OBJECTIVE: To investigate factors affecting the determination of the percent carboxyhemoglobin saturation (HbCO%) of blood in an attempt to offer further data for results interpretation and sample storage requirement. METHODS: The HbCO% of blood samples stored in various conditions were detected by three spectrophotometries during the succeeding 30 days. RESULTS: The data detected by reductive double-wavelength spectrophotometry and double-wavelength spectrophotometry were more stable than mono-wavelength spectrophotometry. The HbCO% of blood was significantly related with the storage conditions which include temperature, time and the degree of exposure to air. CONCLUSION Determinations of HbCO% are reliable which performed by reductive double-wavelength spectrophotometry and double-wavelength spectrophotometry, combine with spectral scans. During 30 days, blood stored at 4 degrees C exposed to a limited volume of air does not influence the determination of HbCO%.
Carbon Monoxide Poisoning/diagnosis* ; Carboxyhemoglobin/analysis* ; Forensic Medicine ; Humans ; Spectrophotometry/methods* ; Temperature

BACKGROUND: Minimal-flow anesthesia can meet the demands of a modern society that is more sensitive to environmental protection and economic burdens. This study compared the safety and efficacy of minimal-flow desflurane anesthesia with conventional high-flow desflurane anesthesia for prolonged laparoscopic surgery. METHODS: Forty-six male patients (ASA physical status II or III) undergoing laparoscopic urologic surgery for more than 6 hours were randomly divided into two groups: the high-flow (HF) group and the minimal-flow (MF) group. The HF group was continuously administered a fresh gas flow of 4 L/min. In the MF group, a fresh gas flow of 4 L/min was administered for the first 20 minutes and was thereafter lowered to 0.5 L/min. Inspiratory and expiratory desflurane concentrations, respiratory variables, and hemodynamic variables were continuously monitored during administration of anesthesia. Measurements of carboxyhemoglobin (COHb) concentration and arterial blood gas analysis were performed every 2 hours during anesthesia. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN) and creatinine were measured on the first and second day after the surgery. RESULTS: Demographic data and duration of anesthesia were not different between the two groups. Significant differences were not observed between the two groups in terms of hemodynamic variables, respiratory variables, and inspiratory and expiratory desflurane concentrations. Inspiratory O2 concentration was maintained lower in the MF group than in the HF group (43-53% vs. 53-59%; P < 0.05). Compared with the HF group, COHb concentrations was higher (P < 0.05), but not increased from the baseline value in the MF group. Serum AST, ALT, BUN, and creatinine were not significantly different between the two groups. CONCLUSIONS: In prolonged laparoscopic surgery, no significant differences were found in safety and efficacy between minimal-flow and high-flow desflurane anesthesia.
Alanine Transaminase ; Anesthesia ; Aspartate Aminotransferases ; Blood Gas Analysis ; Blood Urea Nitrogen ; Carboxyhemoglobin ; Natural Resources ; Creatinine ; Hemodynamics ; Humans ; Isoflurane ; Laparoscopy ; Male

OBJECTIVES: To explore the change rules of behavioral characteristics, survival time and saturation of carboxyhemoglobin （HbCO） in different CO concentration to provide experimental basis for the cases of CO poisoning death in forensic practice. METHODS: Total 160 SD rats were randomly divided into four groups. CO with the concentration of 1 250 mg/m³, 3 750 mg/m³, 6 250 mg/m³ were continuously and respectively replenished in a self-made toxicant exposure equipment until rats died from poisoning. In different CO concentration, the behavioral characteristics and survival time of poisoning rats were observed and recorded. The saturation of HbCO in heart blood was detected by spectrophotometric method. Organs such as brain, heart, lung and liver, and heart blood were obtained via autopsy and histopathological observation was performed. RESULTS: The behavioral characteristics of CO poisoning rats were limp and slow response. There were a gradual decrease of survival time and an increase of HbCO saturation in rats with the increase of CO concentration. Three rats in CO concentration of 1 250 mg/m³ group showed lower saturations of HbCO than the lethal dose and this situation hasn't been found in other groups. CONCLUSIONS The animal model of CO poisoning established under different CO concentration has the advantages such as simplicity and good repeatability, which lays a foundation to the further study for CO and other inhaled toxic gas in the research of forensic sciences.
Animals ; Carbon Monoxide Poisoning/blood* ; Carboxyhemoglobin/analysis* ; Disease Models, Animal ; Dose-Response Relationship, Drug ; Rats ; Rats, Sprague-Dawley

