Prevalence of Carbon Monoxide Poisoning and Hyperbaric Oxygen Therapy in Korea: Analysis of National Claims Data in 2010-2019.

This study aimed to investigate the prevalence of carbon monoxide (CO) poisoning and the provision of hyperbaric oxygen therapy (HBOT) in South Korea. We used data from the Korea Health Insurance Review and Assessment service. In total, 44,361 patients with CO poisoning were identified across 10 years (2010-2019). The prevalence of CO poisoning was found to be 8.64/10,000 people, with a gradual annual increment. The highest prevalence was 11.01/10,000 individuals, among those aged 30-39 years. In 2010, HBOT was claimed from 15 hospitals, and increased to 30 hospitals in 2019. A total of 4,473 patients received HBOT in 10 years and 2,684 (60%) were treated for more than 2 hours. This study suggested that the prevalence of both CO poisoning and HBOT in Korea gradually increased over the past 10 years, and disparities in prevalence were observed by region.

Clinical and Laboratory Characteristics Predicting the Severity of Carbon Monoxide Poisoning in Children: A Single-Center Retrospective Study.

OBJECTIVES: Carbon monoxide poisoning (COP) is extremely common throughout the world. The purpose of this study was to assess the demographic, clinical, and laboratory characteristics predicting the severity COP in children. METHODS: The study included 380 children diagnosed with COP between January 2017 and January 2021 and 380 healthy controls. Carbon monoxide poisoning was diagnosed based on the medical history and a carboxyhemoglobin (COHb) level of more than 5%. The patients were classified as mild (COHb 10%), moderate (COHb 10%-25%), or severely (COHb > 25%) poisoned. RESULTS: The mean age of the severe group was 8.60 ± 6.30, for the moderate group was 9.50 ± 5.81, for the mild group was 8.79 ± 5.94, and for the control group was 8.95 ± 5.98. The most common place of exposure was at home and all cases were affected accidentally. The coal stove was the most common source of exposure, followed by natural gas. The most common symptoms were nausea/vomiting, vertigo, and headache. Neurologic symptoms such as syncope, confusion, dyspnea, and seizures were more common in the severe group. A total of 91.3% of the children had hyperbaric oxygen therapy, 3.8% were intubated, and 3.8% were transferred to intensive care in the severe group, whereas no death or sequela was observed. Mean platelet volume and red cell distribution width had the highest area under the curve in the receiver operating characteristic analysis (0.659; 0.379). A positive and low statistically significant relationship was found between COHb levels and troponin and lactate levels in the severe group ( P < 0.05). CONCLUSIONS: Carbon monoxide poisoning progressed more severely in children presented with neurological symptoms and have elevated red cell distribution width and mean platelet volume. Even in severe COP cases, satisfactory results have been obtained with early and appropriate treatment.

Predictors of Severe Clinical Course in Children With Carbon Monoxide Poisoning.

OBJECTIVE: Carbon monoxide (CO) is a gas, which is produced by incomplete combustion of hydrocarbon-containing substances, and causes significant tissue and organ damage in the common event of CO poisoning. This study aims to evaluate the demographic, clinical, and laboratory characteristics of patients diagnosed with CO poisoning in the emergency department and to determine the factors associated with severe course in the acute phase of poisoning. METHODS: A total of 331 patients diagnosed with CO poisoning in Hacettepe University Children's Hospital, Pediatric Emergency Unit, between January 2004 and March 2014 were included in the study. Their demographic characteristics, presenting complaints, physical examination findings, Glasgow Coma Scale scores, carboxyhemoglobin, leukocyte, hemoglobin, troponin T, pH and lactate levels, type of treatment (normobaric or hyperbaric oxygen), intensive care unit admissions, and outcome of poisoning were investigated. RESULTS: Ninety-three patients were given hyperbaric oxygen. Fifty-one patients were admitted to the pediatric intensive care unit, 18 patients have had a severe clinical course, and 6 patients have died. The risk factors associated with severe disease course were determined to be low Glasgow Coma Scale score, high leukocyte count, and high troponin T levels at presentation. CONCLUSIONS: Glasgow Coma Scale score, leukocyte count, and troponin T level may be beneficial in predicting clinical outcomes and tailoring therapy in children with CO poisoning.

