Elevated Carboxyhemoglobin: Sources of Carbon Monoxide Exposure

Ramirez, Herminia Buchelli; Álvarez, Ramón Fernández; Cuadrado, Gemma Rubinos; Martínez-González, Cristina; Jerez, Francisco Rodríguez; Clarà, Pere Casan

doi:10.1016/j.arbr.2014.09.009

Cited by 9 publications

(7 citation statements)

References 16 publications

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“…According to pathologists, the elevated level of COHb (if so, for one pathologist reported 38% of it in blood and the other did not find any) was surely not caused by liver disease, cirrhosis, as the autopsy confirms [7]. COHb sources are often generated from houses, faulty chimneys, or engine exhaust gases [8]. Persons who work under the special working conditions should be examined at an Occupational medicine department as well as trained for work in a safe way.…”

Section: Discussionmentioning

confidence: 99%

A Drowned Diver – Four Expert Witness Opinions – Who is Right?

Lalić¹

2021

Open Access Maced J Med Sci

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BACKGROUND: The paper describes the case of a drowned diver in the Adriatic Sea near Pula, Croatia. CASE PRESENTATION: The deceased diver had not been trained at any Health and Safety at Work programs nor had he been examined by the occupational medicine (OM) specialist. The pathologist in Pula concluded that this accident was caused by drowning and that diver’s blood was saturated with 38% carboxyhemoglobin (COHb). The second pathologist in Zagreb concluded that the diver drowned due to atherosclerosis sickness but that COHb was not present in his blood. The third expert witness from Forensics in Rijeka evaluated that the diver died due to increased exertion while diving, due to atherosclerosis and weakened heart. The fourth, the OM specialist expert witness from Rijeka, explained that the diver was a healthy athlete who died due to faulty diving equipment. CONCLUSION: Persons who work under the special working conditions should be examined at an Occupational medicine department as well as trained for work in a safe way. Periodical examinations and permanent training courses should be provided. That way the risk of fatal accidents would be reduced to a minimum.

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Section: Discussionmentioning

confidence: 99%

A Drowned Diver – Four Expert Witness Opinions – Who is Right?

Lalić¹

2021

Open Access Maced J Med Sci

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“…This high level of COHb can be attributed to increased exposure to environmental CO due to chemical contaminant exposure. Ramirez et al (2014) measured COHb levels in the general population and reported that levels higher than 3.0% are typically due to more than a single source of CO exposure. Likewise, Czogała et al (2006) showed an increase of 0.31% to 2.19% in non-smokers, which could also be attributed to increased sources of CO exposure.…”

Section: Discussionmentioning

confidence: 99%

Determination of carboxyhaemoglobin and methaemoglobin levels in donated blood

Silvério

Machado

Silva

et al. 2021

RSD

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To determine the percentages of carboxyhaemoglobin (COHb) and methaemoglobin (MeHb) in donor blood and to compare these levels between smokers and nonsmokers at different time points during blood storage. Blood donors were recruited from Haematology Service, University Hospital Alzira Velano, Alfenas-MG. The blood was kept in collecting ducts (noodles) containing citrate, phosphate and dextrose (CPD) and stored at 4°C throughout the storage period. Since the noodles kept the characteristics of the bags, COHb and MeHb levels were analysed on the day of donation and after 20 days of storage. Levels of COHb and MeHb were determined using spectrophotometric methods. Non-parametric Friedman and Mann-Whitney tests were employed to compare COHb and MeHb levels before and after the storage and groups of smokers and nonsmokers, respectively. Levels of COHb and MeHb in the blood collected from smokers and nonsmokers were statistically different (p< 0.05; Mann- Whitney test) when the samples were analyzed before the storage. In blood of smokers, COHb levels were no different over a 20-day storage period (p= 0.7009; Friedman test). On the other hand, MeHb levels were significant different over a 20-day storage period (p< 0.05). The results suggest the need to regularly assess COHb and MeHb levels in donor blood stored in blood banks.

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“…The binding affinity of CO to the heme moiety of adult hemoglobin is so strong that it makes a covalent bond leading to fetal hypoxemia by lowering the partial pressure of available oxygen in the maternal blood. Even at this very early stage when CO has not yet entered the fetal circulation, danger to the fetus is particularly high (Buchelli Ramirez et al, 2014). Umbilical venous blood typically has an oxygen tension of about 20 mmHg, which is on a steep portion of the oxygen-hemoglobin dissociation curve, meaning that small changes in the oxygen tension in the umbilical vein can lead to substantial fetal hypoxia (Greingor et al, 2001;Kopelman & Plaut, 1998).…”

Section: Co Poisoningmentioning

confidence: 99%

Hypoxia: A teratogen underlying a range of congenital disruptions, dysplasias, and malformations

Adam¹,

Payton

Sanchez‐Lara

et al. 2021

American J of Med Genetics Pt A

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In this review, we explore evidence that hypoxia in the developing human fetus can lead not only to the more commonly accepted disruptive-type defects, but also patterns of anomalies that suggest that hypoxia can exert a more classic teratogenic effect, using the brain as one example. We review neuropathology in the context of intrauterine hypoxia, particularly as it relates to carbon monoxide poisoning, in utero strokes, and homozygous alpha-thalassemia. In general, the associated brain injuries resemble those seen with other causes of hypoxic-ischemic injury. Fetal strokes during development usually lead to loss of brain tissue in areas that do not follow a typical embryologic pattern, and therefore are considered disruptions. However, there is also evidence that fetal brain ischemia can cause more classically recognized patterns of abnormal embryonic neuronal migration and organization such as polymicrogyria, cortical dysplasia, or dysgenesis, including select types of focal cortical dysplasia. This study summarizes available literature and evidence to raise clinicians' awareness regarding the association between hypoxia and congenital anomalies, including brain malformations.

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Elevated Carboxyhemoglobin: Sources of Carbon Monoxide Exposure

Cited by 9 publications

References 16 publications

A Drowned Diver – Four Expert Witness Opinions – Who is Right?

A Drowned Diver – Four Expert Witness Opinions – Who is Right?

Determination of carboxyhaemoglobin and methaemoglobin levels in donated blood

Hypoxia: A teratogen underlying a range of congenital disruptions, dysplasias, and malformations

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