ECG intervals on acute carbon monoxide poisoning

Objective: To evaluate the usability of electrocardiography (ECG) intervals in the diagnosis and treatment monitoring of acute carbon monoxide (CO) poisoning. Study Design: An observational study. Place and Duration of Study: Department of Emergency Medicine, Kayseri City Hospital, Turkey, from November 2018 to May 2019. Methodology: Each of 80 patients for study and control groups were prospectively included. For study group, pre- and posttreatment ECG intervals (P-wave and QRS complex periods, PP, PR, RR, QT, and QTc intervals) and carboxyhemoglobin (COHb) levels of the patients were evaluated. For control group, ECG intervals and COHb levels of the patients during admission to the Emergency Department were evaluated. Results: As a result of the statistical analysis in which measurements of the study group and control group were compared, a statistically significant difference was found in the following values: pre-treatment group COHb level (p<0.001), PR interval (p=0.046), PP interval (p<0.001), QT interval (p<0.001), QTC interval (p=0.016), RR interval (p<0.001), and post-treatment group COHb level (p<0.001), PR interval (p=0.009), PP interval (p=0.041), QTC interval (p=0.010), and RR interval (p=0.036). QT interval values in the post-treatment group were similar to those of the control group (p=0.342). In the ROC analysis where the diagnostic performance of ECG intervals was evaluated, the area under the curve (AUC) scale was between 0.29 and 0.62. Conclusion: ECG intervals do not provide as much benefit as COHb measurement in the diagnosis of acute CO poisoning. However, the QT interval is a useful ECG interval in the treatment monitoring of acute CO poisoning. (author)