CO Poisoning:


The Acute CO Poisoning Study of Meigs & Hughes, 1952:

Study: Retrospective chart review of 105 patients admitted to the New Haven unit of the Grace-New Haven Community Hospital, Jan. 1, 1920 - Dec. 31, 1948 with a diagnosis of acute CO poisoning.

- - Patient data grouped by severity of condition (days in hospital) (number of patients in parenthesis):

"Mild" - 2 (46)
"Moderate" - 3-6 (22)
"Severe" - 7 or more (37)

Table 1. Numbers of Cases with Major Abnormal Findings.

Condition / Manifestation No. of Cases Condition / Manifestation No. of Cases
Abnormal mental state (at admission) 98 Hear rate 110 bpm, or above (1st 48 hrs.) 52
Neurological abnormalities (at admission)* 83 Respiration rate 30/min., or above (1st 48 hrs.)* 38
Abnormal skin color* 74 B.P. above 140/90 24
Suffused mucous membranes (on admission) 53 B.P. below 100/60 19
Abnormal chest signs (1st 48 hrs.)* 52 Body temp. >102o F (1st 48 hrs.)* 17
Vomiting (on admission) 33 . .
Headache (1st 48 hrs.) 31 Albuminuria (1st 48 hrs.)* 40
Skin lesions (any time during illness)* 31 Gycosuria (1st 48 hrs.) 21
Excessive sweating (1st 24 hrs.)* 30 Sediment abnormal (1st 48 hrs.)* 19
Palpable liver, enlarged? (on admission)* 23 . .
Localized pain or soreness (any time during illness) 20 RBC of 5.2 x 106/mm3, or above (1st 24 hrs.) 27
Irregular cardiac rhythm (on admission) 18 WBC of 18,000/mm3, or above (1st 24 hrs.)* 15
Localized edema (1st 24 hrs.) 13 . .
Evidence of bleeding (any time during illness)* 11 . .
"Pseudorecovery"* 9 . .

* These findings appeared significantly more frequently in patients with "severe" CO poisoning.

Note: 1) Of the 18 patients with irregular cardiac rhythm on admission, 7 had premature beats, and 3 had totally irregular rhythms. There were 2 cases of ventricular premature beats, 2 cases of auricular fibrillation, 1 of atrioventricular nodal rhythm, 1 with an abnormal T-wave in Lead I, and 1 with very large complexes in all three leads.
2) The onset of pain occurred as late as the 6th hospital day, and duration was up to 2 months. There were proportionately more cases with this symptom in the "severe" group. Sites of localized pain or soreness were legs (8), chest (8), arms (6), abdomen (3), generalized (2), back (1), and rectum (1).
3) Internal bleeding in the patients included erythrocytes in the spinal fluid (4), development of anemia (3), bloody froth at mouth (3), blood in stools (3), blood in sputum (2), hematuria (2), serosanguineous nasal discharge (2), petechiae on hard palate (1), and bleeding gums (1).
4) Nine "pseudorecoveries" occurred between the day of admission and the 4th day. Relapses occurred between the 2nd and the 18th days. Four patients died, 2 had serious permanent personality change, and 3 recovered.


Source: Meigs, J.W. & Hughes, J.P.W. (1952) Acute carbon monoxide poisoning: An analysis of one hundred five cases. Arch. Industr. Hyg. & Occupat. Med., 6, 344-356.


....... Last changed 03/24/02


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