Outcome Following Carbon Monoxide Poisoning in Children
Outcome Following Carbon Monoxide Poisoning in Children
Carbon monoxide poisoning is common. Many adults with CO poisoning have long-term, even
 permanent brain injury following poisoning. However, very little is known about the long-term
 outcome of children with carbon monoxide (CO) poisoning. In this study we plan to perform
 cognitive (thinking) and vestibular (balance) testing in children (ages 6 to 16)at 6 weeks
 and 6 months following CO poisoning.

 At the 6-week visit, if the child and parents agree, we will ask each child to provide a DNA
 sample by one of three methods: mouthwash, spit collection, or swabbing the inside of the
 child's cheek. Each child's DNA will be analyzed for genes that are known to affect outcome
 following brain injury.
Each child's participation in this study is expected to last 6 months. Testing will be
 scheduled around 6 weeks after the carbon monoxide (CO) poisoning episode. During testing,
 each child will be asked to complete tests that measure cognitive (thinking), emotional, and
 behavioral performance. We will collect information from each child's medical record about
 the CO poisoning episode, and we will have a parent complete a questionnaire about any
 problems he or she may have observed in their child since the poisoning. The cognitive
 testing will take about 3.5 hours at the 6-week interval, and 2.5 hours at the 6-month
 interval.

 Around the same time, each child will also be scheduled for vestibular (balance) testing at
 the Intermountain Hearing and Balance Center. Vestibular testing will occur twice, at 6-weeks
 and 6-months following poisoning.

 At the 6-week visit, if the child and parents agree, we will ask each child to provide a DNA
 sample by one of three methods: mouthwash, spit collection, or swabbing the inside of the
 child's cheek. Each child's DNA will be analyzed for genes that are known to affect outcome
 following brain injury such as apolipoprotein E, and the sample will also be stored for an
 indefinite period of time. If discoveries are made about other genes that affect outcome
 following brain injury, each child's DNA will be analyzed for those genes as well.

 The primary outcome measure will be the percentage of patients with cognitive sequelae
 (thinking complications or results) at 6 weeks and 6 months following CO poisoning.

 Secondarily, we will also determine:

 1. Which individual neurocognitive (thinking) outcomes at 6 weeks and 6 months differ from
 normative data.

 2. Whether there is a difference in neurocognitive (thinking) outcomes between measurement
 at 6 weeks and 6 months.

 3. If there is a difference in the vestibular (balance) health of patients between
 measurements at 6 weeks and 6 months.
Inclusion Criteria:

 1. Age 6 through 16.

 2. Acute carbon monoxide poisoning. Since we will be identifying potentially eligible
 patients using an electronic tool, the diagnosis of CO poisoning should be established
 by the evaluating physician. However, with the initial contact with the patients'
 parents, we will confirm the diagnosis, and only those patients with CO poisoning will
 be eligible.

 3. Willing to come to Salt Lake City or Provo for evaluation

 Exclusion Criteria:

 1. Prior history of neurological injury with permanent sequelae.

 2. Prior history of chronic neurological disorder such as attention deficit disorder,
 learning disability, multiple sclerosis, cerebral palsy, demyelinating disease,
 meningitis with sequelae

 3. Insulin dependent diabetes (due to the confound of possible brain microvascular
 disease and episodes of hypoglycemia)

 4. Use of illicit drugs

 5. Use of alcohol in excess

 6. Pregnancy

 7. Carbon monoxide poisoning from a suicide attempt or concomitant smoke inhalation

 8. Subject or parent/guardian non-English-speaking