powered by oil, coal or wood [1]. The mechanism of CO toxicity predominantly relates to tissue hypoxia [2]. As compared to oxygen, CO has 240 times more affinity to hemoglobin leading to displacement of oxygen and reduction of blood oxygen...
Language: en |