Biomarkers of Acute Toxicity by Carbon Monoxide in a Cohort Study of Patients in Argentina

ALICIA GRACIELA FALETTI; CARLOS FABIÁN DAMÍN; ANALÍA ELIZABETH CORTEZ

Honolulu, Hawaii

Congreso; 15th International Congress of Toxicology (IUTOX 2019); 2019

International Society of Toxicology

Carbon monoxide poisoning (CO) is preventable and avoidable. In our country, about 200 people die annually from CO poisoning. This work includes the study of patients with acute CO poisoning, their evolution and the search for new prognostic biomarkers. The most frequent source of exposures were boiler (80%) and water heater (20%). The main clinical manifestations were headache (28%), nausea (28%) and confusion (14%). About 70% of patients had blood carboxyhemoglobin levels (COHb) below 10%. Data were collected from the clinical records, including the Folstein minimental status exam (MMSE) and the Addenbrooke?s Cognitive Examination Revised (ACE-R) test, of patients who entered to the J. A. Fernández Hospital throughout 2016 and 2017. Peripheral blood samples were extracted from these patients to evaluate genetic damage, by the comet assay and expressedas Tail DNA%, before (preT) and after (postT) receiving the established treatment. Some of these patients (67%) received normobaric oxygen (NBO) therapy and the remaining patients (33%) received hyperbaric oxygen (HBO) therapy. Data are expressed as mean ± SEM and statistical analyzes were Student´s test or two way ANOVA with Bonferroni post-test. No significant differences were found between both groups (NBO: pretT 10±3, postT 6±1; HBO: prett 3.8±0.1, postt 6±1). We found two prediction models which had lineal regression between: i) COHb with gender, age, headache and syncope (R2 0.75, Raj 0.24); and ii) TailDNA% with gender, age, COHb (R2 0.67; Raj 0.4). The results obtained in the cognitive tests (n = 24) were the follow: ACE-R: mean = 83±8, average total score = 82.7; MMSE: average = 26.7. The most cognitive domains were memory, verbal fluences andlanguage. In conclusion: i) the most important prevention measures should be focused on home; ii) these tests seems to be appropriate to detect early cognitive disorders although it is could be to enlarge each domain to improve the evaluation; iii) the CO-induced damage was not reversed by any of the applied treatments. It is necessary to include more patients in the protocol.