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Overview of Carbon Monoxide Poisoning

The oxygen in our blood stream is carried in red blood cells, which circulate through the lungs and bind oxygen molecules from the air we breathe. The oxygen binds to the red blood cell via another protein called hemoglobin, which can reversibly bind four oxygen molecules at a time. The oxygenated blood travels from the lung to the rest of the body, where the oxygen is released and taken up by the tissues. The red blood cell then continues through the circulatory system until it once again reaches the lungs and picks up more oxygen.

Carbon monoxide (CO) is a gas composed of one oxygen and one carbon molecule. It is extremely dangerous to inhale because it, too, can bind hemoglobin, taking the place of oxygen. CO forms a much stronger bond with the hemoglobin than oxygen does and also causes a change to the hemoglobin that makes it bind oxygen very tightly at the other three binding sites. This means that although the red blood cell may carry oxygen in addition to the carbon monoxide, it is not easily released into the tissues. The result is carbon dioxide poisoning, in which the blood has a reduced capacity to carry and deliver oxygen to the tissues. The lack of oxygen can slowly suffocate the tissues, potentially causing permanent damage to the heart, lungs, and brain.

CO also has a strong affinity for myoglobin, another oxygen-carrying protein that resides in the muscle tissues. It is thought that this may affect the heart muscle, causing weakness. CO may also interfere with the mitochondria which convert oxygen and nutrients to into energy that the body can use. In the mitochondria, the oxygen conversion occurs through interaction with a protein complex called cytochrome oxidase. This complex does not bind CO nearly as well as it binds oxygen, however, so there would have to be very little oxygen available for this interaction to occur. If it did, it could certainly interfere with normal metabolism. It has also been suggested that CO may induce formation of free radicals, which are highly reactive molecules that can cause significant damage to DNA and proteins.

Symptoms of Carbon Monoxide Poisoning

The symptoms of carbon monoxide poisoning depend on the concentration of the gas and how long it is inhaled. Mild carbon monoxide poisoning may result in headaches, dizziness, nausea, and fatigue. These symptoms are sometimes mistaken for the flu, delaying proper diagnosis. Exposure to higher concentrations of carbon monoxide can cause convulsions, loss of consciousness, and death within one hour. If extremely high levels of carbon monoxide are inhaled, consciousness can be lost after a few breaths and death can occur within minutes.

Risk Factors of Carbon Monoxide Poisoning

Because carbon monoxide poisoning affects oxygen delivery, there is substantial risk to the organs that use the most oxygen. Chronic exposure to carbon monoxide can increase the likelihood of developing heart disease, for example. The central nervous system, particularly the brain, is also highly dependent on oxygen. Those repeatedly exposed to carbon monoxide may suffer from headaches, lightheadedness, nausea, and a persistence of the milder symptoms associated with the poisoning. Acute exposure to carbon monoxide may eventually lead to brain damage, causing memory loss and other cognitive defects.

Causes of Carbon Monoxide Poisoning

On its own, carbon monoxide is odorless, colorless, tasteless, and does not cause any notable irritation upon inhalation, preventing detection by the senses. Carbon monoxide detectors with alarms are typically installed in homes to help monitor levels and alert people when CO levels may put them at risk.

Common sources of carbon monoxide include furnaces, wood burning stoves, and house fires. Camping stoves, grills, and gas powered tools such as high pressure washers, saws, welders, and floor buffers can also increase carbon monoxide to dangerous levels if used in an enclosed space. Car exhaust, generators, and boat engines can also be significant sources of carbon monoxide. Inhalation of the organic solvent methylene chloride can also result in carbon monoxide poisoning, as the body metabolizes the compound to produce CO.

Conventional Treatment of Carbon Monoxide Poisoning

The priority in treating victims of carbon monoxide poisoning is to remove them from exposure as quickly as possible. The conventional medical treatment for the poisoning is reoxygenation of the blood by breathing through an oxygen mask. The atmospheric air that we normally breathe is only about 20% oxygen, so having the victim breathe purer oxygen will help them recover more quickly. With increased blood oxygen levels, the risks of suffocation and tissue damage are reduced. The increased concentration of oxygen in the blood can also help the oxygen molecules better compete with the CO for hemoglobin binding, quelling the toxic effects of the molecule. In severe cases, fluids and electrolytes may also be given to restore metabolic balance.

Patients Medical's Treatment of Carbon Monoxide Poisoning

For carbon monoxide poisoning treatment, we additionally offer hyperbaric oxygen therapy (HBOT) to provide more extensive oxygenation of the blood. During HBOT, the patient will be placed in a pressurized chamber, which allows the air to hold much higher concentrations of oxygen. Breathing this highly oxygenated air will increase blood oxygen levels to exceed what can be achieved with conventional oxygen masks. These therapies will efficiently minimize the effects of any carbon monoxide that may still be circulating within the blood. Clinical trials also suggest that these treatments may be protective against the neurological damage that occurs following acute carbon monoxide poisoning.



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For those that can make the journey, we are happy to welcome new patients to our medical center in New York City. Call us at 212-794-8800 . We are here to listen and to help.

We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street) Manhattan, New York, NY 10017

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