Vol 5, No 4 (2020)
Research paper
Published online: 2020-10-21

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Association of carbon monoxide ratio with neutrophil-lymphocyte ratios and cardiac indicators in carbon monoxide intoxication; a pilot study

Bulut Demirel1, Mehmet Ergin2, Cahit Teke2
Disaster Emerg Med J 2020;5(4):190-192.

Abstract

INTRODUCTION: Carbon monoxide is still a public health problem in developing countries. Brain and heart tissues are mostly affected by intoxications. Carbon monoxide poisoning causes the development of cardiac ischemia and cardiac conduction disorders. Our aim is to study the associations of NRL with cardiac indicators in patients with acute carbon monoxide poisoning.  

MATERIAL AND METHODS: Patients who admitted to the E.R. between the dates 01.10.2015–01.06.2017 were examined retrospectively. Of 54 patients diagnosed with carbon monoxide intoxication, 41 patients with complete parameters and follow-ups were included in the study. Their demographic information, complete blood count, troponin and CK-MB values and carbon monoxide levels were recorded.  

RESULTS: Of the patients who included in the study, 18 (43.9%) were female and 23 (43.9%) were male. Their age average was 43.7 ± 18.9. Troponin, CK-MB, neutrophil-lymphocyte ratio levels of the patients were not correlated with carbon monoxide levels (respectively p = 0.238, 0.707, 0.364). Troponin levels of the patients had a positive correlation with neutrophil-lymphocyte ratio (r: 0,309, p = 0.049).  

CONCLUSIONS: Neutrophil-lymphocyte ratio can be used to identify an early diagnosis of cardiac impacts in carbon monoxide poisonings. However, more studies on the subject are needed.

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References

  1. Omaye S. Metabolic modulation of carbon monoxide toxicity. Toxicology. 2002; 180(2): 139–150.
  2. Carbon Monoxide Poisoning. The Internet Journal of Toxicology. 1997; 1(1).
  3. Prockop LD, Chichkova RI. Carbon monoxide intoxication: an updated review. J Neurol Sci. 2007; 262(1-2): 122–130.
  4. Raub JA, Benignus VA. Carbon monoxide and the nervous system. Neuroscience & Biobehavioral Reviews. 2002; 26(8): 925–940.
  5. Karabacak M, Varol E, Türkdogan KA, et al. Mean platelet volume in patients with carbon monoxide poisoning. Angiology. 2014; 65(3): 252–256.
  6. Şen, H. and S. Özkan, Karbonmonoksit Zehirlenmesi. TAF Preventive Medicine Bulletin. 2009; 8(4).
  7. Lippi G, Rastelli G, Meschi T, et al. Pathophysiology, clinics, diagnosis and treatment of heart involvement in carbon monoxide poisoning. Clin Biochem. 2012; 45(16-17): 1278–1285.
  8. Papa A, Emdin M, Passino C, et al. Predictive value of elevated neutrophil-lymphocyte ratio on cardiac mortality in patients with stable coronary artery disease. Clin Chim Acta. 2008; 395(1-2): 27–31.
  9. Hill L. CARBON MONOXIDE POISONING. BMJ. 1924; 2(3329): 743–743.
  10. Yanir Y, Shupak A, Abramovich A, et al. Cardiogenic shock complicating acute carbon monoxide poisoning despite neurologic and metabolic recovery. Ann Emerg Med. 2002; 40(4): 420–424.
  11. Henry CR, Satran D, Lindgren B, et al. Myocardial injury and long-term mortality following moderate to severe carbon monoxide poisoning. JAMA. 2006; 295(4): 398–402.
  12. Balta S, Celik T, Mikhailidis DP, et al. The Relation Between Atherosclerosis and the Neutrophil-Lymphocyte Ratio. Clin Appl Thromb Hemost. 2016; 22(5): 405–411.
  13. Karabacak M, Turkdogan K, Coskun A, et al. Detection of neutrophil–lymphocyte ratio as a serum marker associated with inflammations by acute carbon monoxide poisoning. Journal of Acute Disease. 2015; 4(4): 305–308.
  14. R. JH, M. D, R. M, et al. Association between neutrophil to lymphocyte ratio and severity of coronary artery disease. International Journal of Advances in Medicine. 2018; 5(2): 265.
  15. Liu P, Li P, Peng Z, et al. Predictive value of the neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-neutrophil ratio, and neutrophil-to-monocyte ratio in lupus nephritis. Lupus. 2020; 29(9): 1031–1039.
  16. Tamhane UU, Aneja S, Montgomery D, et al. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol. 2008; 102(6): 653–657.
  17. Horne BD, Anderson JL, John JM, et al. Intermountain Heart Collaborative Study Group. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol. 2005; 45(10): 1638–1643.
  18. Macrez R, Ali C, Toutirais O, et al. Stroke and the immune system: from pathophysiology to new therapeutic strategies. The Lancet Neurology. 2011; 10(5): 471–480.
  19. Kamisli S, Kamisli O, Gonullu S, et al. The prognostic value of increased leukocyte and neutrophil counts in the early phase of cerebral venous sinus thrombosis. Turkish Journal of Cerebrovascular Diseases. 2012; 18(2): 39–42.
  20. Korkmaz A, Yildiz A, Gunes H, et al. Utility of Neutrophil-Lymphocyte Ratio in Predicting Troponin Elevation in the Emergency Department Setting. Clin Appl Thromb Hemost. 2015; 21(7): 667–671.
  21. Günaydın Y, Vural K, Ok M, et al. Comparison of carbon monoxide poisonings originated from coal stove and natural gas and the evaluation of Neutrophil/Lymphocyte ratio. Dicle Medical Journal / Dicle Tip Dergisi. 2015; 42(3).
  22. Lavanya D. Relationship between Neutrophil Lymphocyte Ratio and Prognosis in Acute Ischemic Stroke. Journal of Medical Science And clinical Research. 2018; 6(11).