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http://www.ncbi.nlm.nih.gov/pubmed/20434271

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Burns. 2011 Jun;37(4):610-5. Epub 2010 Apr 29.

Glasgow Coma Scale and laboratory markers are superior to COHb in predicting
CO intoxication severity.


Grieb G, Simons D, Schmitz L, Piatkowski A, Grottke O, Pallua N.
Source

Department of Plastic Surgery and Hand Surgery, Burn Center, Medical Faculty,
Hospital of the RWTH Aachen University, Aachen, Germany. [e-mail]
Abstract
Carbon monoxide (CO) intoxications can affect several organ systems and lead
to coma or death in severe cases. To date, COHb is routinely used as a marker
for detecting CO intoxication. In this retrospective study, we investigated
173 patients admitted with CO intoxication to our intensive care unit (ICU)
over a period of 8 years. Standardised blood tests, chest X-ray and
neurological status evaluation were performed on admission and throughout the
inpatient treatment. The duration of inpatient treatment
was considered to be an indication of the severity of CO-related illness.
Interestingly, the data did not reveal a significant correlation between
initial COHb level and the duration of inpatient treatment. Instead, a
significant inverse correlation was found between the initial Glasgow Coma
Scale and the duration of inpatient treatment. Furthermore, significant
correlations were found between the duration of inpatient treatment and the
occurrence of elevated leucocyte numbers, elevated C-reactive
protein (CRP) serum concentrations and the presence of lung infiltrates.
In conclusion, we postulate that clinical parameters, such as the Glasgow
Coma Scale and the laboratory markers CRP and leucocyte count are adequate
supportive tools for evaluating the severity of CO-related illness, and further
, that the measurement of COHb alone is insufficient for this purpose.
Copyright  2010 Elsevier Ltd and ISBI. All rights reserved.
PMID: 20434271 [PubMed - indexed for MEDLINE]

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