Is elevated plasma lactate a useful marker in the evaluation of pure carbon monoxide poisoning?
OBJECTIVE
To examine whether CO poisoning induces a significant increase in plasma lactate concentration.


METHODS
Prospective observational clinical study in the emergency department and intensive care unit in a university-affiliated teaching hospital.


METHODS
146 pure CO poisonings resulting from dysfunction of gas cookers or water heaters.


RESULTS
Patients were classified into four neurological impairment groups: 37% were severely, 8% moderately, and 45% mildly intoxicated, while 1% were asymptomatic. We found only very mild increases in plasma lactate concentration (median 2.30 mmol/l) which, however, was significantly correlated with the severity of neurological impairment and blood CO concentration (1.41 mmol/l, Spearman's test r=0.3).


CONCLUSIONS
Plasma lactate is mildly elevated in pure CO-exposed patients. This mild increase and the extensive overlap between the groups of neurological impairment severity do not suggest the usefulness of systematic plasma lactate measurement in pure CO poisoning.
Benaissa
M Lamine
ML
Réanimation Médicale et Toxicologique, Hôpital Lariboisière, Université Paris VII-INSERM U26, 2 rue Ambroise Paré, 5010, Paris, France.
Mégarbane
Bruno
B
Borron
Stephen W
SW
Baud
Frédéric J
FJ
D000328:Adult; D015415:Biomarkers; D002249:Carbon Monoxide Poisoning / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D011446:Prospective Studies
D015415:Biomarkers; D019344:Lactic Acid