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Rationale:
- Physicians must search for and be aware of concomitant illnesses to provide adequate treatment.
- Hemoglobin saturation obtained via pulse oximetry will not reflect the true oxygenation of the patient with CO poisoning.
- Pulse oximeters are unable to distinguish HbO2 from HbCO, and thus the result does not reflect true arterial oxygen saturation in CO poisoning; this is because the percent
saturation of hemoglobin obtained by pulse oximetry is a combination of both HbO2 and HbCO.
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Evidence:
- Acute CO poisoning can lead to myocardial ischemia and infarction, even in the setting of normal coronary arteries as seen
in this case report (26).
- A case series of 150 children with CO poisoning and smoke inhalation injury had significantly higher mortality than children
with only CO poisoning (27).
- Pulse oximetry overestimated arterial oxygen saturation in a case series of 30 CO-poisoned patients by an amount related to
HbCO (28).
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Comments:
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Jeffrey T. Chapman, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott.
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Carbon Monoxide Poisoning
> Diagnosis