OBJECTIVE: To confirm whether formaldehyde disturb detecting carbon monoxide in blood. To give an evidence that can be used for detecting carboxyhemoglobin more accurately in carbon monoxide posioning appraises. METHODS: Blood samples came from carbon monoxide poisoning and the health were collected. Regular methods for detecting carboxyhemoglobin were used. Observing and comparing the detection results between which were spiked with methanal and no spiked one were performed. RESULTS: Methanal will affect the result of following experiments such as heating, adding NaOH, absorbed by PdCl2 and spectrophotometry. CONCLUSION The samples which contaminated by formaldehyde couldn't be used for detecting carboxyhemoglobin.
Carbon Monoxide/blood* ; Carbon Monoxide Poisoning/diagnosis* ; Carboxyhemoglobin/analysis* ; Forensic Medicine ; Formaldehyde/pharmacology* ; Humans ; Spectrophotometry/methods* ; Temperature

Determinant factors for personal carbon monoxide (CO) exposures were sought in Korea, where CO poisoning has been a major public health problem due to coal briquette (Yeontan) combustion for space heating and cooking. Personal 24-hr CO exposures of 15 housewives were measured by CO passive samplers on 2 days of the week (Wednesday and Sunday). Blood samples were taken to measure carboxyhemoglobin (COHb) just after the exposure sampling. Average CO exposure and COHb level were 5.6 ppm and 2.4%, respectively. Personal CO exposures as well as COHb levels were significantly increased by the use of Yeontan, especially on a weekday. Carboxyhemoglobin levels were closely related to the time between blood collection and replacement of Yeontan: the closer the blood collection was to replace Yeontan, the higher the COHb levels were. Assuming a background COHb of 1.34%, COHb increased on average by 1.8% with a 24-hr personal CO exposure of 10 ppm. The relationship between CO exposure and COHb level was provided by simultaneous direct measurements in real environment, although a measurement of COHb at the end of exposure could not represent previous 24-hr exposure thoroughly.
Adult ; Air Pollution, Indoor/*adverse effects ; Carbon Monoxide/*analysis ; Carboxyhemoglobin/*analysis ; Coal ; Environmental Exposure/*analysis ; Female ; Heating ; Human ; Korea ; Middle Age

To investigate the role of endogenous heme oxygenase (HO)/carbon monoxide (CO) system in the lung injury as assessed by lung histology, polymorphonuclear count, malondialdehyde content and wet-to-dry weight ratio following ischemia-reperfusion (I/R) of hind limbs, zinc protoporphyrin (ZnPP), an inhibitor of HO activity, was used, and the lung HO activity and blood carboxyhemoglobin (COHb) level were measured. The results showed that HO activity and COHb level were increased significantly and lung injury occurred after limb I/R. After administration of ZnPP, the lung injury was further aggravated while the HO activity and COHb level were significantly decreased. These findings suggest that upregulation of HO activity followed by subsequent CO production attenuates the lung injury induced by limb I/R in rats.
Animals ; Carbon Monoxide ; physiology ; Carboxyhemoglobin ; analysis ; Heme Oxygenase (Decyclizing) ; analysis ; physiology ; Hindlimb ; Lung Diseases ; etiology ; pathology ; Male ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; complications ; metabolism

To obtain the basic data of prognosis of acute carbon monoxide (CO) intoxication, one hundred and sixteen cases of CO intoxication defined by carboxyhemoglobin (COHb) and admitted via emergency room of Yeungnam University Hospital from Oct. '85 to April' 89 have been clinically analyzed and evaluated, including delayed postanoxic encephalopathy (DPE) and the following results were obtained. 1. The ratio of male to female was 1:1.5 and mental state was drowsy mostly (26.2% of 116 cases) 2. The more disturbed the mental state, the more decreased was the arterial pH and PaCO₂, which may be the result of metabolic acidosis. 3. The early laboratory findings in patients of CO intoxication were as follows: leukocytosis-65.5%, increase of hematocrit-23.3%, hyperglycemia-19.8%, increase of GPT-19.8% increase of creatinine-0.9% and glucosuria-12.1%. 4. The early findings of EKG were abnormal in 35.3%: change of rhythm-25.0%, abnormal ST segment 15.5% (change of rhythm and abnormal ST segment-5.2%) but the conduction disorder was not present. 5. The abnormal EEG above mild degree was 93.1%, of which moderate was most frequent (80.2%). 6. The incidence of DPE was 7.8% among all admitted CO patients. DPE cases had long duration of exposure time (8 hours), severe leukocytosis (20,000) and an abnormal EEG (MA).
Acidosis ; Blood Gas Analysis ; Brain Diseases ; Carbon Monoxide* ; Carbon* ; Carboxyhemoglobin ; Clinical Study* ; Electrocardiography ; Electroencephalography ; Emergency Service, Hospital ; Female ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Leukocytosis ; Male ; Prognosis

