Sample records for carboxyhemoglobin

  1. Carboxyhemoglobin and Methemoglobin in Asthma (United States)

    Naples, Robert; Laskowski, Dan; McCarthy, Kevin; Mattox, Emmea; Comhair, Suzy A. A.; Erzurum, Serpil C.


    Nitric oxide (NO) and carbon monoxide (CO) are synthesized at high levels in asthmatic airways. NO can oxidize hemoglobin (Hb) to methemoglobin (MetHb). CO binds to heme to produce carboxyhemoglobin (COHb). We hypothesized that MetHb and COHb may be increased in asthma. COHb, MetHb, and Hb were measured in venous blood of healthy controls (n=32) and asthmatics (n=31). Arterial COHb and oxyhemoglobin were measured by pulse CO-oximeter. Hb, oxyhemoglobin, and deoxyhemoglobin were similar among groups, but arterial COHb was higher in asthmatics than controls (p=0.04). Venous COHb was similar among groups, and thus arteriovenous COHb (a-v COHb) concentration difference was greater in asthma compared with controls. Venous MetHb was lower in asthma compared to controls (p=0.01) and correlated to venous NO (p=0.009). The greater a-v COHb in asthma suggests CO offloading to tissues, but lower than normal MetHb suggests countermeasures to avoid adverse effects of high NO on gas transfer. PMID:25680415

  2. Relation between workplace accidents and the levels of carboxyhemoglobin in motorcycle taxi drivers

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    Luiz Almeida da Silva


    Full Text Available OBJECTIVE: to investigate the relation between workplace accidents and the levels of carboxyhemoglobin found in motorcycle taxi drivers. METHOD: correlational, quantitative study involving 111 workers and data obtained in July 2012 through a questionnaire to characterize the participants and blood collection to measure carboxyhemoglobin levels. RESULT: 28.8% had suffered workplace accidents; 27.6% had fractured the lower limbs and significant symptoms of carbon monoxide exposure were verified in smokers. The carboxyhemoglobin levels were higher among smokers and victims of workplace accidents. CONCLUSION: motorcycle taxi drivers had increased levels of carboxyhemoglobin, possibly due to the exposure to carbon monoxide; these levels are also increased among smokers and victims of workplace accidents. The study provides advances in the knowledge about occupational health and environmental science, and also shows that carboxyhemoglobin can be an indicator of exposure to environmental pollutants for those working outdoors, which can be related to workplace accidents.

  3. A fluctuating quantum model of the CO vibration in carboxyhemoglobin. (United States)

    Falvo, Cyril; Meier, Christoph


    In this paper, we present a theoretical approach to construct a fluctuating quantum model of the CO vibration in heme-CO proteins and its interaction with external laser fields. The methodology consists of mixed quantum-classical calculations for a restricted number of snapshots, which are then used to construct a parametrized quantum model. As an example, we calculate the infrared absorption spectrum of carboxy-hemoglobin, based on a simplified protein model, and found the absorption linewidth in good agreement with the experimental results.

  4. Utility of the Measurement of Carboxyhemoglobin Level at the Site of Acute Carbon Monoxide Poisoning in Rural Areas

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    Makoto Onodera


    Full Text Available Objective. This study examined the hypothesis that correlations exist between the carbon monoxide exposure time and the carboxyhemoglobin concentration at the site of carbon monoxide poisoning, using a pulse carbon monoxide oximeter in rural areas or the carboxyhemoglobin concentration measured at a given medical institution. Background. In previous studies, no definitive relationships between the arterial blood carboxyhemoglobin level and the severity of carbon monoxide poisoning have been observed. Method. The subjects included patients treated for acute carbon monoxide poisoning in whom a medical emergency team was able to measure the carboxyhemoglobin level at the site of poisoning. We examined the relationship between the carboxyhemoglobin level at the site of poisoning and carbon monoxide exposure time and the relationships between the arterial blood carboxyhemoglobin level and carbon monoxide exposure time. Results. A total of 10 patients met the above criteria. The carboxyhemoglobin levels at the site of poisoning were significantly and positively correlated with the exposure time (rs = 0.710, p=0.021, but the arterial blood carboxyhemoglobin levels were not correlated with the exposure time. Conclusion. In rural areas, the carboxyhemoglobin level measured at the site of carbon monoxide poisoning correlated with the exposure time.

  5. The rise in carboxyhemoglobin from repeated pulmonary diffusing capacity tests. (United States)

    Zavorsky, Gerald S


    The purpose of this study determined the rise in carboxyhemoglobin percentage (COHb) from repeated pulmonary diffusing capacity tests using 5 or 10s single breath-hold maneuvers. Five male and four female non-smokers [baseline COHb=1.2 (SD 0.5%)] performed repeated pulmonary diffusing capacity testing on two separate days. The days were randomized to either repeated 10s (0.28% CO), or 5s (0.28% CO, 55ppm NO) breath-hold maneuvers. Twenty-two 5s breath-hold maneuvers, each separated by 4min rest, raised COHb to 11.1 (1.4)% and minimally raised the methemoglobin percentage (METHb) by 0.3 (0.2)% to a value of 0.8 (0.2)%. After the 22nd test, pulmonary diffusing capacity for carbon monoxide (DLCO) was reduced by about 4mL/min/mmHg, equating to a 0.44% increase in COHb per 5s breath-hold maneuver and a concomitant 0.35mL/min/mmHg decrease in DLCO. Pulmonary diffusing capacity for nitric oxide (DLNO) was not altered after 22 tests. On another day, the 10s single breath-hold maneuver increased COHb by 0.64% per test, and reduced DLCO by 0.44mL/min/mmHg per test. In conclusion, 5s breath-hold maneuvers do not appreciably raise METHb or DLNO, and DLCO is only significantly reduced when COHb is at least 6%.

  6. Significance of the carboxyhemoglobin level for out-of-hospital cardiopulmonary arrest

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    Youichi Yanagawa


    Full Text Available Background: At low concentrations, carbon monoxide (CO can confer cyto and tissue-protective effects, such as endogenous Heme oxygenase 1 expression, which has antioxidative, anti-inflammatory, antiproliferative, and antiapoptotic effects. The level of carboxyhemoglobin in the blood is an indicator of the endogenous production of CO and inhaled CO. Aim of study: To investigate the significance of the value of carboxyhemoglobin for out-of-hospital (OH cardiopulmonary arrest (CPA. Materials and Methods: This study involved a medical chart review of cases treated from January to December 2005. The inclusion criteria included a patient who was transported to this department due to an OH CPA. The exclusion criteria included a patient who did not undergo blood gas analysis on arrival and who experienced CPA due to acute carbon monoxide intoxication. The subjects were divided into two groups based on their final outcome of either survival or non-survival. Results: There was no significant difference associated with the sex, age, frequency of witness collapse, bystander cardiopulmonary arrest, electrocardiogram at scene, cause of CPA, value of PCO 2 , HCO3 - , and methemoglobin. The frequency of OH return of spontaneous circulation and the value of pH, PO 2 , base excess, and carboxyhemoglobin in the survival group were greater than those values in the non-survival group. There were no subjects whose carboxyhemoglobin level was 0% on arrival in the survival groups. Conclusion: There appeared to be an association between higher carboxyhemoglobin levels and survival in comparison with non-survival patients.

  7. Masimo Rad-57 Pulse CO-Oximeter for noninvasive carboxyhemoglobin measurement. (United States)

    Suner, Selim; McMurdy, John


    Noninvasive methods of body fluid chemical measurement have been expanding. New technologies are enabling the quantification of different compounds in the blood and interstitial tissues. One example of this is the pulse oximeter, which has facilitated the measurement of oxyhemoglobin rapidly and reliably without the requirement of blood-draws. The Masimo Rad-57 Pulse CO-Oximeter expanded the capabilities of pulse-oximetry to include measurements of carboxyhemoglobin and methemoglobin. This innovation has revolutionized the paradigm for detection of patients with CO poisoning. Previously, clinicians relied on historical information and patient signs and symptoms pointing to the possibility of CO exposure or toxicity. Only then would a blood test be ordered to measure carboxyhemoglobin levels. Since the presentation of CO poisoning is nonspecific and overlaps with many other conditions, and since the presence of environmental CO is often unknown, the detection of this condition was only possible in cases where the presence of CO was obvious or where the symptoms were severe. We now know, from studies conducted using the Rad-57, the only US FDA-approved device for noninvasive measurement of SpCO, that there are a significant number of patients who experience CO exposure but are nonsymptomatic. The Rad-57 provides a clinical justification for screening in the healthcare setting to identify patients with significant CO exposure who would otherwise be undetected.

  8. Arteriovenous carboxyhemoglobin gradient is a technical artifact that is eliminated by special calibration (SAT 100). (United States)

    Weber, T P; Grosse Hartlage, M A; Meyer, J; Van Aken, H; Uhlig, S; Rolf, N


    Pulmonary enzyme heme oxygenase, which catalyses carbon monoxide production, may be responsible for arteriovenous carboxyhemoglobin (COHb) differences measured in humans. Unspecific inflammatory stimuli have been shown to induce pulmonary heme oxygenase possibly leading to increased pulmonary carbon monoxide production and elevated arterial COHb. Arteriovenous COHb gradients may therefore be a measurable parameter of lung injury severity. To exclude a technical artefact, we repeated measurements of central venous COHb and arterial COHb in healthy humans (ASA I-II) undergoing elective surgery with the ABL 625 and the updated version, ABL 725 (Radiometer, Copenhagen). In addition to the standard calibration, an especially accurate adjustment of the spectrophotometer wavelengths (SAT100) was performed. This adjustment eliminates the FCOHb dependency on the oxygen saturation. No significant differences were detectable between central venous and arterial COHb concentrations with either blood gas analyzer. The difference between central venous COHb and arterial COHb was 0.09 with the ABL 625 and -0.03 with the ABL 725. Therefore, we conclude that previously reported arteriovenous COHb differences are artifactual and may be eliminated by SAT 100 adjustment, as is possible with the ABL 725.

  9. Rate of formation of carboxyhemoglobin in exercising humans exposed to carbon monoxide. (United States)

    Tikuisis, P; Kane, D M; McLellan, T M; Buick, F; Fairburn, S M


    The purpose of this study was to test the CFK equation for its prediction of the rate of formation of carboxyhemoglobin (HbCO) in exercising humans by use of measured values of the respiratory variables and to characterize the rate of appearance of HbCO with frequent blood sampling. Ten nonsmoking male subjects were exposed to carbon monoxide (CO) on two separate occasions distinguished by the level of activity. Steady-state exercise was conducted on a cycle ergometer at either a low (approximately 45 W) or moderate (approximately 90 W) power output. Each experiment began with an exposure of 3,000 ppm CO for 3 min during a rest period followed by three intermittent exposures ranging from 3,000 ppm CO for 1 min at low exercise to 667 ppm CO for 3 min at moderate exercise. Increases in HbCO were normalized against predicted values to account for individual differences in the variables that govern CO uptake. No difference in the normalized uptake of CO was found between the low- and moderate-exercise trials. However, the CFK equation underpredicted the increase in HbCO for the exposures at rest and the first exposure at exercise, whereas it overpredicted for the latter two exposures at exercise. The net increase in HbCO after all exposures (approximately 10% HbCO) deviated by less than 1% HbCO between the measured and predicted values. The rate of appearance of HbCO fits a sigmoidal shape with considerable overshoot at the end of exposure. This can be explained by delays in the delivery of CO to the blood sampling point (dorsal hand vein) and by a relatively small blood circulation time compared with other regions of the body. A simple circulation model is used to demonstrate the overshoot phenomenon.

