title: Correlation between clinical severity and different non-invasive measurements of carbon monoxide concentration: A population study.
abstract: OBJECTIVE
  Carbon monoxide (CO) poisoning is a major concern in industrialized countries. Each year, thousands of victims, resulting in approximately 100 fatalities, are encountered in France. The diagnosis of CO poisoning is challenging; while carboxyhemoglobin (COHb) may be useful, it is a weak indicator of the severity of CO poisoning. This weak indicator may be a result of the delay between poisoning occurrence and the blood assay. Two apparatuses, CO oximeters and exhaled CO analyzers, now permit COHb to be determined outside hospitals. Our hypothesis is that these instruments allow the early measurement of COHb concentrations, which are more correlated with the severity of poisoning, expressed using the poisoning severity score (PSS).
  
  
  METHODS
  In an observational and retrospective cohort study, the distribution of COHb measurements obtained by CO oximetry or by exhaled CO analyzers was compared between groups of severity expressed using the PSS.
  
  
  METHODS
  Data were collected in the Paris area from January 2006 to December 2010 by the French Surveillance System of CO poisoning.
  
  
  METHODS
  All patients with CO poisoning reported to the French Surveillance System of CO poisoning.
  
  
  RESULTS
  There was a significant difference in the COHb values obtained by CO oximetry between groups stratified according to PSS (p<0.0001). A significant difference in the values of exhaled CO was also observed between PSS groups (p = 0.006), although the relationship was not linear.
  
  
  CONCLUSIONS
  The COHb concentrations measured using CO oximetry, but not those measured using exhaled CO analyzers, were well correlated with the severity of CO poisoning.
authors.affiliation: Service de Réanimation Polyvalente, Hôpital Raymond Poincaré, AP-HP, Université de Versailles Saint-Quentin-en-Yvelines, Garches, France.
authors.forename: Thomas
authors.identifier: http://orcid.org/0000-0003-0880-2318
authors.initials: T
authors.lastname: Hullin
authors.affiliation: Service de Réanimation Polyvalente, Hôpital Raymond Poincaré, AP-HP, Université de Versailles Saint-Quentin-en-Yvelines, Garches, France.
authors.forename: Jerome
authors.initials: J
authors.lastname: Aboab
authors.affiliation: Service de Biostatistique et Information Médicale, Hôpital Saint Louis, Paris, France.
authors.forename: Kristell
authors.initials: K
authors.lastname: Desseaux
authors.affiliation: Service de Biostatistique et Information Médicale, Hôpital Saint Louis, Paris, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chevret
authors.affiliation: Service de Réanimation Polyvalente, Hôpital Raymond Poincaré, AP-HP, Université de Versailles Saint-Quentin-en-Yvelines, Garches, France.
authors.forename: Djillali
authors.initials: D
authors.lastname: Annane
mesh_terms: D000293:Adolescent; D000328:Adult; D002248:Carbon Monoxide / Q000097:blood*; D002249:Carbon Monoxide Poisoning / Q000097:blood* / Q000175:diagnosis*; D002263:Carboxyhemoglobin / Q000032:analysis*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D010092:Oximetry / Q000379:methods; D011159:Population Surveillance / Q000379:methods; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D002248:Carbon Monoxide; D002263:Carboxyhemoglobin