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Carbon monoxide

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Carbon monoxide is an odourless gas formed by burning carbon or organic fuels in a limited supply of oxygen. The majority of cases of CO toxicity are due to:

  • car exhausts
  • combustion of fuel in an inadequate flue - for example, a blocked domestic heater

Cyanosis does not occur as the carboxyhaemoglobin maintains a deceptive pink colour in the skin and mucosae.

  • research for the Health and Safety Executive (HSE) in 2007 indicated that there was concern among some stakeholders that there may be under-reporting of CO poisoning, with 8% of the 597 homes surveyed experiencing dangerous levels of CO
  • chronic exposure to lower CO concentrations may lead to the symptoms and signs of infl uenza or food poisoning, exposure to high concentrations of CO leads to collapse and death within minutes
  • what appears to be classic food poisoning of a whole family may in fact be the result of CO poisoning. Prolonged exposure to concentrations that produce only minor symptoms may, in some cases, be associated with lasting neurological effects such as diffi culties in concentrating and emotional lability. Complaints about such problems should alert the doctor to the possibility of CO poisoning

Hyperbaric oxygen therapy (HBOT) in the treatment of carbon monoxide poisoing (2)

  • is an abundance of basic science and preclinical and clinical research supporting the use of HBOT for acute CO poisoning
  • HBOT at a dose of 2.5-3.0 atm absolute is a necessary treatment for this toxidrome

Reference:

  • 1. PL/CMO/2008/8, PL/CNO/2008/8: Recognising Carbon Monoxide Poisoning – 'Think CO'
  • 2. Sethuraman, K, Thom, SR. Hyperbaric oxygen should be used for carbon monoxide poisoning. Br J Clin Pharmacol. 2023; 89( 3): 939-941. doi:10.1111/bcp.15605

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