Pulmonary thromboembolism after carbon monoxide poisoning

Am J Emerg Med. 2018 Sep;36(9):1717.e3-1717.e7. doi: 10.1016/j.ajem.2018.05.063. Epub 2018 May 29.

Abstract

Objective: Carbon monoxide (CO) poisoning is known to increase thrombotic tendency, and the risk of deep vein thrombosis in individuals who have experienced CO poisoning is higher than in the general population. However, there are a few reports describing cases of pulmonary thromboembolisms (PTE) secondary to CO poisoning.

Data sources: Retrospective data analysis.

Study selection: Seven hundred fifty bed tertiary university affiliated hospital.

Data extraction and synthesis: Five patients with PTE after CO poisoning were observed. Two patients experienced cardiac arrest; they were treated successfully with tissue plasminogen activators and targeted temperature management. Their cerebral performance scores at discharge were both 1. Three patients had PTE and were treated with anticoagulation.

Conclusions: To date, the causal relationship between PTE and CO poisoning is unclear. However, PTE should be considered in patients with CO poisoning as a differential diagnosis when unexplained hypoxemia or shock are observed. Further studies on the association between CO poisoning and PTE are warranted.

Keywords: Carbon monoxide poisoning; Pulmonary thromboembolism.

Publication types

  • Case Reports

MeSH terms

  • Carbon Monoxide Poisoning / complications*
  • Echocardiography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Embolism / etiology*
  • Tomography, X-Ray Computed
  • Young Adult