Skip to main content
Top
Published in: Journal of Medical Case Reports 1/2012

Open Access 01-12-2012 | Case report

Status epilepticus and cardiopulmonary arrest in a patient with carbon monoxide poisoning with full recovery after using a neuroprotective strategy: a case report

Authors: Salman Abdulaziz, Ousama Dabbagh, Yaseen Arabi, Suleiman Kojan, Imad Hassan

Published in: Journal of Medical Case Reports | Issue 1/2012

Login to get access

Abstract

Introduction

Carbon monoxide poisoning can be associated with life-threatening complications, including significant and disabling cardiovascular and neurological sequelae.

Case presentation

We report a case of carbon monoxide poisoning in a 25-year-old Saudi woman who presented to our facility with status epilepticus and cardiopulmonary arrest. Her carboxyhemoglobin level was 21.4 percent. She made a full recovery after we utilized a neuroprotective strategy and normobaric oxygen therapy, with no delayed neurological sequelae.

Conclusions

Brain protective modalities are very important for the treatment of complicated cases of carbon monoxide poisoning when they present with neurological toxicities or cardiac arrest. They can be adjunctive to normobaric oxygen therapy when the use of hyperbaric oxygen is not feasible.
Literature
1.
go back to reference Ernst A, Zibrak JD: Carbon monoxide poisoning. N Engl J Med. 1998, 339: 1603-1608. 10.1056/NEJM199811263392206.CrossRefPubMed Ernst A, Zibrak JD: Carbon monoxide poisoning. N Engl J Med. 1998, 339: 1603-1608. 10.1056/NEJM199811263392206.CrossRefPubMed
2.
go back to reference Arabi YM, Haddad S, Tamim HM, Al-Dawood A, Al-Qahtani S, Ferayan A, Al-Abdulmughni I, Al-Oweis J, Rugaan A: Mortality reduction after implementing a clinical practice guidelines-based management protocol for severe traumatic brain injury. J Crit Care. 2010, 25: 190-195. 10.1016/j.jcrc.2009.05.004.CrossRefPubMed Arabi YM, Haddad S, Tamim HM, Al-Dawood A, Al-Qahtani S, Ferayan A, Al-Abdulmughni I, Al-Oweis J, Rugaan A: Mortality reduction after implementing a clinical practice guidelines-based management protocol for severe traumatic brain injury. J Crit Care. 2010, 25: 190-195. 10.1016/j.jcrc.2009.05.004.CrossRefPubMed
3.
go back to reference Touger M, Gallagher EJ, Tyrell J: Relationship between venous and arterial carboxyhemoglobin levels in patients with suspected carbon monoxide poisoning. Ann Emerg Med. 1995, 25: 481-483. 10.1016/S0196-0644(95)70262-8.CrossRefPubMed Touger M, Gallagher EJ, Tyrell J: Relationship between venous and arterial carboxyhemoglobin levels in patients with suspected carbon monoxide poisoning. Ann Emerg Med. 1995, 25: 481-483. 10.1016/S0196-0644(95)70262-8.CrossRefPubMed
4.
go back to reference Peterson JE, Stewart RD: Absorption and elimination of carbon monoxide by inactive young men. Arch Environ Health. 1970, 21: 165-171.CrossRefPubMed Peterson JE, Stewart RD: Absorption and elimination of carbon monoxide by inactive young men. Arch Environ Health. 1970, 21: 165-171.CrossRefPubMed
5.
go back to reference Hee J, Callais F, Momas I, Laurent AM, Min S, Molinier P, Chastagnier M, Claude JR, Festv B: Smokers’ behaviour and exposure according to cigarette yield and smoking experience. Pharmacol Biochem Behav. 1995, 52: 195-203. 10.1016/0091-3057(95)00089-F.CrossRefPubMed Hee J, Callais F, Momas I, Laurent AM, Min S, Molinier P, Chastagnier M, Claude JR, Festv B: Smokers’ behaviour and exposure according to cigarette yield and smoking experience. Pharmacol Biochem Behav. 1995, 52: 195-203. 10.1016/0091-3057(95)00089-F.CrossRefPubMed
6.