PURPOSE: The aim of this study was to evaluate the effects of a smoking cessation education on endothelial function and carboxyhemoglobin levels in smokers with variant angina. METHODS: A nonequivalent control group pretest-posttest design was used. Participants were 60 male smokers with variant angina admitted to one hospital: the control group (30) between September and December, 2009, and the experimental group (30) between February and May, 2010. Endothelial function, as defined by flow-mediated vasodilation (FMD) of the brachial artery, and serum carboxyhemoglobin (COHb) were determined at baseline and at 3 months after the initiation of education in both groups. RESULTS: Three months after the program, smoking cessation was successful in 22 of the 30 smokers in the experimental group, but only in 4 of 30 smokers in the control group (p<.001). After the education, the experimental group showed a significant increase in FMD, and a significant decreased in serum COHb compared with the control group. CONCLUSION: The findings indicate that this smoking cessation education program is effective for hospitalized smokers with variant angina.
Adult ; Angina Pectoris, Variant/blood/*physiopathology ; Brachial Artery/physiology ; Carboxyhemoglobin/*analysis ; Endothelium, Vascular/*physiology ; Humans ; Male ; Middle Aged ; *Program Evaluation ; Smoking/psychology ; *Smoking Cessation ; Vasodilation

OBJECTIVETo study the value of carboxyhemoglobin (COHb) in the diagnosis of neonatal jaundice.

METHODSThis study consisted of 189 patients with neonatal jaundice due to hemolytic disease (n=75), infectious disease (n=52), intracranial hemorrhage (n=32) and breast-milk feeding (n=30). One hundred and forty-two neonates without pathological jaundice that were gestational age, postnatal age- and birth weight-matched were used as the Control group. The level of arterial capillary blood COHb was detected by a 270 CO-oximeter connected to an 800 series system. Total serum bilirubin (STB) content was measured using an Abbott Spectrum CCX chemistry analyzer. The levels of COHb and STB were measured at baseline, and again in patients with jaundice due to hemolytic disease after intravenous gammaglobulin treatment for 2 days.

RESULTSThe levels of COHb [(3.64 +/- 0.83)%] and STB (330.84 +/- 77.15 micromol/L) in patients with jaundice due to hemolytic disease were significantly higher than those measured in the Control group [COHb (2.38 +/- 0.35) %; STB 130.18 +/- 32.86 micromol/L] (P < 0.01). The levels in patients with jaundice due to intracranial hemorrhage were also significantly higher than those in the Control group [COHb (2.48 +/- 0.53) % vs (2.24 +/- 0.32) %; STB 184.15 +/- 29.35 micromol/L vs 112.11 +/- 17.45 micromol/L; P < 0.05]. The patients with jaundice due to infectious disease or breast-milk feeding only demonstrated higher levels of serum STB (P < 0.01) while COHb levels were not different compared with the Control group. The patients with jaundice due to hemolytic disease or intracranial hemorrhage presented with hemolytic unconjugated hyperbilirubinemia and had significantly higher COHb levels and lower STB levels than those patients with nonhemolytic unconjugated hyperbilirubinemia (caused by breast jaundice) (P < 0.01). The levels of COHb [(2.68 +/- 0.51) %] and STB (230.18 +/- 42.96 micromol/L) in patients with jaundice due to hemolytic disease decreased markedly after intravenous gammaglobulin treatment (P < 0.01).

CONCLUSIONSThe COHb level can be used as a supplementary indicator of increased bilirubin production. The elevation of COHb can be useful in the diagnosis of neonatal jaundice since COHb is elevated in hemolytic disease and intracranial hemorrhage.

ABO Blood-Group System ; immunology ; Bilirubin ; blood ; Carboxyhemoglobin ; analysis ; Female ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Infant, Newborn ; Jaundice, Neonatal ; diagnosis ; therapy ; Male

Based on the records of carboxyhemoglobin in blood samples stored for recent years, the stability of carboxyhemoglobin in these samples could be affected by the containers, the storage temperatures, the volumes of air above the blood, the saturation of the initial carboxyhemoglobin and preservatives added in these blood samples, among which the storage temperatures, the volumes of air above the blood and the saturation of the initial carboxyhemoglobin are the major influence factors.
Air ; Blood Preservation ; Carbon Monoxide/chemistry* ; Carbon Monoxide Poisoning/blood* ; Carboxyhemoglobin/analysis* ; Drug Stability ; Forensic Medicine ; Humans ; Specimen Handling/methods* ; Temperature