title: Symptoms of carbon monoxide poisoning do not correlate with the initial carboxyhemoglobin level.
abstract: BACKGROUND
  Symptoms in carbon monoxide (CO) poisoned patients have traditionally been described as being related to corresponding carboxyhemoglobin (COHb) levels without substantive support for the relationship. This study sought to determine whether prospectively collected symptoms correlate with specific COHB level ranges in a large population of CO-poisoned patients.
  
  
  METHODS
  Data from patients reported in the initial two years of operation of the joint UHMS/CDC CO Poisoning Surveillance System were used to compare presenting COHb levels with symptoms collected with a standardized questionnaire.
  
  
  RESULTS
  Data from 1,323 CO-poisoned patients referred for hyperbaric oxygen therapy from August 2008 to July 2010 were analyzed with regard to initial COHb level and symptoms. Of approximately 50 categories of symptoms reported, none was associated with a specific range of COHb levels.
  
  
  CONCLUSIONS
  While symptoms are common in acute CO poisoning, none can be directly correlated to COHb levels, even in a population of more than 1,000 patients. The concept of a table relating specific symptoms to specific COHb levels is invalid. One such table that has often been published comes from a 1923 U.S. government publication and appears to be based at least in part upon the symptoms experienced by three men in a total of 10 low-level laboratory CO exposures.
authors.affiliation: Center for Hyperbaric Medicine, Virginia Mason Medical Center, Seattle, Washington, USA. neil.hampson@vmmc.org
authors.forename: Neil B
authors.initials: NB
authors.lastname: Hampson
authors.forename: Susan L
authors.initials: SL
authors.lastname: Dunn
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002249:Carbon Monoxide Poisoning / Q000097:blood* / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D002263:Carboxyhemoglobin / Q000032:analysis*; D002487:Centers for Disease Control and Prevention, U.S.; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000706:statistics & numerical data; D008297:Male; D011159:Population Surveillance; D011446:Prospective Studies; D012016:Reference Values; D012955:Societies, Medical; D014481:United States
chemical_list: D015415:Biomarkers; D002263:Carboxyhemoglobin