Relación Dosis de oxígeno-Celeridad en la oxigenación hiperbárica para intoxicación con monóxido de carbono / Oxygen Dose-Implementation Celerity relationship in hyperbaric oxygenation for carbon monoxide poisoning

Resumen Se realiza una revisión narrativa que plantea una reflexión acerca del rol de la oxigenación hiperbárica en la recuperación de los intoxicados con monóxido de carbono (ICO). La relación presión de tratamiento de oxigenación hiperbárica (TOHB), o sea dosis de oxígeno, y demora en su implementación son descriptas en esta revisión. Se presentan 9 casos de pacientes con ICO tratados con TOHB a 1,45 ATA (Atmósferas absolutas) por falta de acceso a TOHB de alta presión. Si bien es necesario investigación adicional, sugerimos que esta modalidad terapéutica a 1,45 ATA para ICO debe ser elegida frente al oxígeno normobárico, y considerada cuando las instalaciones de alta presión no están disponibles a distancias razonables.

Abstract A narrative review that raises a reflection about the role of hyperbaric oxygenation in the recovery of monoxide carbon (CO) poisoning is carried out. A description of the relationship of the pressure of hyperbaric oxygen therapy (HBOT), oxygen dosage, and the delay in its implementation was done. Nine cases of intoxications treated with HBOT at 1.45 ATA due to lack of access to high-pressure HBOT were presented. While additional research is necessary, we suggest that this therapeutic modality at 1.45 ATA (Absolute Atmospheres) should be chosen instead of normobaric oxygen therapy for CO poisoning, and considered when high pressure facilities are not available at reasonable distances.

Comparison between carbon monoxide poisoning from hookah smoking versus other sources.

Introduction: Carbon monoxide exposure is a relatively unknown risk of smoking hookah. Dozens of cases of hookah-associated carbon monoxide toxicity have been described over the past decades, but smoking hookah is generally perceived as safe. Only recently have larger series of hookah-associated carbon monoxide toxicity been published. This study evaluates the incidence of hookah-associated carbon monoxide toxicity over 4 years, and compares the exposures from hookah against other carbon monoxide sources.Methods: This is a retrospective cohort study of all patients with carbon monoxide toxicity referred for hyperbaric oxygen therapy at an urban hyperbaric oxygen referral center from January 2015 through December 2018. Cases of hookah-associated carbon monoxide toxicity were compared to patients exposed to other carbon monoxide sources, with an analysis of patient comorbidities, symptomatology, and laboratory evaluation.Results: Over a 48-month period, 376 patients underwent hyperbaric oxygen therapy for carbon monoxide exposure. After exclusions, 265 patients with carbon monoxide toxicity from various sources were analyzed. There were 58 patients with hookah-associated carbon monoxide toxicity (22%). The proportion of hookah-associated carbon monoxide cases increased markedly in the latter years: 2015: 9.5%, 2016: 8.6%, 2017: 24.1%, 2018 41.6%. In the final 2 years analyzed, hookah smoking was the most frequent source of carbon monoxide toxicity referred for therapy. Hookah-associated carbon monoxide patients were younger(28.1 vs. 45.0 years, mean difference 16.8 years, 95% confidence interval: 11.5, 22.1 years, p < 0.001) and more likely to be female (60% vs. 46.6%, p = 0.06) than patients exposed to other carbon monoxide sources. The mean difference in carboxyhemoglobin concentration between hookah associated and those exposed to other carbon monoxide sources was 4.6% (mean 20.1% vs. 24.6%, 95%CI: 1.7, 7.5, p = 0.002).Conclusion: A substantial portion of patients with severe carbon monoxide toxicity was exposed through smoking hookah. The incidence of hookah-related carbon monoxide toxicity appears to be increasing.