go back to reference Jay GD, McKindley DS: Alterations in pharmacokinetics of carboxyhemoglobin produced by oxygen under pressure. Undersea Hyperb Med. 1997, 24: 165-173.PubMed Jay GD, McKindley DS: Alterations in pharmacokinetics of carboxyhemoglobin produced by oxygen under pressure. Undersea Hyperb Med. 1997, 24: 165-173.PubMed
7.
go back to reference Pracyk JB, Stolp BW, Fife CE, Gray L, Piantadosi CA: Brain computerized tomography after hyperbaric oxygen therapy for carbon monoxide poisoning. Undersea Hyperb Med. 1995, 22: 1-7.PubMed Pracyk JB, Stolp BW, Fife CE, Gray L, Piantadosi CA: Brain computerized tomography after hyperbaric oxygen therapy for carbon monoxide poisoning. Undersea Hyperb Med. 1995, 22: 1-7.PubMed
8.
go back to reference Gale SD, Hopkins RO, Weaver LK, Bigler ED, Booth EJ, Blatter DD: MRI, quantitative MRI, SPECT, and neuropsychological findings following carbon monoxide poisoning. Brain Inj. 1999, 13: 229-243. 10.1080/026990599121601.CrossRefPubMed Gale SD, Hopkins RO, Weaver LK, Bigler ED, Booth EJ, Blatter DD: MRI, quantitative MRI, SPECT, and neuropsychological findings following carbon monoxide poisoning. Brain Inj. 1999, 13: 229-243. 10.1080/026990599121601.CrossRefPubMed
9.
go back to reference Hopkins RO, Fearing MA, Weaver LK, Foley JF: Basal ganglia lesions following carbon monoxide poisoning. Brain Inj. 2006, 20: 273-281. 10.1080/02699050500488181.CrossRefPubMed Hopkins RO, Fearing MA, Weaver LK, Foley JF: Basal ganglia lesions following carbon monoxide poisoning. Brain Inj. 2006, 20: 273-281. 10.1080/02699050500488181.CrossRefPubMed
10.
go back to reference Bennetto L, Powter L, Scolding NJ: Accidental carbon monoxide poisoning presenting without a history of exposure: a case report. J Med Case Rep. 2008, 22: 2-118. Bennetto L, Powter L, Scolding NJ: Accidental carbon monoxide poisoning presenting without a history of exposure: a case report. J Med Case Rep. 2008, 22: 2-118.
11.
go back to reference Brown KI, Wilson RF, White MT: Carbon monoxide induced status epilepticus in an adult. J Burn Care Res. 2007, 28: 533-536. 10.1097/BCR.0B013E318053DA82.CrossRefPubMed Brown KI, Wilson RF, White MT: Carbon monoxide induced status epilepticus in an adult. J Burn Care Res. 2007, 28: 533-536. 10.1097/BCR.0B013E318053DA82.CrossRefPubMed
12.
go back to reference Gesell LB: (Ed): Hyperbaric Oxygen 2009: Indications and Results: The Hyperbaric Oxygen Therapy Committee Report. 2008, Durham, NC: Undersea and Hyperbaric Medical Society Gesell LB: (Ed): Hyperbaric Oxygen 2009: Indications and Results: The Hyperbaric Oxygen Therapy Committee Report. 2008, Durham, NC: Undersea and Hyperbaric Medical Society
13.
go back to reference Mori T, Nagai K: Carbon-monoxide poisoning presenting as an isolated afebrile seizure. Pediatr Neurol. 2000, 22: 330-331. 10.1016/S0887-8994(99)00148-4.CrossRefPubMed Mori T, Nagai K: Carbon-monoxide poisoning presenting as an isolated afebrile seizure. Pediatr Neurol. 2000, 22: 330-331. 10.1016/S0887-8994(99)00148-4.CrossRefPubMed
14.
go back to reference Bentur Y: Hyperbaric oxygen for carbon monoxide poisoning. Toxicol Rev. 2005, 24: 153-154. 10.2165/00139709-200524030-00004.CrossRefPubMed Bentur Y: Hyperbaric oxygen for carbon monoxide poisoning. Toxicol Rev. 2005, 24: 153-154. 10.2165/00139709-200524030-00004.CrossRefPubMed
15.
go back to reference Myers RAM, Thom SR: Hyperbaric Medicine Practice. Edited by: Kindwall EP. 1994, Flagstaff, AZ: Best Publishing, 357-Carbon monoxide and cyanide poisoning,Myers RAM, Thom SR, Myers RAM, Thom SR: Hyperbaric Medicine Practice. Edited by: Kindwall EP. 1994, Flagstaff, AZ: Best Publishing, 357-Carbon monoxide and cyanide poisoning,Myers RAM, Thom SR,
