Ischemia-modified albumin levels in carbon monoxide poisoning.
OBJECTIVE
Ischemia-modified albumin (IMA) is an emerging diagnostic biomarker for many ischemic conditions. This study was conducted to investigate whether there is a change in IMA levels in carbon monoxide (CO) poisoning and, if so, the clinical relevance of IMA levels.


METHODS
This cohort study, performed between November 2008 and April 2009, compared the serum IMA levels of 33 CO-poisoned patients taken at the time of presentation at the emergency department and after 3 hours of treatment and 49 healthy controls. In addition, IMA and carboxyhemoglobin levels were analyzed according to CO poisoning patients' poisoning severity scores.


RESULTS
Carbon monoxide patients' IMA levels were higher than those of the control group both at time of admission and at the third hour of the treatment, P < .0001. A significant fall was determined in carboxyhemoglobin (CO-Hb) levels at the end of the third hour of treatment, P < .0001. However, there was no significant difference between the IMA levels measured at admission and at the end of the third hour of treatment (P > .05). There was no significant correlation between IMA and CO-Hb levels in CO-poisoned patients. Also, there was no difference in blood IMA levels in classification according to patients' poisoning severity score and CO-Hb levels.


CONCLUSIONS
Results from this pioneering study established a high level of IMA in CO-poisoned patients, suggesting that IMA may also be sensitive to hypoxia. Considering the preliminary nature of this study, the clinical utility of IMA levels in CO poisoning should be further investigated with more comprehensive studies.
Turedi
Suleyman
S
Department of Emergency Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey. suleymanturedi@hotmail.com
Cinar
Orhan
O
Kaldirim
Umit
U
Mentese
Ahmet
A
Tatli
Ozgur
O
Cevik
Erdem
E
Tuncer
Salim Kemal
SK
Gunduz
Abdulkadir
A
Yamanel
Levent
L
Karahan
Suleyman Caner
SC
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002249:Carbon Monoxide Poisoning / Q000097:blood* / Q000628:therapy; D016022:Case-Control Studies; D004562:Electrocardiography; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007511:Ischemia / Q000097:blood*; D008297:Male; D010102:Oxygen Inhalation Therapy; D012709:Serum Albumin / Q000032:analysis*; D016896:Treatment Outcome
D015415:Biomarkers; D012709:Serum Albumin