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Rationale:
- CO is eliminated from the body via exhalation.
- Once removed from the CO source patients will slowly eliminate CO, as it dissociates from heme or cytochrome and moves down
its concentration gradient and into exhaled gas; this can be measured in parts per billion.
- Importantly, recent cigarette smoking will elevate exhaled CO, and positive results only indicate the need for HbCO testing
if symptoms exist.
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Evidence:
- An observational case series showed that prehospital personnel are able to accurately measure exhaled CO, which correlates
with HbCO and poisoning severity (32).
- Case reports describe where exhaled CO has been used as a substitute for diagnosis at the site of exposure (33) and in rural areas where HbCO determination is not immediately available (34).
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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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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
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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
