title: Is elevated plasma lactate a useful marker in the evaluation of pure carbon monoxide poisoning?
abstract: 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.
authors.affiliation: Réanimation Médicale et Toxicologique, Hôpital Lariboisière, Université Paris VII-INSERM U26, 2 rue Ambroise Paré, 5010, Paris, France.
authors.forename: M Lamine
authors.initials: ML
authors.lastname: Benaissa
authors.forename: Bruno
authors.initials: B
authors.lastname: Mégarbane
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Borron
authors.forename: Frédéric J
authors.initials: FJ
authors.lastname: Baud
mesh_terms: 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
chemical_list: D015415:Biomarkers; D019344:Lactic Acid