• 대한임상독성학회지
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• 제14권2호
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• pp.122-128
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• 2016

Purpose: This study was conducted to describe the characteristics of patients with carbon monoxide (CO) poisoning. Methods: We retrospectively surveyed data from the Emergency Department based Injury In-depth Surveillance of 20 hospitals (2011-2014). We included patients whose mechanism of injury was acute CO poisoning caused by inhalation of gases from charcoal or briquettes. We surveyed the annual frequency, gender, age, result of emergency treatment, rate of intensive care unit (ICU) admission, result of admission, association with alcohol, and place of accident. We also surveyed the cause and experience of past suicide attempts by intentional poisoning. Results: A total of 3,405 patients were included (2,015 (59.2%) and 1,390 (40.8%) males and females, respectively) with a mean age of $39.83{\pm}18.51$ year old. The results revealed that the annual frequency of CO poisoning had increased and the frequency of unintentional CO poisoning was higher than that of intentional CO poisoning in January, February and December. The mean age of intentional CO poisoning was younger than that of unintentional CO poisoning ($38.41{\pm}13.03$ vs $40.95{\pm}21.83$) (p<0.001). The rates of discharge against medical advice (DAMA), ICU care and alcohol association for intentional CO poisoning were higher than for unintentional CO poisoning (36.4% vs 14.0%, 17.8% vs 4.7%, 45.2% vs 5.6%) (p<0.001). The most common place of CO poisoning was in one's residence. Conclusion: The annual frequency of total CO poisoning has increased, and unintentional CO poisoning showed seasonal variation. DAMA, ICU care, and alcohol association of intentional CO poisoning were higher than those of unintentional CO poisoning.

• The Korean Journal of Physiology
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• 제20권1호
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• pp.53-63
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• 1986

과산화수소$(H_2O_2)$가 급성 일산화탄소(CO)중독의 회복에 미치는 영향을 알아보기 위하여 가토를 1% Corktm에 30분간 노출시킨후 자연회복군, 100%산소 흡입군 및 $H_2O_2$관장군(10ml/kg의 0.5% $H_2O_2$용액을 2ml내외의 사람혈액과 함께 관장)으로 나누어, 회복기 15,30,60 및 90분에 동맥혈의 $pH,\;PCO_2,\;CO_2$ 및 HbCO 포화도를 측정하여 다음과 같은 결론을 얻었다. pH는 급성 CO중독시 3개군 모두에서 감소하였고, 회복기에는 서서히 증가하여 자연회복군과 100%산소 흡입군은 회복기 90분에 거의 회복되나, $H_2O_2$관장군에서는 pH의 회복이 다른군보다 늦었다. $PaCO_2$는 급성 Co중독시 3개군 모두에서 감소하였고, 회복기에는 서서히 증가하였으나, 자연회복군의 $PaCO_2$는 회복기 90분에 거의 회복하는데 반하여 100%산소흡입군과 $H_2O_2$관장군의 $PaCO_2$는 회복이 늦었고 회복기 90분에도 완전히 회복되지 못하였다. $PaO_2$는 급성 Co중독시 약간 감소하였다가 회복기에는 회복기 15분부터 급격히 증가하였고 회복기 90분까지 대조치보다 높은 $PaO_2$를 유지하였다. 회복기동안 $H_2O_2$관장군의 $PaO_2$는 $102{\sim}107mmhg$로 자연회복군보다 약 10 mmhg 높은 수준을 보였다. HbCO 포화도는 급성 CO중독시 $54{\sim}72%$까지 증가하였다. 회복기에는 $H_2O_2$관장군의 HbCO 포화도의 회복이 자연회복군이나 100%산소 흡입군보다 빨랐으며, 100%산소 흡입군은 회복기 30분에서 60분사이에 자연회복군보다 더 빠른 회복을 보였다. 이상의 결과에서 0.5% $H_2O_2$관장은 CO중독시 혈액의 산소분압을 어느정도 증가시킬 뿐 아니라 혈색소와 결합된 CO의 해리를 촉진시켜, 단독요법 또는 산소요법과 병행하여 사용할 때 급성CO중독에 효과적인 치료법이 될 수 있을 것으로 사료된다.

• Carbon letters
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• 제16권3호
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• pp.198-202
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• 2015

Carbon-supported Pt catalyst systems containing defect adsorption sites on the anode of direct methanol fuel cells were investigated, to elucidate the mechanisms of H₂ dissociation and carbon monoxide (CO) poisoning. Density functional theory calculations were carried out to determine the effect of defect sites located neighboring to or distant from the Pt catalyst on H₂ and CO adsorption properties, based on electronic properties such as adsorption energy and electronic band gap. Interestingly, the presence of neighboring defect sites led to a reduction of H₂ dissociation and CO poisoning due to atomic Pt filling the defect sites. At distant sites, H₂ dissociation was active on Pt, but CO filled the defect sites to form carbon π-π bonds, thus enhancing the oxidation of the carbon surface. It should be noted that defect sites can cause CO poisoning, thereby deactivating the anode gradually.