16.
go back to reference Raphael JD, Elkharrat D, Jars-Guincestre MC: Trial of normobaric and hyperbaric oxygen for acute carbon monoxide intoxication. Lancet. 1989, 2: 414-419.CrossRefPubMed Raphael JD, Elkharrat D, Jars-Guincestre MC: Trial of normobaric and hyperbaric oxygen for acute carbon monoxide intoxication. Lancet. 1989, 2: 414-419.CrossRefPubMed
17.
go back to reference Scheinkestel CD, Bailey M, Myles PS, Jones K, Cooper DJ, Millar IL, Tuxen DV: Hyperbaric or normobaric oxygen for acute carbon monoxide poisoning: a randomized, controlled clinical trial. Med J Aust. 1999, 170: 203-210.PubMed Scheinkestel CD, Bailey M, Myles PS, Jones K, Cooper DJ, Millar IL, Tuxen DV: Hyperbaric or normobaric oxygen for acute carbon monoxide poisoning: a randomized, controlled clinical trial. Med J Aust. 1999, 170: 203-210.PubMed
18.
go back to reference Weaver LK, Hopkins RO, Chan KJ, Churchill S, Elliott CG, Clemmer TP, Orme JF, Thomas FO, Morris AH: Hyperbaric oxygen for acute carbon monoxide poisoning. New Engl J Med. 2002, 347: 1057-1067. 10.1056/NEJMoa013121.CrossRefPubMed Weaver LK, Hopkins RO, Chan KJ, Churchill S, Elliott CG, Clemmer TP, Orme JF, Thomas FO, Morris AH: Hyperbaric oxygen for acute carbon monoxide poisoning. New Engl J Med. 2002, 347: 1057-1067. 10.1056/NEJMoa013121.CrossRefPubMed
19.
go back to reference Buckley NA, Juurlink DN, Isbister G, Bennett MH, Lavonas EJ: Hyperbaric oxygen for carbon monoxide poisoning. Cochrane Database Syst Rev. 2011, 13: CD002041- Buckley NA, Juurlink DN, Isbister G, Bennett MH, Lavonas EJ: Hyperbaric oxygen for carbon monoxide poisoning. Cochrane Database Syst Rev. 2011, 13: CD002041-
20.
go back to reference Weaver LK, Valentine KJ, Hopkins RO: Carbon monoxide poisoning: risk factors for cognitive sequelae and the role of hyperbaric oxygen. Am J Respir Crit Care Med. 2007, 176: 491-497. 10.1164/rccm.200701-026OC.CrossRefPubMed Weaver LK, Valentine KJ, Hopkins RO: Carbon monoxide poisoning: risk factors for cognitive sequelae and the role of hyperbaric oxygen. Am J Respir Crit Care Med. 2007, 176: 491-497. 10.1164/rccm.200701-026OC.CrossRefPubMed
21.
go back to reference Haddad SH, Arabi YM: Critical care management of severe traumatic brain injury in adults. Scand J Trauma Resusc Emerg Med. 2012, 3: 12-CrossRef Haddad SH, Arabi YM: Critical care management of severe traumatic brain injury in adults. Scand J Trauma Resusc Emerg Med. 2012, 3: 12-CrossRef
22.
go back to reference Busl KM, Greer DM: Hypoxic-ischemic brain injury: pathophysiology, neuropathology and mechanisms. NeuroRehabilitation. 2010, 26: 5-13.PubMed Busl KM, Greer DM: Hypoxic-ischemic brain injury: pathophysiology, neuropathology and mechanisms. NeuroRehabilitation. 2010, 26: 5-13.PubMed
23.
go back to reference Kamijo Soma K: Severe carbon monoxide poisoning complicated by hypothermia: a case report. Am J Emerg Med. 2011, 29: 357. e5-7-PubMed Kamijo Soma K: Severe carbon monoxide poisoning complicated by hypothermia: a case report. Am J Emerg Med. 2011, 29: 357. e5-7-PubMed
Metadata
Title
Status epilepticus and cardiopulmonary arrest in a patient with carbon monoxide poisoning with full recovery after using a neuroprotective strategy: a case report
Authors
Salman Abdulaziz
Ousama Dabbagh
Yaseen Arabi
Suleiman Kojan
Imad Hassan
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2012
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-6-421

Other articles of this Issue 1/2012

Journal of Medical Case Reports 1/2012 Go to the issue