  10. Rate of formation of carboxyhemoglobin in exercising humans exposed to carbon monoxide

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    Tikuisis, P.; Kane, D.M.; McLellan, T.M.; Buick, F.; Fairburn, S.M. (Defence and Civil Institute of Environmental Medicine, North York, Ontario (Canada))


    The purpose of this study was to test the CFK equation for its prediction of the rate of formation of carboxyhemoglobin (HbCO) in exercising humans by use of measured values of the respiratory variables and to characterize the rate of appearance of HbCO with frequent blood sampling. Ten nonsmoking male subjects were exposed to carbon monoxide (CO) on two separate occasions distinguished by the level of activity. Steady-state exercise was conducted on a cycle ergometer at either a low ([approximately]45 W) or moderate ([approximately]90W) power output. Each experiment began with an exposure of 3,000 ppm CO for 3 min during a rest period followed by three intermittent exposures ranging from 3,000 ppm CO for 1 min at low exercise to 667 ppm CO for 3 min at moderate exercise. Increases in HbCO were normalized against predicted values to account for individual differences in the variables that govern CO uptake. No difference in the normalized uptake of CO was found between the low-and moderate-exercise trials. However, the CFK equation underpredicted the increase in HbCO for the exposures at rest and the first exposure at exercise, whereas it overpredicted for the latter two exposures at exercise. The net increase in HbCO after all exposures ([approximately]10% HbCO) deviated by <1% HbCO between the measured and predicted values. The rate of appearance of HbCO fits a sigmoidal shape with considerable overshoot at the end of exposure. This can be explained by delays in the delivery of CO to the blood sampling point (dorsal hand vein) and by a relatively small blood circulation time compared with other regions of the body. A simple circulation model is used to demonstrate the overshoot phenomenon. 26 refs., 6 figs., 1 tab.

  11. Assessment of carboxyhemoglobin, hydrogen cyanide and methemoglobin in fire victims: a novel approach. (United States)

    Ferrari, Luis A; Giannuzzi, Leda


    To establish the cause of death, carboxyhemoglobin (COHb), total hemoglobin (tHb), methemoglobin (MetHb), and hydrogen cyanide (HCN) were quantified in the blood of fire victims. We analyzed 32 out of 33 blood samples from forensic autopsy cases in a disastrous polyurethane mattress fire, which caused the deaths of 33 inmates at a prison in Argentina in 2006. The cadaveric blood samples were collected by femoral vein puncture. These samples were analyzed using the IL80 CO-oximeter system for tHb, MetHb, and COHb levels and by microdiffusion for HCN and COHb levels. Blood alcohol (ethanol) and drugs were examined by headspace gas chromatography-flame ionization detection (HS-GC-FID) and GC-mass spectrometry (MS), respectively. Polyurethane mattress samples were analyzed according to the California 117 protocol. The saturation of COHb ranged from 10% to 43%, tHb from 2% to 19.7%, MetHb from 0.10% to 35.7%, and HCN from 0.24 to 15mg/L. These HCN values are higher than the lethal levels reported in the literature. Other toxic components routinely measured (ethanol, methanol, aldehydes, and other volatile compounds) gave negative results in the 32 cases. Neither drugs of abuse nor psychotropic drugs were detected. The results indicate that death in the 32 fire victims was probably caused in part by HCN, generated during the extensive polyurethane decomposition stimulated by a rapid increase in temperature. We also considered the influence of oxygen depletion and the formation of other volatile compounds such as NOx in this disaster, as well as pathological evidence demonstrating that heat was not the cause of death in all victims. Furthermore, statistical analysis showed that the percentage values of COHb and MetHb in the blood were not independent variables, with χ(2)=11.12 (theoretical χ(2)=4.09, degrees of freedom=12, and α=0.05). However, no correlation was found between HCN and MetHb in the blood of the victims. This is the first report to assess the

  12. Valores de referência para carboxiemoglobina Reference values for carboxyhemoglobin

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    Maria Elisa P. B. de Siqueira


    the present study, the RV for carboxyhemoglobin (COHb was determined for the South of Minas Gerais. MATERIAL AND METHOD: The COHb was analyzed by the Beutler and West (1984 spectrophotometric method, optimized in our laboratory. In all the samples, analyses of some biochemical and hematological parameters were made to evaluate the health condition of a population of 200 volunteer non-smokers occupationally not exposed to CO. Each individual answered a questionnaire to obtain data pertinent to the interpretation of the results. The reference values were expressed as mean values ± standard deviation, with a 95% confidence interval, and an upper reference value. The statistical distribution of the results was made so as to enable comparisons between the results of groups of workers, rather than individual evaluations, to be made. RESULTS AND CONCLUSION: The mean value ± standard deviation was 1.0% ± 0.75; the 95% confidence interval was 0,9 - 1.1% and the upper reference value was 2.5%. By the t Student test (p < 0.05, no difference was detected between the values related to sex, age or ingestion of alcoholic beverages. The reference values obtained were close to those reported for others countries.

  13. Measurement of carboxyhemoglobin in forensic blood samples using UV-visible spectrometry and improved principal component regression

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    Egan, William; Morgan, Stephen L. [Department of Chemistry and Biochemistry, The University of South Carolina, Columbia, South Carolina 29208 (United States)] Brewer, William E. [Toxicology Department, South Carolina Law Enforcement Division, 4416 Broad River Road, Columbia, South Carolina 29210 (United States)


    The forensic determination of carboxyhemoglobin (COHb) in blood was performed by using an improved principal component regression (PCR) technique applied to UV-visible spectra. Calibration data were decomposed into principal components, and the principal components useful for prediction were selected by their correlation with calibration spectra. Cross-validation of prediction results was done by leverage-corrected residuals. Confidence and prediction intervals derived from classical regression theory were found to be reasonable in size. The results compared favorably to a comparison study conducted by using a CO Oximeter method. In analysis of forensic case study samples, the improved PCR method allowed detection of abnormal samples and successfully predicted percentages of COHb and methemoglobin (MetHb), and provided error estimates for those predictions. {copyright} {ital 1999} {ital Society for Applied Spectroscopy}

  14. A new method for the determination of carboxyhemoglobin in blood of newborns. Possible clinical implications of elevated levels. (United States)

    Zwart, A; Siepel, H; Heerspink, W


    Spectral differences between hemoglobin derivatives from adult-(HbA) and fetal-hemoglobin (HbF) make the accurate determination of carboxyhemoglobin (COHb) troublesome in blood of newborns. Only the newest dedicated instruments for the determination of COHb take these differences into account. However, since there are virtually no spectral differences between both hemoglobins in the deoxygenated state, reduction of neonatal blood with sodium dithionite eliminates that spectrophotometric error. Based on this principle, an easy, fast and accurate method for the determination of COHb in minimal amounts of blood was developed; equally well suited for blood of newborns and adults. The instrument used with this new method is a general purpose centrifugal clinical chemistry analyzer (COBAS-FARA, Roche, Basle, Switzerland). After the reduction of blood with sodium dithionite, a simple two component system (Hb and COHb) is formed, which can be spectrophotometrically quantitated by measuring at two suitable wavelengths, i.e., 579 nm and 534 nm. The COHb fraction is calculated with the help of: COHb % = 177.73.(A534/A579)-176.66. Comparison with the OSM3 Hemoximeter (Radiometer A/S, Denmark) for 145 adult blood samples with varying COHb levels (0-30%) yielded a mean difference in COHb % of about 0.06% (SD = 0.38). For fetal blood (N = 63) about the same difference was found when the OSM3 was used in the so-called fetal mode, while comparison with the regular adult mode yielded a difference of about 3.1%. This indicates that the new method is indeed not disturbed by the spectral differences between HbA and HbF.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Investigation of oxyhemoglobin and carboxyhemoglobin ratios in right and left cardiac blood for diagnosis of fatal hypothermia and death by fire. (United States)

    Kanto-Nishimaki, Yuko; Saito, Haruka; Watanabe-Aoyagi, Miwako; Toda, Ritsuko; Iwadate, Kimiharu


    Few large-scale investigations have looked at the oxyhemoglobin ratio (%O2-Hb) or the carboxyhemoglobin ratio (%CO-Hb) in fatal hypothermia and death by fire as applicable to forensic medicine. We therefore retrospectively examined right and left cardiac blood samples for both %O2-Hb and %CO-Hb in 690 forensic autopsy cases. We therefore sought to establish reference values for the above forensic diagnoses, to compare %O2-Hb in fatal hypothermia with or without cardiopulmonary resuscitation (CPR), and to compare the relationship between %CO-Hb and smoking history. All %O2-Hb and %CO-Hb data were obtained during or immediately after autopsies using a portable CO-oximeter. Death by carbon monoxide (CO) intoxication and death by fire were excluded from the analysis involving smoking history. In fatal hypothermia, %O2-Hb in the left cardiac blood was significantly higher than that in the right cardiac blood, providing important evidence for fatal hypothermia. Furthermore, %O2-Hb in the left cardiac blood increases with CPR but that in the right cardiac blood increases in parallel. No correlation was observed between rectal temperature and %O2-Hb in the right and left cardiac blood, indicating that it is unlikely that postmortem cooling increases %O2-Hb in cardiac blood. %CO-Hb in smokers was significantly higher than that in non-smokers, although the number of cigarettes smoked did not appear to be significant. When assessing death by fire, we identified that %CO-Hb of >10% was a reliable marker of antemortem CO inhalation, regardless of smoking history.

  16. The influence of the pre-hospital application of non-invasive measurements of carboxyhemoglobin in the practice of emergency medical services in multiple and mass casualty incidents (MCI – A case report

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    Robert Gałązkowski


    Full Text Available In 2013 a fire broke out in the Nursing Home (NH in the Henryszew village 5 km away from the district hospital in Żyrardów. At the time of the incident 52 residents and 16 staff members were present in the building. Due to a large number of casualties, the occurrence was classified as a potentially mass casualty incident (MCI. Troops of the State Fire Brigade, Paramedic Rescue Squads, choppers of the Helicopter Emergency Medical Service, the Police, and the NH staff took part in the rescue operation. The priority was given to the evacuation of the NH residents carried out by the NH staff and firefighters, extinguishing the fire, as well as to primary and secondary survey triage. Due to the pre-accident health state of the victims, the latter posed a considerable difficulty. A decisive role was played by the need to conduct non-invasive measurements of carboxyhemoglobin in all the casualties, which then made it possible to adequately diagnose the patients and implement proper procedures. The rescue operation was correctly followed although it proved to be a serious logistical and technical undertaking for the participating emergency services. The residents were not found to be suffering from carbon monoxide poisoning, therefore 46 of the residents safely returned to the building. The fact that all the Paramedic Rescue Squads were equipped with medical triage sets and were able to conduct non-invasive measurements of carboxyhemoglobin made it possible to introduce effective procedures in the cases of suspected carbon monoxide poisoning and abandon costly and complicated organisational procedures when they proved to be unnecessary. Med Pr 2014;65(2:289–295

  17. 碳氧血红蛋白对新生儿溶血病的诊断价值%Diagnostic value of carboxyhemoglobin on hemolytic disease of the newborn

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    王慧欣; 林影; 王亚娟; 杨彩云; 邵芳; 杨学芳; 顾松; 姜敏; 罗洁


