Короткий опис (реферат):
A 70-year-old male, weighing approximately 100 kg, was admitted to the ICU for suspected carbon monoxide (CO) poisoning during his birthday celebration preparations in a newly built home. Found unconscious with his
wife in their bedroom, he presented with retrograde amnesia (recalling only it was his birthday), pale skin, respiratory rate of 20 breaths/min, SpO2 of 86%, pulse of 82 beats/min, and blood pressure of 135/85 mmHg. The incident was linked to a new gas heating system, potentially compromised by a 4–5 magnitude earthquake a week prior, disrupting ventilation. Friends, arriving as guests with a chef, waiter, cleaner,
and security guard, discovered the unconscious couple. An anesthesiologist friend, contacted immediately, suggested CO poisoning and advised evacuation to fresh air. No odors or combustion signs were noted. The wife regained consciousness outside (by the time the ambulance arrived approximately 30 minutes later), reporting sudden sleepiness, and declined hospitalization. The patient, conscious after a 15-minute
hospital transport, received oxygen therapy (4-6 l/min, achieving SpO2 98–100% initially, in three hours 96–98% without supplementation) in the ICU for one day. A peripheral venous catheter was inserted, and no additional medications or toxicological tests were needed, as CO poisoning was diagnosed via clinical findings
and a portable CO detector confirming CO presence. The diagnosis was based on clinical findings (unconsciousness, amnesia, low SpO2) and environmental evidence (CO detection in the bedroom), without confirmatory COHb testing. He was discharged the next day in satisfactory condition, and the banquet proceeded. This case highlights carbon monoxide poisoning’s insidious nature, with symptoms like
amnesia and unconsciousness. Rapid evacuation and oxygen therapy ensured recovery. The environmental trigger emphasizes the need for heating system maintenance, especially post-seismic events. Portable CO detectors aided diagnosis. Due to successful differential diagnostic and rapid recovery, there was no necessity in laboratory carboxyhemoglobin testing in the hospital. Public education and CO detector installation are critical for prevention. Long-term neurological follow-up is recommended for potential sequelae. Clinicians and policymakers should prioritize accessible diagnostic tools, such as carboxyhemoglobin (COHb) testing, and
advocate for preventive measures to enhance safety in residential settings, ensuring comprehensive care for carbon monoxide poisoning victims.