Hyperbaric oxygen therapy and mortality from carbon monoxide poisoning: A nationwide observational study.

BACKGROUND: The effects of hyperbaric oxygen therapy (HBOT) on mortality or morbidity in patients with carbon monoxide (CO) poisoning remain unknown. We examined the effects of HBOT on CO poisoning and further strived to delineate its inherent effects on specific subgroups of patients using a nationwide inpatient database. METHODS: We identified adult patients with CO poisoning who were registered in the Japanese Diagnosis Procedure Combination inpatient database from 2010 to 2016. Propensity score-matching was performed to compare patients who received HBOT within 1 day of admission (HBOT group) with those who did not receive HBOT (control group). The primary outcome was in-hospital mortality. The secondary outcomes were a depressed mental status and reduced activities of daily living (ADL) at discharge. We also performed subgroup analyses divided according to severity of CO poisoning. RESULTS: Eligible patients were categorized into the HBOT group (n = 2034) or the control group (n = 4701). One-to-one propensity score-matching created 2034 pairs. In-hospital mortality was not significantly different between the HBOT and control groups (0.8% vs. 1.2%, risk difference: -0.4%, 95% confidence interval: -1.0 to 0.2). Patients in the HBOT group had significantly lower proportions of a depressed mental status and reduced ADL at discharge than did those in the control group. Similar associations were shown in the non-severe poisoning subgroup. CONCLUSIONS: Although HBOT was not significantly associated with reduced mortality, it was significantly associated with a favorable consciousness level and ADL in patients with CO poisoning. HBOT may be beneficial even for patients with non-severe CO poisoning.

Effects of Hyperbaric Oxygen Therapy on Acute Myocardial Infarction Following Carbon Monoxide Poisoning.

Carbon monoxide poisoning (COP) may increase the risk of myocardial infarction. We conducted a study to investigate the effects of hyperbaric oxygen therapy (HBOT) on the risk. We used the Nationwide Poisoning Database in Taiwan to identify COP patients diagnosed between 1999 and 2012. We compared the risk for myocardial infarction between patients with and without HBOT by following up through 2013 and identified the independent predictors of myocardial infarction. The risk of myocardial infarction in the 7278 patients with HBOT was lower than in the 18,459 patients without HBOT, but this difference did not reach statistical significance [adjusted hazard ratio (AHR): 0.69; 95% confidence interval (CI) 0.45-1.07]. Stratified analyses showed that the reductions in the risk associated with HBOT for myocardial infarction reached statistical significance in male patients (AHR: 0.45; 95% CI 0.24-0.83) and during the first 2 weeks of follow-up (AHR: 0.22; 95% CI 0.05-0.96). In patients without HBOT, independent predictors of myocardial infarction were old age, male sex, and the underlying comorbidities of hypertension, diabetes, coronary artery disease, and congestive heart failure. In patients with HBOT, however, old age, male sex, and the underlying comorbidities of diabetes, coronary artery disease, and congestive heart failure were not independent predictors. HBOT was associated with a reduced risk of myocardial infarction in male patients and within 2 weeks following COP. These results may provide important reference for using HBOT in treating COP.

Carbon monoxide poisoning in Denmark with focus on mortality and factors contributing to mortality.