    目的 探讨碳氧血红蛋白(COHb)辅助诊断新生儿溶血病的价值.方法 选择2009年10月至2010年9月本科收治的足月儿,确诊新生儿溶血病者为溶血组,存在母子血型不合和病理性黄疸但未确诊溶血病者为非溶血性黄疸组,无母子血型不合及病理性黄疸者为对照组.分别于生后5天内测定COHb、血红蛋白(Hb)、网织红细胞(Ret)和总胆红素(STB),并进行比较.建立受试者工作曲线(ROC曲线),确定COHb、Hb、Ret的曲线下面积(AUC),同时分析三者不同截断值的敏感度、特异度、阳性和阴性预测值.结果 (1)溶血组COHb、Ret和STB较非溶血性黄疸组及对照组增高,Hb降低(P均<0.001);非溶血性黄疸组STB较对照组增高(P<0.001),但COHb、Hb和Ret差异无统计学意义(P>0.05).(2)COHb、Hb和Ret的AUC分别为96.0%、74.9%、85.7%,三者比较差异有统计学意叉(P<0.05).COHb预计溶血病的最佳截断值为1.2%(敏感度86.8%、特异度91.2%、阳性预测值93.0%、阴性预测值83.9%),敏感度、特异度均优于Hb和Ret.三指标联合诊断的特异度可提高到98.2%.结论 COHb是敏感的新生儿溶血病诊断指标,与Hb和Ret联合检测,对于早期筛查和辅助诊断新生儿溶血病有重要意义.%Objective To study the diagnostic value of carboxyhemoglobin ( COHb ) on hemolytic disease of the newborn (HDN).Methods Full-term infants diagosed serologically with HDN in our department from October,2009 to September,2010 were categorized as hemolytic group.Infants with ABO or Rh blood group incompatibility and pathologic jaundice but without HDN were categorized as non-hemolytic jaundice group, while those without blood group incompatibility and pathologic jaundice were studied as contol.COHb level, serum total bilirubin (STB) , hemoglobin ( Hb) and reticulocyte ( Ret) count were measured within five days after birth and were compared within the three groups.Area under the receiver operating characteristic

  18. 利用脉冲激光技术研究哺乳动物碳氧血红蛋白光解量子产率%Quantum yields in photolyses of mammalian carboxy-hemoglobin studied by pulsed laser pump-probe technique

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    赵瑾瑜; 渠敏; 李家璜; 张铮; 张淑仪; 水修基; 杨跃涛; 华子春


    本文利用脉冲光解法测量了哺乳动物碳氧血红蛋白的光解反应的量子产率.脉冲光解法是利用一束波长为532 nm、脉冲宽度为8 ns、重复频率为10 Hz的脉冲激光照射碳氧血红蛋白溶液,使其发生光解反应.考虑到碳氧血红蛋白溶液和其光解产物脱氧血红蛋白的光吸收系数不同,可利用另一束波长为432 nm的连续激光检测溶液在光解前、后的透射率的变化,以测定溶液的光解量子产率.利用此实验系统,对人、猪、牛、马和兔等5种哺乳动物的碳氧血红蛋白的光解量子产率进行了测量和研究,结果表明,不同物种的光解量子产率各不相同,其中猪、牛、马的碳氧血红蛋白的光解量子产率很接近,兔的碳氧血红蛋白的光解量子产率与其他物种的差异最大.最后,对测量的结果从血红蛋白的氨基酸序列、氢键和盐桥排布、四级结构等方面进行了分析与讨论.%Hemoglobin (Hb) as the allosteric protein, in photo-dissociations of liganded Hb has been studied widely. The mechanisms describing the cooperative binding of CO and other ligands to hemoglobins has been the subject of extensive studies as an important fundamental problem for a long time. In this paper, the quantum yields in photolyses of carboxy-hemoglobins (HbCO) of mammals, such as human,pig, bovine, horse and rabbit, are investigated by the optical pump-probe technique, in which the quantum yield is defined as the molecular number of photoproduct species divided by the absorbed photon number. In the optical pump-probe technique, the HbCO of the mammals are irradiated by a pulsed pumping laser beam with the wavelength 532 nm, pulse width 8 ns and the repetition frequency 10 Hz, then the HbCO is photo-dissociated.Meanwhile, another continuous optical beam with the wavelength 432 nm is used as a probe beam to detect the absorbance change induced by the photo-dissociation before and after the laser pulse illuminating

  19. Methods developed for the mass sampling analysis of CO and carboxyhemoglobin in man

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    Baretta, E.D.; Stewart, R.D.; Graff, S.A.; Donahoo, K.K.


    Gas chromatography was used to quantitate CO in air and also as an indirect means of determining %COHb in blood. The blood was then used to calibrate four CO-Oximeters used in a survey to determine average COHb levels in various segments of the U.S. population. Mean differences, both between the two methods of analysis and between pairs of CO-Oximeters, were less than 0.1% COHb saturation. COHb values obtained on consecutive days using one CO-Oximeter were repeatable within a S.D. +- 0.13% COHb.


    NARCIS (Netherlands)



    We determined the millimolar absorptivities of the four clinically relevant derivatives of fetal and adult human hemoglobin in the visible and near-infrared spectral range (450-1000 nm). As expected, spectral absorption curves of similar shape were found, but the small differences between fetal and

  1. Lyophilized bovine hemoglobin as a possible reference material for the determination of hemoglobin derivatives in human blood

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    Maas, BHA; Buursma, A; Ernst, RAJ; Maas, AHJ; Zijlstra, WG


    We investigated the suitability of a lyophilized bovine hemoglobin (LBH) preparation containing various fractions of oxyhemoglobin (O(2)Hb), carboxyhemoglobin (COHb), and methemoglobin (MetHb) for quality assessment in multicomponent analysis (MCA) of hemoglobin derivatives. It was demonstrated that

  2. Carbon monoxide kinetics following simulated cigarette smoking

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    Karnik, A.S. (Wayne State Univ., Detroit, MI); Coin, E.J.


    Carbon monoxide kinetics were measured in the blood (% carboxyhemoglobin) and alveolar phase (ppM carbon monoxide) after simulated cigarette smoking. Cigarette smoking was siumlated using the same amount of carbon monoxide that 2R1F cigarettes manufactured by the Tobacco Research Institute would contain. Ten boluses of air containing carbon monoxide equivalent to smoking one cigarette were inhaled by six healthy nonsmoker volunteers. Carbon monoxide in the air phase was measured by an Ecolyzer and carboxyhemoglobin was measured by a CO-Oximeter. The mean rise in alveolar carbon monoxide immediately and 20 min after inhaling the last bolus was 3.3 and 3.1 ppM, respectively (p<.005). The mean rise in carboxyhemoglobin immediately and 20 min after inhalation of the last bolus was 0.8 and 0.5% respectively (P<.005). The changes in carboxyhemoglobin were found to be similar to changes that occur when one cigarette is actually smoked.

  3. A simple method for HbF analysis. (United States)

    von Mandach, U; Tuchschmid, P; Huch, A; Huch, R


    Spectrophotometric methods with CO-oxymeters for measurements of carboxyhemoglobin and/or oxygen saturation in human blood include a systematic error depending on the percentage of fetal hemoglobin. It is of clinical importance to estimate the fetal hemoglobin to correct HbCO and SO2 values respectively. The described method is simple and less time consuming than conventional methods like HPLC or electrophoresis. The two measurements of oxy- and carboxyhemoglobin in the same blood sample with different oxygen saturation are needed for the estimation of the HbF and can be performed, including the deoxygenation procedure, in about 40 minutes.

  4. Simulations of exercise and brain effects of acute exposure to carbon monoxide in normal and vascular-diseased persons. (United States)

    At some level, carboxyhemoglobin (RbCO) due to inhalation of carbon monoxide (CO) reduces maximum exercise duration in normal and ischemic heart patients. At high RbCO levels in normal subjects, brain function is also affected and behavioral performance is impaired. These are fin...

  5. The current status of continuous noninvasive measurement of total, carboxy, and methemoglobin concentration. (United States)

    Shamir, Micha Y; Avramovich, Aharon; Smaka, Todd


    Intraoperative early detection of anemia, identifying toxic levels of carboxyhemoglobin after carbon monoxide exposure and titrating drug dosage to prevent toxic levels of methemoglobin are important goals. The pulse oximeter works by illuminating light into the tissue and sensing the amount of light absorbed. The same methodology is used by laboratory hemoglobinometers to measure hemoglobin concentration. Because both devices work in the same way, efforts were made to modify the pulse oximeter to also measure hemoglobin concentration. Currently there are 2 commercial pulse oximeters (Masimo Rainbow SET and OrSense NBM-200MP) that measure total hemoglobin concentration and one (Masimo) that also measures methemoglobin and carboxyhemoglobin. In this review, we describe the peer-reviewed literature addressing the accuracy of these monitors.

  6. Precision of a new bedside method for estimation of the circulating blood volume

    DEFF Research Database (Denmark)

    Christensen, P; Eriksen, B; Henneberg, S W


    and after ventilation with a gas mixture containing 20-50 ml of CO for a period of 10-15 min. A special Water's to and fro system was designed in order to avoid any leakage when measuring during intermittent positive pressure ventilation (IPPV). Blood samples were taken before and immediately after......, determination of CBV can be performed with an amount of CO that gives rise to a harmless increase in the carboxyhemoglobin concentration.(ABSTRACT TRUNCATED AT 250 WORDS)...

  7. In Vivo Optical Coherence Tomography Detection of Differences in Regional Large Airway Smoke Inhalation Induced Injury in a Rabbit Model (United States)


    the end of smoke exposure. To obtain a broad range of carbon monoxide levels, additional breaths were given to some animals to raise the...of a movement with the rotational probe would yield false results); and finally, the rotational probe can only capture a fraction of the image...endotracheal tube.2 Carboxyhemoglobin levels were obtained in the animals as a marker of the degree of exposure. A range of carbon monoxide levels was

  8. Human Adaptation to the Tibetan Plateau (United States)


    588-91. 32. Penaloza D, Sime F. Chronic cor pulmonale ventilatory drives in Tibetan than Han residents 28. Mahler DA, Cunningham LN, Skrinar GS, due...Tibetan. er (Warren Collins) could be attached. The sured using the dry gas meter and were cor - Diagnosis of CMS was based on a blood remaining...02 carrying-capacity was cor - rial 02 content was lower in the pregnant rected for the carboxyhemoglobin levels Colorado and Tibet women compared to

  9. Development of Behavioral Toxicology Methodology for Interactive Exposure Regimens. (United States)


    include forest fires, terpene oxidation, and the oceans (National Academy of Science, 1977). The principal anthropogenic source is the incomplete...Carboxyhemoglobin in Blood 1. Principle of the Method Absorbance measurements are made in the Soret region at a blood .dilution of approximately 1:1000. The...thus providing the two component system COHb-Hb for absorbance measurements -at 420 and 432 nm. At 420 nm. the absorbance of COHb is about double

  10. Heme Oxygenase-1 mRNA Expression in Egyptian Patients With Chronic Liver Disease

    Directory of Open Access Journals (Sweden)

    Abeer El-Sayed Abd El-Wahab


    Full Text Available Background: Chronic liver disease (CLD is a global medical problem. This disease is associated with increased hepatic oxidative stress. One of the antioxidant enzymes that protect cells against this stress is heme oxygenase-1 (HO-1.Objectives: This study aimed to investigate the mRNA expression of HO-1 in Egyptian patients with CLD and its relation to oxidative stress biomarkers.Patients and Methods: Levels of serum ferritin, carboxyhemoglobin, malondialdehyde (MDA, and erythrocyte-reduced glutathione (GSH were measured, and HO-1 mRNA expression was detected in 45 CLD patients (15 with nonalcoholic steatohepatitis [NASH], 15 with chronic hepatitis C, and 15 with liver cirrhosis and 15 healthy controls.Results: HO-1 mRNA expression was increased in patients with NASH, chronic hepatitis C, and liver cirrhosis compared to controls. The expression in cirrhotic patients was significantly higher than that in patients with NASH and chronic hepatitis C. Compared to controls, patients with NASH, chronic hepatitis C, and liver cirrhosis had higher levels of ferritin, carboxyhemoglobin, and MDA and lower levels of GSH. HO-1 mRNA expression was positively correlated with levels of carboxyhemoglobin, serum ferritin, and serum MDA and negatively correlated with levels of erythrocyte GSH in CLD patients.Conclusions: HO-1 mRNA expression was significantly increased in CLD patients, and the increase reflected the severity of the disease. The significant relationship between the increased HO-1 expression and oxidative stress biomarkers in patients with CLD suggests that HO-1 may play an important role in protecting the liver from oxidative stress-dependent damage. Therefore, induction of HO-1 could be a novel therapeutic option for CLD.

