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Disease Control and Prevention) 1968 1998 116,703 70.6% 29%

94 8 22 65 154

1

1

3 ( )

93 327 353 74 ppm 10

( ) 1979 1990 1500 500 (The centers for

1 2 3 Carbon monoxide poisoning Hyperbaric oxygen

(propane)

(methylene chloride)

(

)

302

(oxyhemoglobin)

(

)

(Reoxygenation) (Hyperoxygenation)

Louise W. Kao and Kristine A. Nanagas, 2004

<1% (Reperfusion injury)

Hemoglobin O 2 Saturation(%)

0% Carboxyhemoglobin 60% Carboxyhemoglobin

10-15% (myoglobin) (cytochrome) cyclase 1% 200250 quanylyl

PO 2 (mmHg)

(Ernst and Zibrak. 1998)

303

(Peroxygenation) (Demyelinization)

(cyanosis)

%

91 77 53 47 43 40 25 9 6 5 5 (Ernst and Zibrak. 1998) ( Kao and Nanagas, 2004)

304

DNS (myelin basic protein , MBP )

3 240

(Delayed Neurological Syndrome, DNS) 10-30% DNS

(nystagmus) blindness) DNS 1. nosis) 2.

(cortical Disease with a Thousand face

(misdiag-

3.

(delayed therapy)

DNS (NO) 2004

305

(spectrophotometer)

CONSB(Carbon Monoxide Neuropsychological Screening Battery) 6 >20% (CT) (low-density lesions) (MRI)

(diffuse symmetric white matter lesions) (MRI) (CT)

(FiO2) 4-6 100% 40-80 100% 1530 1962 : 1. 2. 3. 4. 5. 6. 1895 Haldaney

306

1. 2. 3. 4. 5. 6. 7. 8. 9.

(

(coma) CONSB(Carbon Monoxide Neuropsychological Screening Battery) 40% 15% 20% 3 4-6

Ernst & Zibrak. 1998)

(coma)

(Occupation Safe and Health Administration) TWA 200ppm 35ppm STEL

1. Ernst A. Zibrak JD. Carbon monoxide poisoning. NEJM 1998;339:1603-8. 2. Kao LW, Nanagas KA :Carbon monoxide poisoning. Emerg Med Clin North Am. 2004; 22: 985-1018. 3. Cobb N. Etzel RA. Unintentional carbon monoxide-related deaths in the United States, 1979 through 1988. JAMA 1991;266:659-63. 4. Fish J. Carbon monoxide poisoning: a disease of a thousand faces. Chest 1999;115:322-32.

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