Carbon monoxide Poisoning

Abstract

Carbon monoxide is originated from incomplete combustion of carbon-containing fuel. It is found in smoke from fires, industry with running machine or engine, and automobile exhaust fumes. This gas is colorless, odorless, and non-irritating. Therefore, patients who exposed to carbon monoxide were unable to detect this poisoning exposure by themselves. The mechanism of carbon monoxide toxicity is the binding of carbon monoxide to hemoglobin at higher affinity (approximately 200-250 times) than oxygen, resulting in carboxyhemoglobin and less hemoglobin binding to oxygen. The oxygen carrying capacity of red blood cells is diminished and consequently causes a decrease in oxygen delivery to peripheral tissue that leads to tissue hypoxia. The common symptoms of toxicity are headache and dizziness. Other symptoms are nausea, fatigue, confusion and flu-like symptoms. The diagnosis of carbon monoxide poisoning is based on symptoms and history of exposure. The general management is to bring patients from environment of exposure to fresh air, remove carbon monoxide-contaminated clothes and change to new one, administer 100% oxygen, and closely supportive care. In some patients, hyperbaric oxygen therapy may be useful.