  11. Analysis of Carbon Monoxide in Blood (United States)

    Huddle, Benjamin P.; Stephens, Joseph C.


    Forensic tests used to perform the qualitative and quantitative analyses of carbon monoxide in blood are described. The qualitative test uses the diffusion of CO, which is released from blood by reaction with H2SO4, into a PdCl2 solution in a Conway cell and the resultant formation of a palladium mirror. The quantitative analysis is based on the absorption of visible light by carboxyhemoglobin at 541 nm and reduced hemoglobin at 555 nm. Both procedures are suitable for undergraduate chemistry experiments.

  12. Admission Chest CT Complements Fiberoptic Bronchoscopy in Prediction of Adverse Outcomes in Thermally Injured Patients (United States)


    full-thickness burn (% FT), injury severity score (ISS), presence of tracheos- tomy, arterial carboxyhemoglobin levels (COHb), and the ratio ( PFR ) of...146) 57 (12, 126) .03 No. CT slices 17 (16, 20) 17 (16, 19) .87 RADS per slice 7.1 (4.4, 9.7) 3.0 (0.2, 7.2) .03 RADS ≥ 8 36 (9) 16 (3) .181 PFR 252...113, 407) 284 (130, 504) .32 * Expressed as median (Q1, Q3) or % (total). RADS, radiologist score; PFR , arterial oxygen tension to fraction of

  13. Evaluation of carbon monoxide in blood samples from the second health and nutrition survey. Progress report No. 1

    Energy Technology Data Exchange (ETDEWEB)

    Radford, E.P.


    This is a study of carbon monoxide (CO) in the blood of human subjects participating in the Second National Health and Nutrition Survey (HANES II), a detailed study of health indicators in sample populations of many communities throughout the U.S. The purpose of this aspect of the survey is to evaluate the levels of blood carboxyhemoglobin in normal individuals of all ages in typical U.S. communities, from whom accurate histories and clinical studies are available. This report gives results of the first of three years of analyses. A careful calibration of the analytical method has been completed, and more than 3000 blood samples have been analyzed. Although smoking histories are not yet available to permit evaluation of carboxyhemoglobin in non-smokers, in children under 12 years of age, blood COHb has been found to be consistently low, with less than 3% greater than 1.5% COHb. These preliminary results suggest that urban exposure to carbon monoxide among the general population is not now significant in the U.S., at least during the period of these early examinations.

  14. Validation of the smoking habits of a sample of the patient population seen in a pulmonary function laboratory. (United States)

    Herbert, F A; Enarson, D A; Hackett, R L


    From a structured history of 32 current smokers seen in the pulmonary function laboratory of a community hospital, we determined the number of cigarettes they smoked in 24 h. We also asked them to estimate their cigarette butt lengths from a visual model and to collect all cigarette butts over the next 24 h and mail them to us. We counted the butts, individually measured their lengths, and compared these with their previous estimates in order to validate their claims. While in the laboratory, we determined the level of carboxyhemoglobin in the peripheral blood of each patient. Patients tended to estimate the numbers of cigarettes that they smoked in units of five. Light smokers returned more butts and heavy smokers returned fewer butts than the numbers they reported as usually smoking. All patients were able to precisely estimate the average length of their cigarette butts, and they left butts of consistent lengths. There was no association between the numbers of cigarettes smoked and the butt lengths. Carboxyhemoglobin levels were positively associated with the numbers of cigarettes smoked in 24 h and negatively associated with the butt length and the time elapsed since the last cigarette was smoked, but these were not associated with the amount of tar in the cigarettes or with the number of years the person had smoked.

  15. Are self-reports of smoking rate biased? Evidence from the Second National Health and Nutrition Examination Survey. (United States)

    Klesges, R C; Debon, M; Ray, J W


    This study determined evidence for digit preference in self-reports of smoking in the Second National Health and Nutrition Examination Survey (NHANES II). Subjects were 4275 adult smokers. Self-reports of smoking showed a marked degree of digit preference, with the vast majority of smokers reporting in multiples of 10 cigarettes per day. When number per day was compared to an objective measure of smoking exposure (carboxyhemoglobin; n = 2070) the distribution was found to be significantly assymetrical. Analysis of the distribution of COHb and various levels of number per day indicates that the differences in distribution are not due to variability in COHb. Heavier smokers, Caucasians, and those with less education were more likely to report a digit preference than lighter smokers. African-Americans, and those with more education. Results suggest that self-reports of number of cigarettes per day may be biased towards round numbers (particularly 20 cigarettes per day). Implications for assessment of smoking behavior are discussed.

  16. Suicide by self-incineration

    DEFF Research Database (Denmark)

    Leth, Peter Mygind; Hardt-Madsen, Michael


    was 43 years, with a broad age range (20-87). Many incidents of self-incineration as a form of political protest were reported in the press especially during the 1960s and 1970s, and the press reports often inspired others to commit suicide in the same way. None of the cases in our investigation were...... victims were of Danish origin, and a religious motive played no significant role. Most of the victims were suffering from mental illness, and a majority had tried to commit suicide before. None of the victims left a suicide note. The scene was most often at home and indoors--only a minority committed...... suicide in remote areas of the countryside. Most were found dead at the scene, and the cause of death was usually heat exposure. Only a minority had a lethal carboxy-hemoglobin (CO-Hb) concentration. It is concluded that close cooperation between police, fire experts, and the forensic pathologist...

  17. Immunohistochemical investigation of pulmonary surfactant-associated protein A in fire victims. (United States)

    Zhu, B L; Ishida, K; Oritani, S; Quan, L; Taniguchi, M; Li, D R; Fujita, M Q; Maeda, H


    To evaluate the forensic pathological significance of the immunohistochemical distribution of pulmonary surfactant-associated protein A (SP-A) in determining the cause of death in fires, 57 fire victims were examined by scoring the staining intensity. The highest SP-A score with dense granular deposits (aggregates) in the intra-alveolar space was frequently observed in cases with a lower blood carboxyhemoglobin (COHb) level (fires. High SP-A scores showed a relation to the serum level and in part related to the bloody exudate in the lower airway. These observations suggested that the increase in SP-A in fire victims may be mainly related to pulmonary alveolar injury due to the inhalation of hot air and/or irritant gases rather than hypoxia.

  18. 11.3.Upper respiratory tract disease and bronchial asthma

    Institute of Scientific and Technical Information of China (English)


    930295 Factors influencing carboxyhemog-lobin kinetics in inhalation lung injury.WU Wenxi (吴文溪).ist Affili Hosp,Nanjing MedCoil,210029.Chin J Intern Med 1992;31 (11):689—691.Anesthetized dogs were ventilated with 1%carbon monoxide (CO) in air for 10 minutes toproduce CO poisoning and then with room air (n=5) or pure oxygen (n=5) for 3 hours as con-trol.Acute lung injury was produced by intratra-cheal injection of 0.1 N HC1 (2 ml/kg) 30 min-utes before CO poisoning in another 10 experi-mental dogs.Arterial blood gas and earboxyhe-moglobin (COHb) were monitored before andafter CO poisoning.Pharmacokinetic analysis

  19. Carbon monoxide toxicity. (Latest citations from the Life Sciences Collection database). Published Search

    Energy Technology Data Exchange (ETDEWEB)



    The bibliography contains citations concerning the mechanism and clinical manifestations of carbon monoxide (CO) exposure, including the effects on the liver, cardiovascular, and nervous systems. Topics include studies of the carbon monoxide binding affinity with hemoglobin, measurement of carboxyhemoglobin in humans and various animal species, carbon monoxide levels resulting from tobacco and marijuana smoke, occupational exposure and the NIOSH (National Institute for Occupational Safety and Health) biological exposure index, symptomology and percent of blood CO, and intrauterine exposure. Air pollution, tobacco smoking, and occupational exposure are discussed as primary sources of carbon monoxide exposure. The effects of cigarette smoking on fetal development and health are excluded and examined in a separate bibliography. (Contains 50-250 citations and includes a subject term index and title list.) (Copyright NERAC, Inc. 1995)

  20. Carbon monoxide toxicity. (Latest citations from the Life Sciences Collection database). Published Search

    Energy Technology Data Exchange (ETDEWEB)



    The bibliography contains citations concerning the mechanism and clinical manifestations of carbon monoxide (CO) exposure, including the effects on the liver, cardiovascular, and nervous systems. Topics include studies of the carbon monoxide binding affinity with hemoglobin, measurement of carboxyhemoglobin in humans and various animal species, carbon monoxide levels resulting from tobacco and marijuana smoke, occupational exposure and the NIOSH (National Institute for Occupational Safety and Health) biological exposure index, symptomology and percent of blood CO, and intrauterine exposure. Air pollution, tobacco smoking, and occupational exposure are discussed as primary sources of carbon monoxide exposure. The effects of cigarette smoking on fetal development and health are excluded and examined in a separate bibliography.(Contains 50-250 citations and includes a subject term index and title list.) (Copyright NERAC, Inc. 1995)

  1. Carbon monoxide toxicity. (Latest citations from the Life Sciences Collection database). NewSearch

    Energy Technology Data Exchange (ETDEWEB)


    The bibliography contains citations concerning the mechanism and clinical manifestations of carbon monoxide (CO) exposure, including the effects on the liver, cardiovascular, and nervous systems. Topics include studies of the carbon monoxide binding affinity with hemoglobin, measurement of carboxyhemoglobin in humans and various animal species, carbon monoxide levels resulting from tobacco and marijuana smoke, occupational exposure and the NIOSH (National Institute for Occupational Safety and Health) biological exposure index, symptomology and percent of blood CO, and intrauterine exposure. Air pollution, tobacco smoking, and occupational exposure are discussed as primary sources of carbon monoxide exposure. The effects of cigarette smoking on fetal development and health are excluded and examined in a separate bibliography. (Contains a minimum of 137 citations and includes a subject term index and title list.)

  2. Carbon monoxide toxicity. (Latest citations from the Life Sciences Collection data base). Published Search

    Energy Technology Data Exchange (ETDEWEB)


    The bibliography contains citations concerning the mechanism and clinical manifestations of carbon monoxide (CO) exposure, including the effects on the liver, cardiovascular, and nervous systems. Topics include studies of the carbon monoxide binding affinity with hemoglobin, measurement of carboxyhemoglobin in humans and various animal species, carbon monoxide levels resulting from tobacco and marijuana smoke, occupational exposure and the NIOSH (National Institute for Occupational Safety and Health) biological exposure index, symptomology and percent of blood CO, and intrauterine exposure. Air pollution, tobacco smoking, and occupational exposure are discussed as primary sources of carbon monoxide exposure. The effects of cigarette smoking on fetal development and health are excluded and examined in a separate bibliography. (Contains a minimum of 172 citations and includes a subject term index and title list.)