INTRODUCTION: Carbon monoxide (CO) poisoning is frequent worldwide but knowledge regarding the epidemiology is insufficient. The aim of this study was to clarify the extent of this intoxication, its mortality and factors associated with mortality. MATERIALS AND METHODS: National databases from Statistics Denmark were used to identify individuals who suffered from CO-poisoning during 1995-2015, as well as information regarding co-morbidities, mortality and manner of death. RESULTS: During the period from 1995 to 2015, 22,930 patients suffered from CO-poisoning in Denmark, and 21,138 of these patients (92%) were hospitalized. A total of 2,102 patients died within the first 30 days after poisoning (9.2%). Among these, 1,792 (85% of 2,102) were declared dead at the scene and 310 (15% of 2,102) died during hospitalization. Deaths due to CO-poisoning from smoke were intentional in 6.3% of cases, whereas deaths due to CO containing gases were intentional in 98.0% of cases. Among patients who survived >30 days, there was no significant difference in survival when comparing hyperbaric oxygen therapy (HBO) treatment with no HBO treatment after adjustment for age and co-morbidities such as drug abuse, psychiatric disease, stroke, alcohol abuse, arterial embolism, chronic obstructive pulmonary disease, cerebrovascular disease and atrial fibrillation. Several co-morbidities predicted poorer outcomes for patients who survived the initial 30 days. CONCLUSIONS: Poisoning from smoke and/or CO is a frequent incident in Denmark accounting for numerous contacts with hospitals and deaths. Both intoxication and mortality are highly associated with co-morbidities interfering with cognitive and physical function. Treatment with HBO was not seen to have an effect on survival.

Carbon Monoxide Poisoning in Miami-Dade County Following Hurricane Irma in 2017.

OBJECTIVE: The Florida Department of Health in Miami-Dade County (DOH-Miami-Dade) investigated 106 reported carbon monoxide (CO) exposures over a 9-day timeframe after Hurricane Irma. This report evaluates risk factors for CO poisoning and the importance of heightened surveillance following natural disasters. METHODS: Data on CO poisoning cases from September 9 to 18, 2017 were extracted from Merlin, the Florida Department of Health Surveillance System. Medical records were obtained and follow-up interviews were conducted to collect data on the confirmed CO poisoning cases. Data were analyzed using SAS v9.4. RESULTS: Ninety-one of the 106 people exposed to CO met the case definition for CO poisoning: 64 confirmed, 7 probable, and 20 suspect cases. Eighty-eight percent of the affected individuals were evaluated in emergency departments and 11.7% received hyperbaric oxygen treatment. The most frequently reported symptoms included headache (53.3%), dizziness (50.7%), and nausea (46.7%). Three patients expired due to their exposure to CO. CONCLUSIONS: Post Hurricane Irma, the DOH-Miami-Dade investigated numerous cases for CO exposure. By understanding who is most likely to be impacted by CO and the impact of generators' location on people's health, education efforts can be tailored to the population most at risk and further CO exposures and related mortalities following natural disasters can be reduced. (Disaster Med Public Health Preparedness. 2019;13:94-96).

Carbon monoxide intoxication: What we know.

Carbon monoxide (CO) is a toxic, color-, taste- and odorless gas with fatal consequences if undetected. Intoxication caused by CO is frequent possibly leading to a high morbidity and mortality. The disease involves multiple organ systems without a typical clinical presentation. The clinical picture is furthermore unrelated to levels of carboxyhemoglobin - the routine biomarker. Therefore the diagnosis and treatment can be very demanding. This article in detail reviews epidemiology, symptoms, diagnosis and the therapy of this multidisciplinary challenge.

Demographic and clinical characteristics of carbon monoxide poisoning: nationwide data between 1999 and 2012 in Taiwan.

BACKGROUND: Carbon monoxide poisoning (COP) is not uncommon, but nationwide epidemiological data are limited. We conducted a study in Taiwan to fill the data gaps. METHODS: We used a nationwide poisoning database to study all COP patients in Taiwan diagnosed between 1999 and 2012. We conducted descriptive analyses and compared the differences between the two sexes. In addition, we assessed the trends in suicide and mortality rates from 1999 to 2012. RESULTS: We identified 25,912 COP patients with an almost equal female and male distribution (50.6% vs. 49.4%). The mean age was 36.0 years, and most of the patients were between 20 and 50 years old. The highest incidence rate in the year occurred during winter. While female patients were more likely to have mental disorders (35.9% vs. 28.1%, p < 0.001), male patients were more likely to be resulted from suicide attempts (22.9% vs. 17.7%, p < 0.001). In both sexes, the suicidal rate increased from 1999, reached the peak in 2007, and then decreased gradually. Hyperbaric oxygen therapy was performed in 24.2% of the patients. Neurological sequelae developed in 9.1% of the patients, and chronic respiratory failure and requirement of long-term care were observed in 5.0% and 0.1% of the patients. The 1-month and 3-month mortality rates were 1.6% and 5.0%. The 3-month mortality rate did not show significant change between 1999 and 2012. DISCUSSION: This study showed a whole picture of COP in Taiwan, which could add to the important knowledge of this disastrous problem in public health. CONCLUSION: Some important findings, including higher percentages of mental disorders in female patients and suicide attempt in male patients, seasonal changes, and trends in mortality and morbidity (suicide) rates, may help developing strategies for prevention and treatment of COP.

