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FABAD  J. Pharm. Sci.
ISSN 1300-4182
Copyright Ó 2010 FABAD. All rights reserved 

FABAD J. Pharm. Sci., 35(3), 163-172, 2010. PDF (533 KB)

Scientific Review

ABSTRACT

Carbon monoxide Intoxication – Review
Cetin KAYMAK*°, Hulya BASAR**


* MD, PhD, Associate Professor, Ministry of Health, Ankara Education and Research Hospital, Department of Anesthesiology and Reanimation, Ankara, Turkey
** MD, Associate Professor, Ministry of Health, Ankara Education and Research Hospital, Department of Anesthesiology and Reanimation, Ankara, Turkey
° Corresponding Author E-mail: cetinkaymak@yahoo.com


Summary


Carbon monoxide (CO), is a toxic gas produced by incomplete combustion of carbon containing materials such as kerosene, gasoline, propane and coal. As it’s a colourless, odorless, tasteless and non-irritating gas, CO is described as the“silent killer”.
CO, binds to the iron atoms in hemoglobin, with an affinity 200-250 times that of oxygen, and impairs oxygen carrying capacity of the blood. Hence, CO toxicity is a situation characterized by impairment of oxygen transportation and consumption. It has been reported that 30% of such cases are not diagnosed since the signs and symptoms in CO intoxication. Definitive diagnosis of CO intoxication is established by measuring the COHb concentration in arterial or venous blood. Elimination half life of COHb and partial oxygen pressure produced by inspired oxygen concentration is closely related. High levels of inspired oxygen fractions both accelerate CO removal and improve oxygenation. Hyperbaric oxygen (HBO) treatment is first discussed in 1890’s and was initially used in 1960’s. Although, acceleration of removal of the CO from hemoglobin was aimed initially, other effects were recognized in time. When HBO treatment is not possible, high flow 100% oxygen is applied via tight-fitting face mask. for 6-12 hours. Although, the dominance of f HBO to normobaric oxygen theraphy has been supported by several studies, more randomized clinical trials are needed.
In general, most of the CO intoxications are nonfatal. Cases with mild symptoms and those that do not show any neurological symptoms can be discharged from hospital after 4-6 hours of treatment. Despite the therapy, it is still impossible to predict long term results of CO intoxication.

Key Words :
Carbon monoxide, Intoxication