  3. [Fire disaster due to deflagration of a propane gas-air mixture]. (United States)

    Nadjem, Hadi; Vogt, Susanne; Simon, Karl-Heinz; Pollak, Stefan; Geisenberger, Dorothee; Kramer, Lena; Pircher, Rebecca; Perdekampl, Markus Große; Thierauf-Emberger, Annette


    On 26 Nov 2012, a serious fire occurred at Neustadt/Black Forest in which 14 persons in a sheltered workshop died and 10 other individuals were injured. The fire was caused by the unbridled escape of propane gas due to accidental disconnection of the screw fixing between a gas bottle and a catalytic heater. Deflagration of the propane gas-air mixture set the workshop facilities on fire. In spite of partly extensive burns the fatally injured victims could be rapidly identified. The results of the fire investigations at the scene and the autopsy findings are presented. Carboxyhemoglobin concentrations ranged between 8 and 56 % and signs of fire fume inhalation were present in all cases. Three victims had eardrum ruptures due to the sudden increase in air pressure during the deflagration.

  4. Precision of a new bedside method for estimation of the circulating blood volume

    DEFF Research Database (Denmark)

    Christensen, P; Eriksen, B; Henneberg, S W


    The present study is a theoretical and experimental evaluation of a modification of the carbon monoxide method for estimation of the circulating blood volume (CBV) with respect to the precision of the method. The CBV was determined from measurements of the CO-saturation of hemoglobin before...... and after ventilation with a gas mixture containing 20-50 ml of CO for a period of 10-15 min. A special Water's to and fro system was designed in order to avoid any leakage when measuring during intermittent positive pressure ventilation (IPPV). Blood samples were taken before and immediately after......, determination of CBV can be performed with an amount of CO that gives rise to a harmless increase in the carboxyhemoglobin concentration.(ABSTRACT TRUNCATED AT 250 WORDS)...

  5. Determination of Human Hemoglobin Derivatives. (United States)

    Attia, Atef M M; Ibrahim, Fatma A A; Abd El-Latif, Noha A; Aziz, Samir W; Abdelmottaleb Moussa, Sherif A; Elalfy, Mohsen S


    The levels of the inactive hemoglobin (Hb) pigments [such as methemoglobin (metHb), carboxyhemoglobin (HbCO) and sulfohemoglobin (SHb)] and the active Hb [in the oxyhemoglobin (oxyHb) form] as well as the blood Hb concentration in healthy non pregnant female volunteers were determined using a newly developed multi-component spectrophotometric method. The results of this method revealed values of SHb% in the range (0.0727-0.370%), metHb% (0.43-1.0%), HbCO% (0.4-1.52%) and oxyHb% (97.06-98.62%). Furthermore, the results of this method revealed values of blood Hb concentration in the range (12.608-15.777 g/dL). The method is highly sensitive, accurate and reproducible.

  6. Maintain levels of nicotine but reduce other smoke constituents: a formula for ''less-hazardous'' cigarettes

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, J.C.; Young, J.C.; Rickert, W.S.


    Twenty-two volunteers who smoked more than 20 cigarettes with ''high'' nicotine yields (0.8 to 1.2 mg) per day participated in an 8-week study designed to test the hypothesis that smoking cigarettes with a constant level of nicotine but reduced deliveries of tar, carbon monoxide, and hydrogen cyanide leads to a decrease in smoke absorption. All subjects smoked their usual high-nicotine brand for the first 3 weeks (P1), and the absorption of smoke constituents was determined from levels of thiocyanate and cotinine in saliva and serum, levels of carbon monoxide in expired air, and levels of carboxyhemoglobin in the blood. During the final 5 weeks (P2), the treatment group (16 subjects) switched to the ''light'' version of their usual brands (similar yields of nicotine but with reduced yields of tar, carbon monoxide, and hydrogen cyanide); the control group (6 subjects) smoked their usual brands for the duration of the study. Average levels of cotinine for the subjects who switched during P2 were not significantly different from those of the control group as was expected. Slight reductions were noted in average expired-air carbon monoxide levels, blood carboxyhemoglobin, and saliva thiocyanate, but these reductions were smaller than anticipated based on brand characteristics. The results suggest that the ratio of smoke constituents is different when individuals, rather than machines, smoke cigarettes. Yields determined under subject-defined conditions are necessary in order to properly evaluate the role of nicotine in the design of ''less-hazardous'' cigarettes.

  7. Evaluation of neurological and cardiological findings in carbonmonoxide poisoning in children (United States)

    Boztepe, Hatice; Yalaki, Zahide; Bilge, Yıldız Dallar


    Aim: The aim of our study was to investigate the relation of blood carboxyhemoglobin level with presentation finding and clinical properties and to demonstrate neurological and cardiological findings which are indicators of tissue hypoxia in patients followed up because of carbonmonoxide (CO) poisoning. Material and Methods: Three hundred and twenty-five patients who were followed up because of carbonmonoxide poisoning between 2011 and 2013 in our pediatric emergency department were evaluated prospectively. Ethics committee approval was obtained for the study on 10.19.2011 (number: 0437). The carbonmonoxide levels, source of intoxication, neurological and cardiological findings and treatment methods were recorded. Blood gases and cardiac enzymes were studied and electrocardiography (ECG) was performed. The data were analysed using SPSS for windows 16.0 package program. Results: One hundred and sixty-eight (51.7%) of the patients were female and the median age was 9 years (11 days–17 years). Two hundred and twenty-eight (70.2%) of the patients were poisoned while using heater and 78.1% presented during winter months. The median carbonmonoxide level of the patients was found to be 24.8%. Cardiac enzymes were found to be increased in 10.5% of the patients, first degree A-V block was found in 0.6% and negative T wave was found in 0.3%. Glasgow coma score was found to be below 14 in 4.6% of the patients. A significant correlation was found between the carboxyhemoglobin levels and neurological findings, cardiological findings and lactate (p<0.05). Normobaric oxygen treatment was given to 76.3% of the patients and hyperbaric oxygen treatment was given to 23.7%. Conclusions: We think that neurological disorders and cardiac findings may be closely related, since systemic involvement may be easier in carbonmonoxide poisoning in children, Glasgow coma score should be assessed in the follow-up of the patients and cardiac enzymes and serum lactate levels should be monitored

  8. Nitric oxide modulates hypoxic pulmonary smooth muscle cell proliferation and apoptosis by regulating carbon monoxide pathway

    Institute of Scientific and Technical Information of China (English)

    Yan-fei WANG; Hong TIAN; Chao-shu TANG; Hong-fang JIN; Jun-bao DU


    Aim: To explore the role of carbon monoxide (CO) in the regulation of hypoxic pulmonary artery smooth muscle cell (PASMC) proliferation and apoptosis by nitric oxide (NO). Methods: PASMC of Wistar rats was cultured in vitro in the presence of a NO donor, sodium nitroprusside, or an inhibitor of heme oxygenase (HO), zinc protoporphyrin-IX, or under both normoxic and hypoxic conditions.Nitrite and carboxyhemoglobin in PASMC medium were detected with spectrophotometry. The proliferating and apoptotic percentage of PASMC was measured by flow cytometry. The expression of HO-1 mRNA in PASMC was analyzed by fluorescent real-time quantitative PCR, and the proliferating cell nuclear antigen and caspase-3 were examined by immunocytochemical analysis. Results: The results showed that hypoxia suppressed NO generation from PASMC, which promoted hypoxic PASMC proliferation and induced apoptosis. Meanwhile, hy-poxia induced HO-1 expression in PASMC and promoted CO production from PASMC, which inhibited PASMC proliferation and regulated PASMC apoptosis. NO upregulated the expression of HO-1 mRNA in hypoxic PASMC; NO also inhib-ited proliferation and promoted apoptosis of hypoxic PASMC, possibly by regu-lating the production of CO. Conclusion: The results indicated that CO could inhibit proliferation and regulate apoptosis of PASMC, and NO inhibited prolifera-tion and promoted apoptosis of hypoxic PASMC, possibly by regulating the pro-duction of CO.

  9. In-utero carbon monoxide poisoning and multiple fetal abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Hennequin, Y.; Blum, D.; Vamos, E.; Steppe, M.; Goedseels, J.; Cavatorta, E. (Free Univ. of Brussels (Belgium). Queen Fabiola Children' s Hospital)


    Carbon monoxide (CO) poisoning during pregnancy can lead to feto-maternal fatalities and stillbirths. Teratogenic effects have been reported. The authors strongly suspected an association between mild but chronic CO poisoning of the mother and major multiple malformations in the baby. Retrospective interviews of the mother disclosed that at 10 weeks' gestation, she had complained of headache and dizziness. At the same time, her 16-month-old daughter had an episode of unconsciousness. A faulty kitchen gas water-heater was suspected but the family did not have it repaired. The mother continued to have headaches regularly. During the 7th month of pregnancy, the daughter was found comatose. In the emergency ward, carboxyhemoglobins levels were 27.5% for the child and 14% for the pregnant mother. Both were treated with hyperbaric oxygen. Investigations by the gas company revealed a highly abnormal CO production from the kitchen and bathroom gas-water heaters: 120 and 100 parts per million, respectively, after 2 minutes of use.

  10. The complex analytical method for assessment of passive smokers' exposure to carbon monoxide. (United States)

    Czogala, Jan; Goniewicz, Maciej Lukasz


    Carbon monoxide (CO) is one of the toxic constituents in tobacco smoke. The aim of the study was to evaluate a complex analytical method that allows quantification of the exposure of passive smokers to CO. The exposed volunteers were placed in the model room where portions of cigarettes (5, 10, or 15 cigarettes every 30 or 60 min over 4 h) were smoked using a homemade smoking machine. The concentrations of CO and of the ventilation marker (methane) were monitored for the duration of each experiment. CO and methane were analyzed on-line using GC-FID with methanization. Carboxyhemoglobin (COHb) was analyzed twice: just before and after the experiment. After hemolysis of a 100-microL blood sample, CO was quantitatively released by adding 10% K3[Fe(CN)6] inside a small reactor and under stable pressure transported through a microtube with an absorbing agent on a chromatography loop. The proposed analytical method allows us to quantify exposure of passive smokers by measuring the dose-effect correlation. We observed that increasing COHb levels were directly correlated with the CO concentration in the air, but were also intermediately correlated with the frequency and number of smoked cigarettes and with the ventilation coefficient.

  11. Combined characterization of bovine polyhemoglobin microcapsules by UV-Vis absorption spectroscopy and cyclic voltammetry. (United States)

    Knirsch, Marcos Camargo; Dell'Anno, Filippo; Salerno, Marco; Larosa, Claudio; Polakiewicz, Bronislaw; Eggenhöffner, Roberto; Converti, Attilio


    Polyhemoglobin produced from pure bovine hemoglobin by reaction with PEG bis(N-succynimidil succinate) as a cross-linking agent was encapsulated in gelatin and dehydrated by freeze-drying. Free carboxyhemoglobin and polyhemoglobin microcapsules were characterized by UV-Vis spectroscopy in the absorption range 450-650 nm and cyclic voltammetry in the voltage range from -0.8 to 0.6 mV to evaluate the ability to break the bond with carbon monoxide and to study the carrier's affinity for oxygen, respectively. SEM used to observe the shape of cross-linked gelatin-polyhemoglobin microparticles showed a regular distribution of globular shapes, with mean size of ~750 nm, which was ascribed to gelatin. Atomic absorption spectroscopy was also performed to detect iron presence in microparticles. Cyclic voltammetry using an Ag-AgCl electrode highlighted characteristic peaks at around -0.6 mV that were attributed to reversible oxygen bonding with iron in oxy-polyhemoglobin structure. These results suggest this technique as a powerful, direct and alternative method to evaluate the extent of hemoglobin oxygenation.