Intoxicacion por monoxido de carbono / Carbon monoxide poisoning

Resumen:La intoxicación por monóxido de carbono o "asesino silente" es la intoxicación mortal más común, encontrándose en fuentes de exposición muy comunes como automóviles, tabaquismo y combustión de gases o combustibles.La principal característica nociva aguda del gas se basa en su alta afinidad por la hemoglobina, mientras que los efectos crónicos se basan en su interacción con otras proteínas. Ante la clínica inespecífica del cuadro, se debe tener un alto grado de sospecha diagnóstica, para iniciar el tratamiento adecuado o oxigenoterapia normobárica o hiperbárica según corresponda.

Abstract:Carbon monoxide poisoning or "silent killer" is the most common fatal poisoning, found in very common sources of exposure such as cars, smoking and gas or fuel combustion. The main acute harmful characteristic of gas is based on its high affinity for hemoglobin, while the chronic effects are based on its interaction with other proteins.Before the nonspecific clinic of the table, must have a high degree of diagnostic suspicion, to start the appropriate treatment or normobaric or hyperbaric oxygen therapy as appropriate.

Requests for emergency hyperbaric oxygen treatment for carbon monoxide poisoning in Ankara, Turkey.

BACKGROUND: Carbon monoxide (CO) poisoning is common in Turkey. Our department is the main provider of emergency hyperbaric oxygen therapy (HBOT) in Ankara and neighboring cities. In this study, we analyzed the characteristics of CO-poisoned patients who were referred by phone to our department for emergency HBOT. METHODS: We retrospectively reviewed the records of phone consultations with emergency departments regarding the need for treatment of CO-poisoned patients with HBOT between 14 January 2014 and 14 January 2015. The following information was extracted from medical records: age, gender, CO source, exposure duration, carboxyhemoglobin (COHb) level, symptoms, electrocardiography (ECG) findings, cardiac enzymes, pregnancy, the distance of referring hospital to our centre, time between admission and consultation and HBOT decision. RESULTS: Over the one-year period, 562 patients with CO poisoning were referred for HBOT. We recommended HBOT for 289 (51%) patients. HBOT was recommended for 58% (n = 194) of the patients with COHb ≥ 25%, 72% (n = 163) of the patients with a history of syncope, 67% (n = 35) of the patients with ECG abnormality, and 67% (n = 14) of pregnant patients. Patients for whom HBOT was not recommended despite having positive signs of severe poisoning were referred significantly later compared to patients for whom HBOT was recommended. CONCLUSION: We found that the duration from admission to an emergency department to HBOT consultation affected our decision-making.

El monóxido de carbono y la neurología. Réplica / Carbon monoxide and neurology. Reply

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Carbon monoxide poisoning in Utah: 1996-2013.

