Skip to main content
Top
Gepubliceerd in: Tijdschrift voor Gerontologie en Geriatrie 5/2015

17-06-2015 | Klinische les

Laattijdige neuropsychologisch syndroom na CO-intoxicatie bij een bejaarde vrouw

Auteurs: Liesbeth Vander Weyden, Roxana-Maria Voigt, Steven Boonen, Katleen Fagard, Eddy Dejaeger

Gepubliceerd in: Tijdschrift voor Gerontologie en Geriatrie | Uitgave 5/2015

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Samenvatting

Dit artikel beschrijft de ziektegeschiedenis van een 87-jarige vrouw met bewustzijnsverlies na accidentele CO-intoxicatie. Enkele weken nadien ontstaat er een progressieve cognitieve achteruitgang bij de patiënte. Het gaat hier om een geval van laattijdige neuropsychologische symptomen na CO-intoxicatie (Delayed Neurological Symptoms, DNS). Dit komt voor bij 40 % van de patiënten met CO-intoxicatie en treedt op drie tot 240 dagen na schijnbaar herstel. De afwijkingen kunnen langdurig aanhouden en in sommige gevallen zelfs permanent aanwezig blijven. De behandeling van CO-intoxicatie bestaat meestal uit toediening van normobare zuurstof en eventueel hyperbare zuurstof in specifieke gevallen. De rol van behandeling met hyperbare zuurstof in voorkomen van laattijdige neuropsychologische symptomen bij CO-intoxicatie is omstreden.
Literatuur
1.
go back to reference Doodsoorzakenstatistiek 2007–2011, Centraal Bureau voor de Statistiek; Landelijke Medische Registratie 2007–2011, Dutch Hospital Data; Letsel Informatie Systeem 2007–2011, VeiligheidNL; Letsellastmodel 2011, VeiligheidNL i.s.m. Erasmus Medisch Centrum; Bevolkingsstatistiek 2007–2012, Centraal Bureau voor de Statistiek. Doodsoorzakenstatistiek 2007–2011, Centraal Bureau voor de Statistiek; Landelijke Medische Registratie 2007–2011, Dutch Hospital Data; Letsel Informatie Systeem 2007–2011, VeiligheidNL; Letsellastmodel 2011, VeiligheidNL i.s.m. Erasmus Medisch Centrum; Bevolkingsstatistiek 2007–2012, Centraal Bureau voor de Statistiek.
4.
go back to reference Centers for Disease Control and Prevention (CDC). Unintentional non-fire-related carbon monoxide exposures—United States, 2001–2003. MMWR Morb Mortal Wkly Rep. 2005;54:36. Centers for Disease Control and Prevention (CDC). Unintentional non-fire-related carbon monoxide exposures—United States, 2001–2003. MMWR Morb Mortal Wkly Rep. 2005;54:36.
5.
go back to reference Hardy KR, Thom SR. Pathophysiology and treatment of carbon monoxide poisoning. J Toxicol Clin Toxicol. 1994;32:613.CrossRefPubMed Hardy KR, Thom SR. Pathophysiology and treatment of carbon monoxide poisoning. J Toxicol Clin Toxicol. 1994;32:613.CrossRefPubMed
6.
go back to reference Hampson NB, Hauff NM. Risk factors for short-term mortality from carbon monoxide poisoning treated with hyperbaric oxygen. Crit Care Med. 2008;36:2523.CrossRefPubMed Hampson NB, Hauff NM. Risk factors for short-term mortality from carbon monoxide poisoning treated with hyperbaric oxygen. Crit Care Med. 2008;36:2523.CrossRefPubMed
7.
go back to reference Tritapepe L, Macchiarelli G, Rocco M, et al. Functional and ultrastructural evidence of myocardial stunning after acute carbon monoxide poisoning. Crit Care Med. 1998;26:797.CrossRefPubMed Tritapepe L, Macchiarelli G, Rocco M, et al. Functional and ultrastructural evidence of myocardial stunning after acute carbon monoxide poisoning. Crit Care Med. 1998;26:797.CrossRefPubMed
8.
go back to reference 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.PubMedCentralCrossRefPubMed 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.PubMedCentralCrossRefPubMed
9.
