Carbon monoxide intoxication.
Am Fam Phys 1993 Nov; 48(6):1100-1104
This review of carbon-monoxide intoxication discussed the sources of carbon-monoxide, pathophysiology following inhalation of carbon-monoxide, clinical presentation of carbon-monoxide intoxication, laboratory tests needed for diagnosis, and management of patients suffering from exposure. Common sources of acute and chronic carbon-monoxide exposure included motor vehicle exhaust fumes, smoke from fires, and fumes from malfunctioning or poorly ventilated heating systems. Inhaled carbon-monoxide rapidly diffuses across the alveolar capillary membranes into the bloodstream, where reversible binding with hemoglobin occurs and carboxyhemoglobin is formed. The amount of uptake depends on the duration of exposure, the concentrations of carbon-monoxide and oxygen in the inspired air, and the ventilatory rate. The fetus is particularly vulnerable to carbon-monoxide intoxication. Symptoms of intoxication include headache, dizziness, weakness, fatigue, nausea, and difficulty thinking. In more severe cases tachycardia, tachypnea and changes in mental status occur. Carboxyhemoglobin levels can be measured in either arterial or venous blood. Serial blood gas determinations may be needed to follow the acid/base status. Lactic acidosis may result and higher lactate levels are associated with more severe carbon-monoxide poisoning in some patients. For management of the condition, the patient must be removed from the source of carbon-monoxide exposure. Normobaric 100% oxygen is the fundamental therapy. Fire victims require special consideration as smoke inhalation is a complex injury that can involve carbon-monoxide, cyanide and other toxic gases as well as thermal injury.
NIOSH-Publication; NIOSH-Grant; Training; Toxic-gases; Indoor-air-pollution; Combustion-products; Blood-analysis; Smoke-inhalation; Inhalation-studies; Diagnostic-techniques; First-aid; Medical-treatment; Indoor-environmental-quality
Environmental Science and Physiology Department, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115
American Family Physician
Harvard University, Boston, Massachusetts