INTRODUCTION: The true incidence of carbon monoxide (CO) poisoning is not clearly known, but a description of possible trends could aid in prevention. METHODS: Investigators searched Utah state databases for emergency department (ED) visits and admissions for CO poisoning and medical examiner records for CO-related fatalities. RESULTS: From 1996-2013, 7,590 individuals were diagnosed with CO poisoning: 6,469 were treated/ released from EDs; 596 were admitted; 525 died. Of 7,065 non-fatal poisonings, 5,950 (84%) were accidental and 498 (7%) were suicide attempts. Few patients (9.7%) were treated with hyperbaric oxygen. For accidental poisonings, internal combustion engines accounted for 43%, smoke inhalation, 34%, and heating sources, 22%. Internal combustion engines were implicated in 97% of suicide attempts. Non-fatal poisonings declined following a 2008 legislative change requiring CO alarms in residences, but we do not know if legislation caused the decline. One hundred forty-one (27%) fatal poisonings were accidental, 361 (70%) suicides and two (0.4%) homicides. Victims with cardiovascular autopsy findings/past cardiovascular history had lower carboxyhemoglobin levels (mean 51.2%, n=53) compared to those without (70.8%, n=472). Mean postmortem carboxyhemoglobin was highest in ages 20-29 years (72.5%). CONCLUSIONS: The incidence of CO poisoning in Utah is declining, but CO poisoning is still common. Alarm legislation may aid prevention efforts. An educational campaign addressing the many causes and circumstances of CO poisoning is required for prevention.

Síndrome neurológico tardío tras intoxicación por monóxido de carbono / Delayed neurological syndrome following carbon monoxide poisoning

Introducción. La intoxicación por monóxido de carbono es la más frecuente en nuestro medio a consecuencia de la exposición a gases tóxicos. Los efectos de la intoxicación por monóxido de carbono no se limitan a la exposición aguda porque, tras la aparente recuperación de la intoxicación, pueden aparecer alteraciones neurológicas o del comportamiento. Pacientes y métodos. Se realizó un estudio de las intoxicaciones por monóxido de carbono en un área sanitaria de 80.000 habitantes durante un período de 10 años. Posteriormente se hizo un seguimiento de estos pacientes y se valoró la aparición de síndrome neurológico tardío (SNT) y su relación con diferentes variables en la exposición inicial al monóxido de carbono, en el tratamiento administrado o en la gravedad de la intoxicación. Resultados y conclusiones. Se observó que el 9,1% de los intoxicados por monóxido de carbono detectados en el área sanitaria de Salnés desarrollan el SNT, que es más frecuente en los pacientes con criterios analíticos de gravedad y muy poco probable en los que no los tienen. Los pacientes con SNT no expresaron manifestaciones clínicas ni analíticas diferentes a los que no presentaron el síndrome; tampoco se observaron diferencias en relación con la terapia con oxígeno administrada. La tasa de SNT en el área sanitaria de Salnés entre 2002 y 2012 es de 0,84 casos por 100.000 habitantes y año (AU)

Introduction. Poisoning by carbon monoxide is the most frequent form of intoxication in our milieu as a result of exposure to poisonous gases. The effects of carbon monoxide poisoning are not limited to acute exposure, since, following apparent recovery from the acute intoxication, neurological or behavioural disorders may appear. Patients and methods. A study was conducted to examine the cases of carbon monoxide poisoning that had occurred in a healthcare area of 80,000 inhabitants over a 10-year period. These patients were then submitted to a follow-up to appraise the appearance of delayed neurological syndrome (DNS) and its relationship with different variables in the initial exposure to the carbon monoxide, in the treatment that was administered or in the severity of the intoxication. Results and conclusions. It was observed that around 9.1% of those intoxicated by carbon dioxide detected within the healthcare district of Salnés went on to develop DNS, which is more frequent in patients with severe analytical criteria and very unlikely in those who do not have them. Patients with DNS did not express any clinical or analytical manifestations that differed from those who did not have the syndrome; no differences were observed in relation to the oxygen therapy that was administered. The rate of DNS within the healthcare district of Salnés between 2002 and 2012 is 0.84 cases per 100,000 inhabitants per year. (AU)

Suicidal carbon monoxide poisoning has decreased with controls on automobile emissions.