• 대한임상독성학회지
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• 제19권2호
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• pp.100-109
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• 2021

Purpose: The purpose of this study was to investigate effect of N-acetylcysteine (NAC) on the injury of putative parvalbumin positive interneurons defined by molecular marker and hippocampal long-term potentiation (LTP), a marker of neural plasticity following acute carbon monoxide (CO) poisoning. Methods: Adult Sprague-Dawley rats were exposed to 1100 ppm CO for 40 minutes followed by 3000 ppm CO for 20 minutes. Animals received daily intraperitoneal injection of NAC (150 mg/kg) for 5 days after CO exposure. Changes in learning and spatial memory were evaluated by Y-maze test 5 days after the poisoning. In vivo LTP in hippocampal CA1 area was evaluated by using extracellular electrophysiological technique. Immunohistochemical staining were adopted to observe expressional damages of parvalbumin (PV) immunoreactive interneurons in the hippocampus following the poisoning. Results: Acute CO intoxication resulted in no changes in memory performance at Y-maze test but a significant reduction of LTP in the in hippocampal CA1 area. There was also a significant reduction of PV (+) interneurons in the hippocampal CA1 area 5 days after CO poisoning. Daily treatment of NAC significantly improved hippocampal LTP impairment and reduced immunoreactivity for PV in the hippocampus following the acute CO poisoning. Conclusion: The results of this study suggest that reduction of hippocampal LTP and PV (+) interneurons in the hippocampus is sensitive indicator for brain injury and daily NAC injections can be the alternative therapeutics for the injury induced by acute CO poisoning.

• The Korean Journal of Physiology
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• 제1권2호
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• pp.185-191
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• 1967

In order to evaluate the elimination of CO through the lung comparing with the decrease of CO content in the blood, authors had induced acute CO poisoning on 9 dogs. Arterial CO-Hb saturation, CO concentration, %, in expired gas and eliminated CO amount through the lung were measured at 1,5,10,30,60, and 120 minutes after acute CO poisoning in 6 dogs breathing room air and 3 dogs breathing room air and oxygen alternately. Results obtained are summarized as follows. In room air breathing group, arterial CO-Hb saturation averaged 50.8% , and 53.67 ml of CO was blew off through the lung during 120 minutes and in alternately air and oBygen breathing group, the arterial CO-Hb saturation averaged 65.6% and 95.6 ml of CO was blew off through the lung. The amount of CO eliminated in expired gas for 120 minute was much less than the amount of decreased CO in arterial blood which was calculated with the decreased CO-Hb content in the estimated circulating blood volume. Such difference between the amount of eliminated CO in expired gas and the decreased CO in blood might be attributed to the oxidation of CO to $CO_2$ in the tissues. Concentration of CO in expired gas was markedly increased and the rate of decrease in arterial CO-Hb saturation is enhanced by oxygen breathing. In early period of recovery from acute CO poisoning, neither the CO concentration in expired gas, nor, the rate of CO elimination (unlit 2 minutes after CO poisoning) showed close correlation with the blood CO-Hb saturation level. The reason seemed to be due to irregularly depressed or unevenly stimulated respiration which were induced by acute CO poisoning.

• 청정기술
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• 제25권4호
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• pp.296-301
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• 2019

본 연구는 습윤함침법으로 제조하여 400 ℃에서 소성한 Pt/TiO₂ 촉매를 이용하여 NO 피독에 의한 CO 산화반응특성에 대하여 확인하였다. Pt/TiO₂ 촉매의 NO 피독영향을 확인하기 위하여 CO + O₂ 반응 중 NO를 주입하면서 반응활성의 변화를 관찰하였으며, 200 ℃ 이하에서 CO 전환율이 급격하게 저하되는 것을 확인하였다. 또한125 ℃ 이하에서 CO 전환율을 나타내지 않았다. 125 ℃에서 NO의 주입을 차단하더라도 초기 CO 전환율의 회복이 확인되지 않았다. 이에 따라 NO 주입에 따른 다양한 분석을 수행하였다. 먼저, TPD 분석 결과, 촉매에 NO의 선흡착은 CO 흡착을 방해하였으며 흡착된 CO에서 CO₂로의 전환탈착을 억제하는 것을 확인하였다. 다음으로, NO가 선흡착될 경우, 촉매의 산소전달능력을 감소함을 H₂-TPR 분석을 통하여 확인하였다. 또한 FT-IR 분석을 통하여, 촉매의 redox cycle (Pt²⁺→Pt⁰→Pt²⁺)을 방해하는 것을 확인하였다. 따라서 Pt/TiO₂ 촉매에서 NO의 존재는 CO 산화반응에서의 피독 인자으로 작용을 하였으며, NO 피독을 방지하기 위해서는 촉매의 산소전달능력의 증진이 필요하다고 판단되어진다.