  12. Consequences of brief exposure to high concentrations of carbon monoxide in conscious rats. (United States)

    Gu, Zengfa; Januszkiewicz, Adolph J; Mayorga, Maria A; Coleman, Gary D; Morrissette, Craig R


    Exposure to high-concentration carbon monoxide (CO) is of concern in military operations. Experimentally, the physiologic manifestations of a brief exposure to elevated levels of CO have not been fully described. This study investigated the development of acute CO poisoning in conscious male Sprague-Dawley rats (220-380 g). Animals were randomly grouped (n = 6) and exposed to either air or 1 of 6 CO concentrations (1000, 3000, 6000, 10,000, 12,000, or 24,000 ppm) in a continuous air/CO dynamic exposure chamber for 5 min. Respiration was recorded prior to and during exposures. Mixed blood carboxyhemoglobin (COHb) and pH were measured before and immediately after exposure. Before exposure the mean baselines of respiratory minute volumes (RMVs) were 312.6 +/- 43.9, 275.2 +/- 40.8, and 302.3 +/- 39.1 ml/min for the 10,000, 12,000 and 24,000 ppm groups, respectively. In the last minute of exposure RMVs were 118.9 +/- 23.7, 62.1 +/- 10.4, and 22.0 +/- 15.1% (p 82%. Blood pH was unaltered and no death occurred in rats exposed to CO at concentrations 10,000 ppm for brief periods as short as 5 min may change RMV, resulting in acute respiratory failure, acidemia, and even death.

  13. Response of Hepatoma 9618a and Normal Liver to Host Carbogen and Carbon Monoxide Breathing

    Directory of Open Access Journals (Sweden)

    Simon P. Robinson


    Full Text Available The effects of hyperoxia (induced by host carbogen 95% oxygen/5% carbon dioxide breathing. and hypoxia (induced by host carbon monoxide CO at 660 ppm. breathing were compared by using noninvasive magnetic resonance (MR methods to gain simultaneous information on blood flow/oxygenation and the bioenergetic status of rat Morris H9618a hepatomas. Both carbogen and CO breathing induced a 1.5- to 2-fold increase in signal intensity in blood oxygenation level dependent (BOLD MR images. This was due to a decrease in deoxyhemoglobin (deoxyHb, which acts as an endogenous contrast agent, caused either by formation of oxyhemoglobin in the case of carbogen breathing, or carboxyhemoglobin with CO breathing. The results were confirmed by observation of similar changes in deoxyHb in arterial blood samples examined ex vivo after carbogen or CO breathing. There was no change in nucleoside triphosphates (NTP/PI in either tumor or liver after CO breathing, whereas NTP/Pl increased twofold in the hepatoma (but not in the liver after carbogen breathing. No changes in tumor intracellular pH were seen after either treatment, whereas extracellular pH became more alkaline after CO breathing and more acid after carbogen breathing, respectively. This tumor type and the liver are unaffected by CO breathing at 660 ppm, which implies an adequate oxygen supply.

  14. Rhesus isoimmunization: increased hemolysis during early infancy. (United States)

    Hayde, M; Widness, J A; Pollak, A; Kohlhauser-Vollmuth, C; Vreman, H J; Stevenson, D K


    The objective of the present study was to determine whether whole blood carboxyhemoglobin (COHb) and plasma bilirubin, two indicators of hemolysis, are elevated in infants with severe Rh isoimmune hemolytic disease during the first months of life. Beginning at 2 wk of age and continuing monthly for 3 mo, serial blood samples were obtained for COHb, plasma bilirubin, Hb, reticulocyte count, plasma erythropoietin, plasma enzymes, and plasma iron. Because control infants (n = 13) and infants with ABO hemolytic disease (n = 5) did not differ from one another in any of the study parameters, these two groups were combined and compared with infants with the Rh isoimmunization. Infants with severe Rh isoimmune hemolytic disease (n = 13) were found to have significantly lower Hb and significantly higher bilirubin, the COHb fraction divided by the Hb concentration (COHb/Hb), and plasma erythropoietin levels at 2 and 6 wk of age, and reticulocyte counts at 6 wk. The remaining parameters were not different between the control-ABO group and Rh-isoimmune group at any of the study intervals. The study's two primary indicators of hemolysis, plasma bilirubin and COHb/Hb, were significantly correlated with one another in the Rh-immunized group (r = 0.66, p isoimmunization demonstrated a mean half-life of 14.3 d. We speculate that, among infants with severe Rh isoimmune hemolytic disease, elevated total bilirubin levels and COHb/Hb ratios identified in the early weeks of life indicate continuing hemolysis due to persistence of maternal Rh antibodies.

  15. Intramuscular bleeding of the tongue in the victims of house fire. (United States)

    Hashimoto, Yoshiaki; Moriya, Fumio; Nakanishi, Akinori


    Intramuscular bleeding of the tongue is frequently observed in autopsy cases of house fire victims. The meaning of this finding has not yet been fully discussed. We examined 69 autopsy cases of house fire victims and investigated several factors contributing to intramuscular bleeding of the tongue. Victims comprised 45 males and 24 females, ranging in age from 1 to 95 years old. Sixty-four cases (93%) involved severely charred bodies, while the remaining five bodies displayed slight burns. Factors studied were age, sex, posture of the body at the scene of the fire, degree of burn injury and carboxyhemoglobin (CO-Hb) levels in blood. CO-Hb level proved to be the only factor relevant to intramuscular bleeding of the tongue. Of 69 autopsy cases, 23 (33%) demonstrated intramuscular bleeding of the tongue (13 cases of slight bleeding, ten cases of severe bleeding). Low concentrations of CO-Hb (fire victims. The burned regions of the body in the early stage of the fire process were unclear due to severe charring in most victims. However, asphyxiation due to neck compression is known to often induce intramuscular bleeding of the tongue. Lack of skin elasticity following burns, particularly in the neck, might act in a similar manner to asphyxial neck compression. In conclusion, intramuscular bleeding of the tongue in fire victims may occur as a vital reaction to burns.

  16. Swedish forensic data 1992-2009 suggest hydrogen cyanide as an important cause of death in fire victims. (United States)

    Stamyr, Kristin; Thelander, Gunilla; Ernstgård, Lena; Ahlner, Johan; Johanson, Gunnar


    Between 60 and 80% of all deaths related to fire are attributed to toxic fumes. Carbon monoxide (CO) is commonly thought to be the major cause. However, hydrogen cyanide (HCN) is also formed. Still, the exact contribution of HCN to fire-related fatalities is unknown. The aim of the study was to investigate the impact of HCN in relation to CO as a cause of death in fire victims. Data on carboxyhemoglobin (COHb) and blood cyanide from deceased fire victims in the period 1992-2009 were collected from two Swedish nationwide forensic databases (ToxBase and RättsBase). The databases contain data on COHb and/or cyanide from 2303 fire victims, whereof 816 on both COHb and cyanide. Nonparametric statistical tests were used. Seventeen percent of the victims had lethal or life-threatening blood cyanide levels (>1 µg/g) and 32% had lethal COHb levels (>50% COHb). Over 31% had cyanide levels above 0.5 µg/g, an indication of significant HCN exposure. The percentages may be underestimates, as cyanide is quickly eliminated in blood also after death. Our results support the notion that HCN contributes more to the cause of death among fire victims than previously thought.

  17. Contribution of forensic autopsy to scene reconstruction in mass fire casualties: a case of alleged arson on a floor consisting of small compartments in a building. (United States)

    Michiue, Tomomi; Ishikawa, Takaki; Oritani, Shigeki; Maeda, Hitoshi


    A fire is an important cause of mass disasters, involving various forensic issues. Before dawn on an early morning, 16 male visitors in their twenties to sixties were killed in a possibly incendiary fire at a 'private video parlor' consisting of small compartments in a building. The main causes of death as determined by forensic autopsy were acute carbon monoxide (CO) intoxication for all of the 15 found-dead victims, and hypoxic-ischemic encephalopathy following acute CO intoxication for a victim who died in hospital. Burns were mild (victims, except for three victims found between the entrance and the estimated fire-outbreak site; thus, identification was completed without difficulty, supported by DNA analysis. Blood carboxyhemoglobin saturation (COHb) was higher for victims found dead in the inner area. Blood cyanide levels were sublethal, moderately correlated to COHb, but were higher in victims found around the estimated fire-outbreak site. There was no evidence of thinner, alcohol or drug abuse, or an attack of disease as a possible cause of an accidental fire outbreak. These observations contribute to evidence-based reconstruction of the fire disaster, and suggest how deaths could have been prevented by appropriate disaster measures.

  18. Idiopathic erythrocytosis in a patient on chronic hemodialysis

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    Dong Hyun Lee


    Full Text Available A 78-year-old man on hemodialysis presented to our hospital with erythrocytosis. He had started hemodialysis 4 years previously, with a hemoglobin level of 9.8 g/dL, and was administered erythropoiesis stimulating agents and ferrous sulfate. Two years previously, his hemoglobin level increased to 14.5 g/dL and the treatment for anemia was discontinued. He continued hemodialysis thrice weekly; however, the hemoglobin level had increased to 17.0 g/dL at the time of presenting to our hospital. His serum erythropoietin level was 31.4 mIU/mL (range, 3.7–31.5 mIU/mL, carboxyhemoglobin level was 0.6% (range, 0–1.5%, and oxygen saturation in ambient air was 95.4%. The JAK2 V617F mutation was not observed and other bone marrow abnormalities were not identified. The patient was diagnosed with bladder cancer and a transurethral resection was performed. Eight months after the treatment of bladder cancer, his hemoglobin level was 15.1 g/dL, and he was diagnosed with idiopathic erythrocytosis.

  19. Optical noninvasive calculation of hemoglobin components concentrations and fractional oxygen saturation using a ring-scattering pulse oximeter (United States)

    Abdallah, Omar; Stork, Wilhelm; Muller-Glaser, Klaus


    The deficiencies of the currently used pulse oximeter are discussed in diverse literature. A hazardous pitfalls of this method is that the pulse oximeter will not detect carboxyhemoglobin (COHb) and methemoglobin (metHb) concentrations. This leads to incorrect measurement of oxygen saturation by carbon monoxide poisoning and methemoglobinemia. Also the total hemoglobin concentration will not be considered and can only be measured in-vitro up to now. A second pitfall of the standard pulse oximetry is that it will not be able to show a result by low perfusion of tissues. This case is available inter alia when the patient is under shock or has a low blood pressure. The new non-invasive system we designed measures the actual (fractional) oxygen saturation and hemoglobin concentration. It will enable us also to measure COHb and metHb. The measurement can be applied at better perfused body central parts. Four or more light emitting diodes (LEDs) or laser diodes (LDs) and five photodiodes (PDs) are used. The reflected light signal detected by photodiodes is processed using a modified Lambert-Beer law (I=I0×e-α.d ). According to this law, when a non scattering probe is irradiated with light having the incident intensity I0, the intensity of transmitted light I decays exponentially with the absorption coefficient a of that probe and its thickness d. Modifications of this law have been performed following the theoretical developed models in literature, Monte Carlo simulation and experimental measurement.