go back to reference Goldbaum LR, Ramirez RG, Absalon KB. What is the mechanism of carbon monoxide toxicity? Aviat Space Environ Med. 1975;46:1289.PubMed Goldbaum LR, Ramirez RG, Absalon KB. What is the mechanism of carbon monoxide toxicity? Aviat Space Environ Med. 1975;46:1289.PubMed
11.
go back to reference Thom SR. Carbon monoxide-mediated brain lipid peroxidation in the rat. J Appl Physiol. 1990;68:997.PubMed Thom SR. Carbon monoxide-mediated brain lipid peroxidation in the rat. J Appl Physiol. 1990;68:997.PubMed
12.
go back to reference Thom SR, Xu YA, Ischiropoulos H. Vascular endothelial cells generate peroxynitrite in response to carbon monoxide exposure. Chem Res Toxicol. 1997;10:1023.CrossRefPubMed Thom SR, Xu YA, Ischiropoulos H. Vascular endothelial cells generate peroxynitrite in response to carbon monoxide exposure. Chem Res Toxicol. 1997;10:1023.CrossRefPubMed
13.
go back to reference Harper A, Croft-Baker J. Carbon monoxide poisoning: undetected by both patients and their doctors. Age Ageing. 2004;33:105.CrossRefPubMed Harper A, Croft-Baker J. Carbon monoxide poisoning: undetected by both patients and their doctors. Age Ageing. 2004;33:105.CrossRefPubMed
15.
go back to reference Seger D, Welch L. Carbon monoxide controversies: neuropsychologic testing, mechanism of toxicity, and hyperbaric oxygen. Ann Emerg Med. 1994;24:242.CrossRefPubMed Seger D, Welch L. Carbon monoxide controversies: neuropsychologic testing, mechanism of toxicity, and hyperbaric oxygen. Ann Emerg Med. 1994;24:242.CrossRefPubMed
16.
go back to reference Pont A de. [The guideline ‘Treatment of acute carbon-monoxide poisoning’ from doctors in clinics with a tank for hyperbaric ventilation]. Ned Tijdschr Geneeskd. 2006;150:665–9. Pont A de. [The guideline ‘Treatment of acute carbon-monoxide poisoning’ from doctors in clinics with a tank for hyperbaric ventilation]. Ned Tijdschr Geneeskd. 2006;150:665–9.
17.
go back to reference Bozeman WP, Myers RA, Barish RA. Confirmation of the pulse oximetry gap in carbon monoxide poisoning. Ann Emerg Med. 1997;30:608.CrossRefPubMed Bozeman WP, Myers RA, Barish RA. Confirmation of the pulse oximetry gap in carbon monoxide poisoning. Ann Emerg Med. 1997;30:608.CrossRefPubMed
19.
go back to reference Satran D, Henry CR, Adkinson C, et al. Cardiovascular manifestations of moderate to severe carbon monoxide poisoning. J Am Coll Cardiol. 2005;45:1513.CrossRefPubMed Satran D, Henry CR, Adkinson C, et al. Cardiovascular manifestations of moderate to severe carbon monoxide poisoning. J Am Coll Cardiol. 2005;45:1513.CrossRefPubMed
20.
go back to reference Finelli PF, DiMario FJ Jr. Hemorrhagic infarction in white matter following acute carbon monoxide poisoning. Neurology. 2004;63:1102.CrossRefPubMed Finelli PF, DiMario FJ Jr. Hemorrhagic infarction in white matter following acute carbon monoxide poisoning. Neurology. 2004;63:1102.CrossRefPubMed
21.
22.
go back to reference Zagami AS, Lethlean AK, Mellick R. Delayed neurological deterioration following carbon monoxide poisoning: MRI findings. J Neurol. 1993;240:113.CrossRefPubMed Zagami AS, Lethlean AK, Mellick R. Delayed neurological deterioration following carbon monoxide poisoning: MRI findings. J Neurol. 1993;240:113.CrossRefPubMed
23.
go back to reference Teksam M, Casey SO, Michel E, et al. Diffusion-weighted MR imaging findings in carbon monoxide poisoning. Neuroradiology. 2002;44:109.CrossRefPubMed Teksam M, Casey SO, Michel E, et al. Diffusion-weighted MR imaging findings in carbon monoxide poisoning. Neuroradiology. 2002;44:109.CrossRefPubMed
