Carbon monoxide intoxication: an updated review.
Carbon monoxide (CO), a highly toxic gas produced by incomplete combustion of hydrocarbons, is a relatively common cause of human injury. Human toxicity is often overlooked because CO is tasteless and odorless and its clinical symptoms and signs are non specific. The brain and the heart may be severely affected after CO exposure with carboxyhemoglobin (COHb) levels exceeding 20%. Damage occurs because the affinity of hemoglobin for CO is 210 times higher than for O(2). Hypoxic brain damage predominates in the cerebral cortex, cerebral white matter and basal ganglia, especially in the globus pallidus. Diagnosis requires clinical acumen and a high index of suspicion, combined with epidemiological data, clinical examination, analysis of ambient air CO and patient COHb levels; also required are cardiology evaluation including ECG as well as neurological evaluation including brain imaging (CT and/or MRI, MR spectroscopy), and neuropsychological testing. Although immediate O(2) breathing is sometimes an adequate treatment, hyperbaric oxygen therapy (HBO) is favored. Subsequently, only symptomatic therapy is available for the long-term sequelae of CO poisoning.
Prockop
Leon D
LD
Department of Neurology, College of Medicine, University of South Florida, FL, USA. lprockop@health.usf.edu
Chichkova
Rossitza I
RI
D000393:Air Pollutants / Q000633:toxicity*; D001921:Brain / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D002248:Carbon Monoxide / Q000633:toxicity*; D002249:Carbon Monoxide Poisoning / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D006321:Heart / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000592:standards; D002534:Hypoxia, Brain / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D017202:Myocardial Ischemia / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D009410:Nerve Degeneration / Q000139:chemically induced / Q000473:pathology / Q000503:physiopathology
D000393:Air Pollutants; D002248:Carbon Monoxide