  20. Environmentally-induced methemoglobinemia in an infant

    Energy Technology Data Exchange (ETDEWEB)

    Dean, B.S.; Lopez, G.; Krenzelok, E.P. (Pittsburgh Poison Center, Children' s Hospital of Pittsburgh, PA (United States))


    Acquired methemoglobinemia results from the exposure to various chemicals and drugs able to oxidize hemoglobin at a rate exceeding the normal enzymatic capacity for hemoglobin reduction. Levels of methemoglobin exceeding 60-70% may be associated with coma and death. We describe a case of complete, uneventful recovery involving a 10 week-old infant who presented to the Emergency Department with profound sudden onset of cyanosis, irritability, metabolic acidosis, and a lethal methemoglobin level of 71.4%. Intravenous administration of 12 mg methylene blue resulted in immediate resolution of the cyanosis and reduction of measured methemoglobin to 1.3%. The carboxyhemoglobin was negative. Sodium bicarbonate successfully corrected the acidosis. RBC reductase measurement was within normal limits, ruling out congenital methemoglobinemia. Family history revealed a wood-burning stove which emitted pine tar fumes as the potential environmental methemoglobin-producing source. The infant's cradle was situated five feet from the stove. The infant was discharged on day three of hospitalization with a methemoglobin level of 0.2%.

  1. Some short-term effects of changing to lower yield cigarettes

    Energy Technology Data Exchange (ETDEWEB)

    Minty, B.D.; Royston, D.; Jones, J.G.


    The rate of clearance from the lung of the hydrophilic tracer molecule /sup 99m/Tc DTPA was used to investigate the short-term effects on lung epithelial function when smokers switched to cigarettes with lower yields of tobacco smoke constituents. Two separate studies were performed. In the first study, subjects smoked conventional mid- and low-tar cigarettes. The second study used two specially manufactured cigarettes with similar tar and nicotine yields, but differing carbon monoxide yields. Neither study demonstrated any significant improvement in /sup 99m/Tc DTPA clearance. The yields of carbon monoxide determined under standard machine smoking conditions implied that there would be a 44 percent reduction in exposure to carbon monoxide when subjects switched from smoking conventional mid-tar to low-tar cigarettes. However, measurements of carboxyhemoglobin showed that the smokers compensated for the lower yields and their exposure was reduced by only 11 percent. Similarly, in the second study, the subjects reduced their exposure by 7 percent instead of the expected 44 percent. Urine nicotine/cotinine excretion measurements in this study indicated that there was no complimentary increase in nicotine absorption suggesting the possibility that subjects may be able to regulate their intake of individual components of the cigarette smoke. Thus, the unexpected result from this study was the finding that cigarette smokers could, in some way, regulate their intake of smoke from cigarettes of different composition so as to maintain a constant exposure of smoke constituents.

  2. Conformational changes in hemoglobin triggered by changing the iron charge

    Energy Technology Data Exchange (ETDEWEB)

    Croci, S., E-mail: [University of Parma, Departments of Public Health, INBB Parma (Italy); Achterhold, K. [Physik-Department E17 (Germany); Ortalli, I. [University of Parma, Departments of Public Health, INBB Parma (Italy); Parak, F. G. [Physik-Department E17 (Germany)


    In this work the hemoglobin conformational changes induced by changing the iron charge have been studied and compared with Myoglobin. Moessbauer spectroscopy was used to follow the change of the iron conformation. In order to compare the conformational relaxation of hemoglobin and myoglobin, and to study a possible influence of the quaternary structure, an intermediate metastable state of hemoglobin has been created by low temperature X-ray irradiation of methemoglobin. The irradiation reduces the Fe(III) of the heme groups to Fe(II) Low Spin, where the water is still bound on the sixth coordination. Heating cycles performed at temperatures from 140 K to 200 K allow the molecules to overcome an activation energy barrier and to relax into a stable conformation such as deoxy-hemoglobin or carboxy-hemoglobin, if CO is present. Slightly different structures (conformational substates) reveal themselves as a distribution of energy barriers ({Delta}G). The distribution of the activation energy, for the decay of the Fe(II) Low Spin intermediate, has been fitted with a Gaussian. For comparison, published myoglobin data were re-analysed in the same way. The average energy value at characteristic temperature is very similar in case of myoglobin and hemoglobin. The larger Gaussian energy distribution for myoglobin with respect to hemoglobin shows that more conformational substates are available. This may be caused by a larger area exposed to water. In hemoglobin, part of the surface of the chains is not water accessible due to the quaternary structure.

  3. Optical sensor technology for a noninvasive continuous monitoring of blood components (United States)

    Kraitl, Jens; Timm, Ulrich; Lewis, Elfed; Ewald, Hartmut


    NIR-spectroscopy and Photoplethysmography (PPG) is used for a measurement of blood components. The absorptioncoefficient of blood differs at different wavelengths. This fact is used to calculate the optical absorbability characteristics of blood which is yielding information about blood components like hemoglobin (Hb), carboxyhemoglobin (CoHb) and arterial oxygen saturation (SpO2). The measured PPG time signals and the ratio between the peak to peak pulse amplitudes are used for a measurement of these parameters. Hemoglobin is the main component of red blood cells. The primary function of Hb is the transport of oxygen from the lungs to the tissue and carbon dioxide back to the lungs. The Hb concentration in human blood is an important parameter in evaluating the physiological status of an individual and an essential parameter in every blood count. Currently, invasive methods are used to measure the Hb concentration, whereby blood is taken from the patient and subsequently analyzed. Apart from the discomfort of drawing blood samples, an added disadvantage of this method is the delay between the blood collection and its analysis, which does not allow real time patient monitoring in critical situations. A noninvasive method allows pain free continuous on-line patient monitoring with minimum risk of infection and facilitates real time data monitoring allowing immediate clinical reaction to the measured data.

  4. Factors affecting exposure to nicotine and carbon monoxide in adult cigarette smokers. (United States)

    Muhammad-Kah, Raheema; Liang, Qiwei; Frost-Pineda, Kimberly; Mendes, Paul E; Roethig, Hans J; Sarkar, Mohamadi


    Exposure to cigarette smoke among smokers is highly variable. This variability has been attributed to differences in smoking behavior as measured by smoking topography, as well as other behavioral and subjective aspects of smoking. The objective of this study was to determine the factors affecting smoke exposure as estimated by biomarkers of exposure to nicotine and carbon monoxide (CO). In a multi-center cross-sectional study of 3585 adult smokers and 1077 adult nonsmokers, exposure to nicotine and CO was estimated by 24h urinary excretion of nicotine and five of its metabolites and by blood carboxyhemoglobin, respectively. Number of cigarettes smoked per day (CPD) was determined from cigarette butts returned. Puffing parameters were determined through a CreSS® micro device and a 182-item adult smoker questionnaire (ASQ) was administered. The relationship between exposure and demographic factors, smoking machine measured tar yield and CPD was examined in a statistical model (Model A). Topography parameters were added to this model (Model B) which was further expanded (Model C) by adding selected questions from the ASQ identified by a data reduction process. In all the models, CPD was the most important and highest ranking factor determining daily exposure. Other statistically significant factors were number of years smoked, questions related to morning smoking, topography and tar yield categories. In conclusion, the models investigated in this analysis, explain about 30-40% of variability in exposure to nicotine and CO.

  5. Carbon monoxide poisoning while using a small cooking stove in a tent. (United States)

    Thomassen, Øyvind; Brattebø, Guttorm; Rostrup, Morten


    Carbon monoxide (CO) is formed wherever incomplete combustion of carbonaceous products occurs.(1) CO is the leading cause of poisoning in the United States, and common sources of CO poisoning include housefires, automobile exhaust, water heaters, kerosene space heaters, and furnaces.(2) Stoves used for cooking and heating during outdoor activities also produce significant amounts of CO. Mountain climbers have been reported to succumb to fumes generated by small cook stoves.(3) The aim of this study was to investigate if burning a cooking stove inside a tent is a potential health hazard. Seven healthy male volunteers used a cooking stove inside a small tent for 120 minutes. CO levels in the ambient tent air were measured in addition to hearth rate (HR) and pulse oximetry (SpO2). Venous blood samples were obtained every 15 minutes for measurement of carboxyhemoglobin (COHb). After 2 hours, all the subjects had significant CO levels in their blood (mean COHb = 21.5%). Mean SpO2, also fell from 98% to 95.3% (P tent. The concentration is high enough to cause significant COHb levels in venous blood after 120 minutes' stay in the tent.

  6. An accurate method for microanalysis of carbon monoxide in putrid postmortem blood by head-space gas chromatography-mass spectrometry (HS/GC/MS). (United States)

    Hao, Hongxia; Zhou, Hong; Liu, Xiaopei; Zhang, Zhong; Yu, Zhongshan


    Carbon monoxide (CO) may be the cause of more than half the fatal poisonings reported in many countries, with some of these cases under-reported or misdiagnosed by medical professionals. Therefore, an accurate and reliable analytical method to measure blood carboxyhemoglobin level (COHb%), in the 1% to lethal range, is essential for correct diagnosis. Herein a method was established, i.e. head-space gas chromatography-mass spectrometry (HS/GC/MS) that has numerous advantages over other techniques, such as UV spectrometry, for determination of COHb%. There was a linear relationship (R(2)=0. 9995) between the peak area for CO and the COHb% in blood. Using a molecular sieve-packed column, CO levels in the air down to 0.01% and COHb% levels in small blood samples down to 0.2% could be quantitated rapidly and accurately. Furthermore, this method showed good reproducibility with a relative standard deviation for COHb% of <1%. Therefore, this technique provides an accurate and reliable method for determining CO and COHb% levels and may prove useful for investigation of deaths potentially related to CO exposure.

  7. Blood gases and oximetry: calibration-free new dry-chemistry and optical technology for near-patient testing. (United States)

    Boalth, N; Wandrup, J; Larsson, L; Frischauf, P A; Lundsgaard, F C; Andersen, W L; Jensen, N; Singer, R; Troldborg, C P; Lunding, G


    The first calibration-free Near-Patient-Testing instrument (NPT7) for blood gases, pH and oximetry has been developed. With cartridges of 30 single-use cuvettes, the NPT7 needs no preparation prior to sample aspiration, no manual calibration, and no maintenance apart from paper and cartridge changes and regulatory quality control. Each cuvette measures pCO2, pO2, pH, total hemoglobin (ctHb), oxygen saturation (sO2), fractions of carboxyhemoglobin (FCOHb) and methemoglobin (FMetHb) on 95 microl whole blood with a 110-s measuring cycle. The measurement principles are as follows: pCO2-three-wavelength infrared spectroscopy of dissolved CO2; pO2-measurement of O2-induced changes in the decay time of phosphorescence; pH-the absorbance spectra change of an azo-dye color indicator; and oximetry is performed with a 128-wavelength spectrophotometer. We determined the within and between instrument variations with tonometered whole blood on seven prototype instruments, using between one and five control levels per analyte. The 95% analytical performance limits: +/-(/Bias/ +2 xS(T)) in the NPT7 instrument matched the analytical performance criteria for the measured quantities as defined by AACC guidelines. The application of these optical measuring methods for blood gases, pH and oximetry in single-use devices introduces a new concept into point-of-care testing (POCT), where preanalytical activities otherwise associated with instrument preparation are eliminated.