24.
go back to reference Kim JH, Chang KH, Song IC, et al. Delayed encephalopathy of acute carbon monoxide intoxication: diffusivity of cerebral white matter lesions. AJNR Am J Neuroradiol. 2003;24:1592.PubMed Kim JH, Chang KH, Song IC, et al. Delayed encephalopathy of acute carbon monoxide intoxication: diffusivity of cerebral white matter lesions. AJNR Am J Neuroradiol. 2003;24:1592.PubMed
25.
go back to reference Chu K, Jung KH, Kim HJ, et al. Diffusion-weighted MRI and 99mTc-HMPAO SPECT in delayed relapsing type of carbon monoxide poisoning: evidence of delayed cytotoxic edema. Eur Neurol. 2004;51:98.CrossRefPubMed Chu K, Jung KH, Kim HJ, et al. Diffusion-weighted MRI and 99mTc-HMPAO SPECT in delayed relapsing type of carbon monoxide poisoning: evidence of delayed cytotoxic edema. Eur Neurol. 2004;51:98.CrossRefPubMed
26.
go back to reference Wolf SJ, Lavonas EJ, Sloan EP, Jagoda AS; American College of Emergency Physicians. 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(2):138–52.CrossRefPubMed Wolf SJ, Lavonas EJ, Sloan EP, Jagoda AS; American College of Emergency Physicians. 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(2):138–52.CrossRefPubMed
27.
go back to reference Ziser A, Shupak A, Halpern P, et al. Delayed hyperbaric oxygen treatment for acute carbon monoxide poisoning. Br Med J. (Clin Res Ed). 1984;289:960.CrossRef Ziser A, Shupak A, Halpern P, et al. Delayed hyperbaric oxygen treatment for acute carbon monoxide poisoning. Br Med J. (Clin Res Ed). 1984;289:960.CrossRef
28.
go back to reference Weaver LK, Hopkins RO, Chan KJ, et al. Hyperbaric oxygen for acute carbon monoxide poisoning. N Engl J Med. 2002;347:1057.CrossRefPubMed Weaver LK, Hopkins RO, Chan KJ, et al. Hyperbaric oxygen for acute carbon monoxide poisoning. N Engl J Med. 2002;347:1057.CrossRefPubMed
29.
go back to reference Scheinkestel CD, Bailey M, Myles PS, et al. Hyperbaric or normobaric oxygen for acute carbon monoxide poisoning: a randomised controlled clinical trial. Med J Aust. 1999;170:203.PubMed Scheinkestel CD, Bailey M, Myles PS, et al. Hyperbaric or normobaric oxygen for acute carbon monoxide poisoning: a randomised controlled clinical trial. Med J Aust. 1999;170:203.PubMed
30.
go back to reference Annane D, Chadda K, Gajdos P, et al. Hyperbaric oxygen therapy for acute domestic carbon monoxide poisoning: two randomized controlled trials. Intensive Care Med. 2011;37:486.CrossRefPubMed Annane D, Chadda K, Gajdos P, et al. Hyperbaric oxygen therapy for acute domestic carbon monoxide poisoning: two randomized controlled trials. Intensive Care Med. 2011;37:486.CrossRefPubMed
31.
go back to reference Buckley NA, Juurlink DN, Isbister G, et al. Hyperbaric oxygen for carbon monoxide poisoning. Cochrane Database Syst Rev. 2011:CD002041. Buckley NA, Juurlink DN, Isbister G, et al. Hyperbaric oxygen for carbon monoxide poisoning. Cochrane Database Syst Rev. 2011:CD002041.
Metagegevens
Titel
Laattijdige neuropsychologisch syndroom na CO-intoxicatie bij een bejaarde vrouw
Auteurs
Liesbeth Vander Weyden
Roxana-Maria Voigt
Steven Boonen
Katleen Fagard
Eddy Dejaeger
Publicatiedatum
17-06-2015
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Tijdschrift voor Gerontologie en Geriatrie / Uitgave 5/2015
Print ISSN: 0167-9228
Elektronisch ISSN: 1875-6832
DOI
https://doi.org/10.1007/s12439-015-0143-3

Andere artikelen Uitgave 5/2015

Tijdschrift voor Gerontologie en Geriatrie 5/2015 Naar de uitgave

Recente onderzoeksliteratuur

Optimale leerschema’s bij dementie

Congresagenda

Congresagenda