الفهرس 
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Abstract
Carbon monoxide poisoning occurs after enough inhalation of carbon monoxide which is a colorless, odorless and tasteless toxic gas so it is difficult to be detected. Carbon monoxide is a product of incomplete combustion of organic matter due to insufficient oxygen supply to enable complete oxidation to carbon dioxide.
Carbon monoxide poisoning is the most common cause of injury and death due to poisoning worldwide. Carbon monoxide combines with hemoglobin to produce COHB, which is ineffective for delivering oxygen to tissues. It also binds to other molecules such as myoglobin and mitochondrial cytochrome oxidase. Both the early and late complications of acute CO poisoning are responsible for its significant mortality rate
The main manifestations of acute carbon monoxide poisoning occur in the organ systems most dependent on oxygen, the central nervous system and the heart. Central nervous system manifestations include headache, tinnitus, dizziness, confusion, agitations, seizures, loss of consciousness, syncope, respiratory arrest and death while cardiac manifestations include tachycardia, palpitations, hypotension and cardiac dysrhythmias.
The aim of this study was to determine serum IMA levels in the prediction of acute neurological findings in patients with carbon monoxide exposure, and if there is a correlation between serum IMA levels and COHB levels and other acute neurological findings.
This study included 80 subjects (60 patients and 20 controls). The patients were 42 males and 18 females. These patients were diagnosed as acute CO poisoning (according to: history, clinical presentation at the time of admission, carboxyhemoglobin level, and improvement on oxygen therapy) at Minia University Hospital Poison Control Center during the period from November, 1st, 2016 to October, 31th, 2017.
Physical, neurological examinations and laboratory investigations including, renal and liver function tests, random blood sugar, serum electrolytes, arterial blood gases, ischemia-modified albumin and COHb levels were carried out to all the patients on admission and for healthy controls. In addition, IMA was carried out to all patients after 3 and 6 hour of admission.
The results of this study revealed that there were no statistically significant differences between acute carbon monoxide poisoning groups and the control group as regard the sociodemographic data except smoking. There were statistically significant differences between the studied groups as regards, the heart rate, respiratory rate, systolic, diastolic blood pressure, GCS, pH, HCO3-, ischemia-modified albumin(on admission, 3h and 6h after admission) and COHb levels.
It was found that ischemia-modified albumin level on admission can be a predictor of acute neurological findings. Also, it was found that the optimal cutoff point for IMA level on admission of > 15.66 ng/ml to predict acute neurological findings with CO intoxication.