• 대한임상독성학회지
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• 제17권2호
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• pp.86-93
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• 2019

Purpose: The objective was to determine the association between PaCO₂ and adverse cardiovascular events (ACVEs) in carbon monoxide (CO)-poisoned patients. Methods: This retrospective study included 194 self-breathing patients after CO poisoning with an indication for hyperbaric oxygen therapy and available arterial blood gas analysis at presentation and 6 hours later. The baseline characteristics and clinical course during hospitalization were collected and compared. The mean PaCO₂ during the first 6 hours after presentation was calculated. Results: The incidence rates of moderate (30 mmHg< PaCO₂ <35 mmHg) or severe (PaCO₂ ≤30 mmHg) hypocapnia at presentation after acute CO poisoning were 40.7% and 26.8%, respectively. The mean PaCO₂ during the first 6 hours was 33 (31-36.7) mmHg. The incidence of ACVEs during hospitalization was 50.5%. A significant linear trend in the incidence of ACVEs was observed across the total ranges of PaCO₂ variables. In multivariate regression analysis, mean PaCO₂ was independently associated with ACVEs (OR 0.798 (95% CI 0.641-0.997)). Conclusion: Mean PaCO₂ during the first 6 hours was associated with increased ACVEs. Given the high incidence of ACVEs and PaCO₂ derangement and the observed association between PaCO₂ and ACVEs, this study suggests that 1) PaCO₂ should be monitored at the acute stage to predict and/or prevent ACVEs; and 2) further study is needed to validate this result and investigate early manipulation of PaCO₂ as treatment.

• 대한임상독성학회지
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• 제21권2호
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• pp.117-127
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• 2023

Purpose: No consensus currently exists regarding the maximal pressure of hyperbaric oxygen (HBO₂) therapy performed within 24 hours of acute carbon monoxide (CO) poisoning. This study aimed to evaluate the difference in therapeutic effects according to the first HBO₂ pressure (3.0 atmospheres absolute [ATA] vs. 2.8 ATA). Methods: We used prospectively collected registry data on CO poisoning at a tertiary academic hospital in the Republic of Korea. Adult patients with acute CO poisoning treated with HBO₂ within 24 hours after arrival at the emergency department and without the use of additional HBO₂ after 24 hours between January 2007 and February 2022 were included. Data from 595 patients were analyzed using propensity score matching (PSM). Patients with mild (non-intubated) and severe (intubated) poisoning were also compared. Neurocognitive outcomes at 1 month after CO poisoning were evaluated using the Global Deterioration Scale combined with neurological impairment. Results: After PSM, the neurocognitive outcomes at 1-month post-CO exposure were not significantly different between the 2.8 ATA (110 patients) and 3.0 ATA (55 patients) groups (p=1.000). Similarly, there was also no significant difference in outcomes in a subgroup analysis according to poisoning severity in matched patients (165 patients) (mild [non-intubated]: p=0.053; severe [intubated]: p=1.000). Conclusion: Neurocognitive sequelae at 1 month were not significantly different between HBO₂ therapy pressures of 2.8 ATA and 3.0 ATA in patients with acute CO poisoning. In addition, the 1-month neurocognitive sequelae did not differ significantly between intubated and non-intubated patients.

• 대한임상독성학회지
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• 제19권1호
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• pp.17-23
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• 2021

Purpose: Alcohol ingestion enhances impulsivity and aggression, and has been proven to have a close relationship with suicide. This study investigates whether alcohol co-ingestion affects the Poisoning Severity Score (PSS) grade in patients with intentional poisoning. Methods: We conducted a retrospective analysis of intentional poisoning patients who visited the emergency department (ED) from January 1 to December 31, 2020. Patients were divided into non-drunken and drunken groups. We collected the data based on the medical records of the patients and serum ethanol level results recorded during initial blood tests at the ED. To grade the PSS, the highest score was assessed through clinical signs and test results during the hospital stay. A comparative analysis was conducted between the two groups. Results: A total of 277 patients were included in the study. 163 (58.8%) were in the non-drunken group, and 114 (41.2%) were in the drunken group. The PSS grade showed a significant difference between the two groups (p=0.002). While grade 1 (mild) was observed more in the non-drunken group, grade 2 (moderate) and grade 3 (severe) were seen more in the drunken group. In an ordinal logistic regression analysis, alcohol co-ingestion (adjusted odds ratio [aOR] 2.557, 95% confidence interval [CI] 1.554-4.208, p<0.001) was considered to be a risk factor for a higher PSS grade. There was no significant correlation between the serum ethanol level and the PSS grade. (p=0.568) Conclusion: Intentional poisoning patients with alcohol co-ingestion had a higher PSS. Hence close observation and aggressive treatment in the ED is warranted in such cases.

• 한국환경보건학회지
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• 제5권1호
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• pp.25-39
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• 1978

Carbon monoxide poisoning is one of the most serious health problems in Korea. In this review, the author made a intensive reference review on the causes of carbon monoxide poisoning, the patterns of carbon monoxide poisoning and the prospects of CO poisoning. Following findings were induced through the review. 1. Carbon monoxide poisoning is influenced by variable social factors than any other diseases or accidents and is more closely related with the economical and cultural parameters of the community. 2. The increase of risk in the populatlon is expected by National Energy Policy and the hazards of CO poisoning will rather be increasing as long as no radical control measure will be taken. 3. More practical control measure, including extensive public relation service, should be established to eradicate this serious health hazard in Korea.