Hopp til hovedinnhold

Kullosforgiftning, akutt

Sist revidert:
Sist revidert av:


Definisjon:
Karbonmonoksid (CO) er en gass som binder seg lite reversibelt til hemoglobin og blokkerer for oksygentransport
Forekomst:
Sjelden forgiftning i Norge. Langt hyppigere er selvmord ved kullosforgiftning
Symptomer:
Frembyr svært variable og uspesifikke symptomer som hodepine, slapphet, kvalme, svimmelhet, tungpust, brystsmerter, økende forvirring og bevissthetstap
Funn:
Kliniske funn ved CO-forgiftning er vanligvis begrenset til endringer i mental status
Diagnostikk:
Måling av karbonmonoksidhemoglobin, arterielle blodgasser, EKG, ev. infarktmarkører og generelle blodprøver inngår i diagnostikken
Behandling:
Fjerne pasienten fra CO-kilden og gi 100% oksygen. Hyperbar oksygen kan bli aktuelt på sykehus
  1. Clardy PF, Manaker S, Perry H. Carbon monoxide poisoning. UpToDate, last updated Feb 23, 2017. UpToDate  
  2. Engtrø F, Haugen O. Dødelige kullosforgiftninger. Tidsskr Nor Lægeforen 2003; 123: 1081-3. PubMed  
  3. Shochat G. Carbon Monoxide Toxicity. Medscape, last updated Dec 28, 2016. emedicine.medscape.com  
  4. Giftinformasjonen. Karbonmonoksid - behandlingsanbefaling ved forgiftning. Helsebiblioteket.no. Sist oppdatert 19.02.2019. www.helsebiblioteket.no  
  5. Rose JJ, Wang L, Xu Q, et al. Carbon Monoxide Poisoning: Pathogenesis, Management, and Future Directions of Therapy. Am J Respir Crit Care Med 2017; 195:596. PubMed  
  6. Unintentional non-fire-related carbon monoxide exposures--United States, 2001-2003. MMWR Morb Mortal Wkly Rep 2005; 54: 36. PubMed  
  7. Hampson NB, Piantadosi CA, Thom SR, Weaver LK. Practice recommendations in the diagnosis, management, and prevention of carbon monoxide poisoning. Am J Respir Crit Care Med. 2012 Dec 1. 186 (11):1095-101.
  8. Wolf SJ, Lavonas EJ, Sloan EP, Jagoda AS. Clinical policy: Critical issues in the management of adult patients presenting to the emergency department with acute carbon monoxide poisoning. Ann Emerg Med 2008; 51: 138-52. PubMed  
  9. Satran D, Henry CR, Adkinson C, et al. Cardiovascular manifestations of moderate to severe carbon monoxide poisoning. J Am Coll Cardiol 2005; 45: 1513. PubMed  
  10. Henry CR, Satran D, Lindgren B, et al. Myocardial injury and long-term mortality following moderate to severe carbon monoxide poisoning. JAMA 2006; 295: 398. Journal of the American Medical Association  
  11. Thom SR, Bhopale VM, Fisher D, et al. Delayed neuropathology after carbon monoxide poisoning is immune-mediated. Proc Natl Acad Sci U S A 2004; 101:13660. PubMed  
  12. Harper A, Croft-Baker J. Carbon monoxide poisoning: undetected by both patients and their doctors. Age Ageing 2004; 33: 105. PubMed  
  13. Kao LW, Nanagas KA. Carbon monoxide poisoning. Emerg Med Clin North Am 2004; 22: 985. PubMed  
  14. Helms AK, Whelan HT, Torbey MT. Hyperbaric oxygen therapy of cerebral ischemia. Cerebrovasc Dis 2005; 20: 417-26. PubMed  
  15. Buckley NA, Juurlink DN, Isbister G, Bennett MH, Lavonas EJ. Hyperbaric oxygen for carbon monoxide poisoning. Cochrane Database of Systematic Reviews 2011, Issue 4. Art. No.: CD002041. DOI: 10.1002/14651858.CD002041.pub3. DOI  
  16. Hampson, NB, Scott, KL, Zmaeff, JL. Carboxyhemoglobin measurement by hospitals: Implications for the diagnosis of carbon monoxide poisoning. J Emerg Med 2006; 31: 13. PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim