![]() ![]() Particularly, magnetic resonance imaging (MRI) can sensitively recognize COP-related cytotoxic edema when performed within 72 h after exposure to CO 16, demonstrating the possibility of diagnosing DNS in an early phase. Therefore, lesions caused by COP can be identified through brain imaging examinations during the acute poisoning phase. Thus, no validated tool for diagnosing DNS in the acute poisoning phase currently exists.ĬOP may induce hypoxic damage to the brain, which starts the demyelinating process of white matter that is recognized as the main pathologic feature of neurological 13, 14, 15. However, other studies report conflicting results or poor evidence regarding the use of these factors as DNS diagnostics 7, 11, 12. showed that QT prolongation on electrocardiogram combined with LOC and a low GCS score was associated with the occurrence of DNS 8. Accordingly, clinicians are investigating several factors, including clinical manifestations, such as loss of consciousness (LOC) or a low score on the Glasgow Coma Scale (GCS) 2, 6, 7, 8, 9, and blood biomarkers, such as elevated troponin or creatinine kinase levels 2, 6, 10, that may predict the development of sequelae. The COHb level measured in an emergency setting upon the onset of poisoning symptoms cannot diagnose DNS. In some patients with acute COP, an asymptomatic lucid period may occur, after which DNS develops 3, 4, 5. If clinical information related to poisoning cannot be assessed due to, for example, an altered mental state, COP may be missed or the diagnosis may be delayed.Īfter the onset of acute COP symptoms, some patients may develop delayed neurological sequelae (DNS) 2–40 days after CO exposure 3, 4, 5. COP symptoms are varied but they are also non-specific 2. ![]() Compared with oxygen, CO has a 250-fold greater affinity with hemoglobin, competitively combining with it to produce carboxyhemoglobin (COHb). The results indicate that detecting abnormal brain lesions using MRI or CT may assist in diagnosing DNS in acute COP patients.Ĭarbon monoxide poisoning (COP) is a leading cause of poisoning-related mortality worldwide 1. The areas under the curve for MRI and CT were 0.81 (standard error, 0.08 Q* = 0.74) and 0.80 (standard error, 0.05, Q* = 0.74), respectively. ![]() ![]() Eight and seven studies on magnetic resonance imaging (MRI) and computed tomography (CT), respectively, underwent meta-analysis. Seventeen studies were systematically reviewed. Observational studies that included adult patients with COP and DNS were retrieved from Embase, MEDLINE, and Cochrane Library databases in December 2020 and pooled using a random-effects model. We aimed to assess the evidence regarding the usefulness of brain imaging as a diagnostic tool for delayed neurological sequelae (DNS) in patients with acute carbon monoxide poisoning (COP). ![]()
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