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Rationale:
- CO binds with high affinity to hemoglobin, approximately 200 to 250 times more avidly than oxygen, to form HbCO and can be
measured by CO oximetry in either venous or arterial blood samples.
- Most hospitals and emergency departments have quick access to a CO oximeter and can determine the level of HbCO in minutes.
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Evidence:
- Simultaneous sampling of arterial and venous blood in CO-poisoned patients yields nearly identical results, as shown in a
series of 61 CO patients (29).
- Smoking tobacco elevates HbCO, with levels an average of 4% to 5%, compared to 0.7% in nonsmokers, as shown in a case series
of 520 patients (30).
- HbCO levels do not correlate with symptoms or neurologic outcomes as shown in a case series of 155 patients with CO poisoning
(31).
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Comments:
- Results are expressed as percent HbCO, with normal values being less than 3%.
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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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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
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PIER is copyrighted (c) 2009 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Carbon Monoxide Poisoning
> Diagnosis
