Carbon monoxide toxicity

From IDWiki

Pathophysiology

  • CO binds heme with high affinity, impairing oxygen release

Differential Diagnosis

Clinical Manifestations

  • History
    • Headache
    • Malaise
    • Nausea/vomiting
    • Dizziness
    • Seizures, coma
    • Acute coronary syndromes
    • Ventricular arrhythmias
    • Acute respiratory distress syndrome (ARDS)
  • Physical Exam "Cherry red" skin and lips
    • Pulse oximetry normal (needs co-oximetry)
  • Delayed neuropsychiatric syndrome (up to 10 months)
    • Cognitive impairment
    • Movement disorders
    • Personality changes

Investigations

Management

  • Supportive care
  • Poison centre
  • High FiO2 supplemental oxygen
    • Non-rebreather
  • Hyperbaric oxygen is controversial
  • Rule out other inhalational exposures such as cyanide toxicity