BACKGROUND: Highway vehicle CO emissions have decreased 85% since introduction of the catalytic converter in 1975. We sought to examine whether morbidity and mortality from intentional motor vehicle-related CO poisoning have also changed. METHODS: Vehicle CO emissions data from 1970-2013 were obtained from the U.S. Environmental Protection Agency. U.S. Centers for Disease Control and Prevention data were used for the suicide crude death rate (CDR) from CO poisoning from 1999-2010. Data on non-fatal intentional CO poisonings treated at a regional hyperbaric treatment center from 1981-2013 were analyzed with regard to numbers treated and presenting carboxyhemoglobin (COHb) levels. RESULTS: Since 1985, the CDR for suicidal motor vehicle-related CO poisoning has decreased in parallel with CO emissions (R2 = 0.985). Non-fatal motor vehicle-related intentional CO poisoning cases decreased 63% over 33 years (p = 0.0017). COHb levels decreased 35% in these patients (p < 0.0001). CONCLUSIONS: There has been a decrease in both fatal and non-fatal intentional CO poisoning from motor vehicle exhaust since the 1980s. This correlates with reductions in vehicle CO emissions and is a likely result of the U.S. Clean Air Act of 1970 and the application of catalytic converters since 1975.

Carbon monoxide poisoning: an ancient and frequent cause of accidental death.

Carbon monoxide poisoning is both an ancient and current cause of inadvertent (accidental) death and more recently has emerged as a cause of suicide worldwide. This article describes the pathophysiology and epidemiology of this most toxic and frequently occult poison.

El asesino silencioso: intoxicaciones por monóxido de carbon / The silent killer. Carbón monoxide poisoning

Introducción. El monóxido de carbono (CO) es un contaminante de la atmósfera terrestre y tóxico para el ser humano. Las intoxicaciones por CO están infradiagnosticadas. Objetivo. Describir las característica sociodemográficas. Objetivo. Describir las características sociodemográficas y clínicas de los pacientes atendidos por intoxicación por CO (ICO). Metodología. Estudio transversal entre 2006 y 2010 en el servicio de urgencias de un hospital, en menores de 15 años atendidos por ICO. Se incluyeron variables sociodemográficas y clínicas. Se realizó una estadística descriptiva mediante frecuencias y estadístico exacto de Fisher, mediante SPSS 18. Resultados. Se registraron 63 urgencias por ICO. La prevalencia incrementó del 0,14/1.000 en 2006 al 3,07/1.000 en 2010. La mayoría se presentó en varones (34 niños, 53,9%), entre 0-4 años (37, 58,7%), españoles (28, 58,3%). La causa principal de las ICO fue la incorrecta combustión del carbón (14, 30,2%). La sintomatología que predomina es la neurológica, como cefalea (16, 25,4%), destacando los asintomáticos (23, 36,5%). La carboxihemoglobina fue superior al 10% en un 35,6% de las ICO. 36 niños (57,1%) precisaron tratamiento en cámara hiperbárica. Conclusiones. La clínica de las ICO es muy inespecífica, similar a cuadros virales y síntomas neurológicos sin causa aparente y afecta a diversos miembros de una familia, sobre todo en invierno (AU)

Introduction. Carbon monoxide (CO) is a contaminant of the Earth´s atmosphere and toxic to humans. The incidence of CO poisoning (COP) is underdiagnosed. Objectives. To describe the sociodemographic and clinical characteristics of patients treated for CO poisoning (COP). Methodology. Cross-sectional study between 2006 and 2010 in the emergency room of a local hospital in under 15 attended by COP. We included sociodemographic and clinical variables. Descriptive statistics were performed using frequencies and Fisher exact test, using SPSS 18. Results. There were 63 emergency COP, each corresponding to a different child. The increased prevalence of 0,14/1,000 in 2006 to 3,07/1.000 in 2010. Most occurred in males (34, 53,9%), 0-4 years (37, 58,7%), Spanish (28, 58,3%). The main cause of COP was the incorrect burning coal (14, 30,2%). The predominant symptoms are neurological, such as headache (16, 25,4%), highlighting the asymptomatic (23, 36,5%). Carboxyhemoglobin was above 10% in 35,6% of the COP. 36 children (57,1%) required treatment in a hyperbaric chamber. Conclusion. The clinic of the COP is very nonspecific, similar to viral conditions and unexplained neurological symptoms and affects several members of a family, especially in winter (AU)