  8. An air quality assessment onboard an Oberon class submarine : HMCS Okanagan

    Energy Technology Data Exchange (ETDEWEB)

    Severs, Y.D.; Sabiston, B.H.


    The Defence and Civil Institute of Environmental Medicine (DCIEM) re-examined the air quality on an Oberon class submarine, the HMCS Okanagan, to determine if the atmosphere complied with Air Purification Standard BR 1326. The main objective of the assessment was to help in the development of future submarine air quality management. The information obtained from the Oberon class submarine could be readily applied to the Victoria class submarines. The assessment involved a trial aboard an Oberon under patrol conditions. The functional and detection capabilities of analytical air monitoring instruments were assessed for a 24-hour period to obtain data regarding the contaminants onboard the submarine. A profile of carbon dioxide accumulation and oxygen consumption was determined. This was followed by an assessment of the effectiveness of air purification such as carbon dioxide scrubbing, oxygen generation and snorting. Carbon monoxide was also monitored and carboxyhemoglobin was measured in both smokers and non-smokers. In order to determine if the sanitary or electrical systems, or engine exhaust posed any danger, ammonia, ozone and nitrous compounds were also measured. In addition, hydrogen, arsine and stibene were monitored to determine any possible danger from charging batteries. The health risks associated with aerosolized particles from cooking, smoking and exhaust gases were also measured. Results showed that all contaminants were within allowable limits. However, the study also confirmed that air purification measures on diesel submarines are minimal and poorly placed and that there is a lack of exhaust ventilation. Poor air exchange was worsened by compartmentalization and blackout curtains. Several recommendations were proposed to improve the management of air quality in Victoria class submarines. 18 refs., 2 tabs., 5 figs.

  9. Nose-only water-pipe smoking effects on airway resistance, inflammation, and oxidative stress in mice. (United States)

    Nemmar, Abderrahim; Raza, Haider; Yuvaraju, Priya; Beegam, Sumaya; John, Annie; Yasin, Javed; Hameed, Rasheed S; Adeghate, Ernest; Ali, Badreldin H


    Water-pipe smoking (WPS) is a common practice in the Middle East and is now gaining popularity in Europe and the United States. However, there is a limited number of studies on the respiratory effects of WPS. More specifically, the underlying pulmonary pathophysiological mechanisms related to WPS exposure are not understood. Presently, we assessed the respiratory effects of nose-only exposure to mainstream WPS generated by commercially available honey flavored "moasel" tobacco. The duration of the session was 30 min/day and 5 days/wk for 1 mo. Control mice were exposed to air only. Here, we measured in BALB/c mice the airway resistance using forced-oscillation technique. Lung inflammation was assessed histopathologically and by biochemical analysis of bronchoalveolar lavage (BAL) fluid, and oxidative stress was evaluated biochemically by measuring lipid peroxidation, reduced glutathione and several antioxidant enzymes. Pulmonary inflammation assessment showed an increase in neutrophil and lymphocyte numbers. Likewise, airway resistance was significantly increased in the WPS group compared with controls. Tumor necrosis factor α and interleukin 6 concentrations were significantly increased in BAL fluid. Lipid peroxidation in lung tissue was significantly increased whereas the level and activity of antioxidants including reduced glutathione, glutathione S transferase, and superoxide dismutase were all significantly decreased following WPS exposure, indicating the occurrence of oxidative stress. Moreover, carboxyhemoglobin levels were significantly increased in the WPS group. We conclude that 1-mo nose-only exposure to WPS significantly increased airway resistance, inflammation, and oxidative stress. Our results provide a mechanistic explanation for the limited clinical studies that reported the detrimental respiratory effects of WPS.

  10. Concentrations of cyanide in blood samples of corpses after smoke inhalation of varying origin. (United States)

    Stoll, Simone; Roider, Gabriele; Keil, Wolfgang


    Cyanide (CN) blood concentration is hardly considered during routine when evaluating smoke gas intoxications and fire victims, although some inflammable materials release a considerable amount of hydrogen cyanide. CN can be significant for the capacity to act and can in the end even be the cause of death. Systematic data concerning the influence of different fire conditions, especially those of various inflammable materials, on the CN-blood concentration of deceased persons do not exist. This study measured the CN level in 92 blood samples of corpses. All persons concerned were found dead in connection with fires and/or smoke gases. At the same time, the carboxyhemoglobin (COHb) level was determined, and the corpses were examined to detect pharmaceutical substances, alcohol and drugs. Furthermore, we analysed autopsy findings and the investigation files to determine the inflammable materials and other circumstances of the fires. Due to the inflammable materials, the highest concentration of CN in the victims was found after enclosed-space fires (n = 45) and after motor-vehicle fires (n = 8). The CN levels in these two groups (n = 53) were in 47 % of the cases toxic and in 13 % of the cases lethal. In victims of charcoal grills (n = 17) and exhaust gases (n = 6), no or only traces of CN were found. Only one case of the self-immolations (n = 12) displayed a toxic CN level. The results show that CN can have considerable significance when evaluating action ability and cause of death with enclosed-space fires and with motor-vehicle fires.

  11. Chemical factors affecting the interpretation of blood cyanide concentrations in fire victims. (United States)

    Moriya, Fumio; Hashimoto, Yoshiaki


    The purpose of this study was to examine the effects of methemoglobinemia caused by fire gases on blood cyanide concentrations in fire victims. Twenty-two fire victims with postmortem intervals of 8-48 h were involved. Blood cyanide concentrations at the time of death (C(0)) were estimated using the formula: C(0)=Ce(0.046 t) (C=blood cyanide concentration detected at autopsy, 0.046=first-order rate constant of cyanide disappearing from blood in corpses, and t=postmortem interval). Total (free and combined with cyanide) methemoglobin (MetHb) content was used to estimate the maximum capacity of MetHb for combining cyanide. Blood cyanide concentrations at the time of death were very high (5.32-6.47 mg/l) in five victims. Three showed high saturation (54.7-63.0%) of carboxyhemoglobin (CO-Hb) and elevated total MetHb contents (2.6-5.0%). MetHb at these levels is capable of scavenging up to 8.6-11.4 mg/l of blood cyanide. Thus, blood cyanide might have been completely combined with MetHb at the time of their death. In the remaining two victims, CO-Hb saturation was not high (30.9 and 37.9%) and no free MetHb was detected. As a result they may have exhibited severe toxic effects of cyanide at the time of their death. Our results indicate that MetHb contents and CO-Hb saturation should be determined to evaluate the toxic effects of cyanide in fire victims.

  12. Manner of Death Determination in Fire Fatalities: 5-Year Autopsy Data of Istanbul City. (United States)

    Esen Melez, İpek; Arslan, Murat Nihat; Melez, Deniz Oguzhan; Gürler, Ahmet Selçuk; Büyük, Yalçin


    Death resulting from burns is an important social problem and a frequent accident. However, because approximately 10% of cases are estimated to result from a fire that was deliberately started, all fire-related deaths should be treated as suspicious, and the cause of a fire should be investigated. For the bodies recovered from the scene of a fire, the manner of death could also be suicide or homicide. The objective of this study was to contribute to the clarification of controversial data present in the literature on the manner of death determination of fire-related deaths, through evaluation of autopsy findings of bodies recovered from fires. We reviewed 20,135 autopsies performed in a 5-year period, in Istanbul, as the whole autopsy data of the city and found 133 fire-related deaths. The death scene investigation reports and other judicial documents, autopsy findings, and toxicological analysis results were evaluated to determine the parameters of age, sex, level of the burn, vital signs [red flare; soot in the lower respiratory tract, esophagus, and/or stomach; and screening of carboxyhemoglobin (COHb) levels in the blood], toxicological substances, presence of accelerants, cause of death, and manner of death. The manner of death was determined to be an accident in 98 (73.7%) and homicide in 12 (9%) cases, whereas there was no suicide. In addition, it could not be determined in 23 (17.2%) cases. In accidental deaths, the most frequent cause of death was COHb poisoning with statistically significant blood COHb levels greater than 10%. Further, the presence of soot in the lower respiratory tract, esophagus, and/or stomach and the existence of at least 1 or 2 vital signs together were found to be valid deterministic criteria with statistical significance in terms of identifying the manner of death.

  13. Electrocardiographic Findings and Serum Troponin I in Carbon Monoxide Poisoned Patients

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    Scott Reza Jafarian Kerman


    Full Text Available Carbon monoxide (CO poisoning, though with different sources, is one of the most deadly emergencies in all countries. CO can threaten men's life by several paths especially cardiac complications, which can mimic other cardiac problems such as myocardial infarction. The objective of this study was to determine ECG findings and serum troponin I levels in CO poisoned patients. In this analytical cross-sectional study, 63 CO poisoning patients were consecutively included from hospital's emergency departments. CO content was measured by a CO-oximeter and an electrocardiography was taken first thing on admission. Arterial blood gas (ABG, troponin I and other data was collected afterwards. Data were divided by age groups (adults and children and gender. CO content was significantly higher only in subjects with normal T wave compared to patients with inverted T wave in their initial ECG (P=0.016. No other significant difference was noticed. None of the ABG findings correlated significantly with CO content. Also no significant correlation was found with CO content after stratification by gender and age groups, but pH in children (r=-0.484, P=0.026. CO content was significantly higher in adults (P=0.023, but other ABG data were not significantly different. Only 3 patients had elevated troponin I. Receiver operating characteristic (ROC analysis showed no significant cutoff points in CO content for ECG changes. No significant specific change in electrocardiograms (ECG could contribute carboxyhemoglobin content in carbon monoxide poisoned patients. In addition, no specific difference was found between adults and pediatric subjects' ECGs. All other findings seemed to be accidental.

  14. Effects of inhaled CO administration on acute lung injury in baboons with pneumococcal pneumonia (United States)

    Kraft, Bryan D.; Hess, Dean R.; Harris, R. Scott; Wolf, Monroe A.; Suliman, Hagir B.; Roggli, Victor L.; Davies, John D.; Winkler, Tilo; Stenzler, Alex; Baron, Rebecca M.; Thompson, B. Taylor; Choi, Augustine M.; Welty-Wolf, Karen E.; Piantadosi, Claude A.


    Inhaled carbon monoxide (CO) gas has therapeutic potential for patients with acute respiratory distress syndrome if a safe, evidence-based dosing strategy and a ventilator-compatible CO delivery system can be developed. In this study, we used a clinically relevant baboon model of Streptococcus pneumoniae pneumonia to 1) test a novel, ventilator-compatible CO delivery system; 2) establish a safe and effective CO dosing regimen; and 3) investigate the local and systemic effects of CO therapy on inflammation and acute lung injury (ALI). Animals were inoculated with S. pneumoniae (108-109 CFU) (n = 14) or saline vehicle (n = 5); in a subset with pneumonia (n = 5), we administered low-dose, inhaled CO gas (100–300 ppm × 60–90 min) at 0, 6, 24, and/or 48 h postinoculation and serially measured blood carboxyhemoglobin (COHb) levels. We found that CO inhalation at 200 ppm for 60 min is well tolerated and achieves a COHb of 6–8% with ambient CO levels ≤ 1 ppm. The COHb level measured at 20 min predicted the 60-min COHb level by the Coburn-Forster-Kane equation with high accuracy. Animals given inhaled CO + antibiotics displayed significantly less ALI at 8 days postinoculation compared with antibiotics alone. Inhaled CO was associated with activation of mitochondrial biogenesis in the lung and with augmentation of renal antioxidative programs. These data support the feasibility of safely delivering inhaled CO gas during mechanical ventilation and provide preliminary evidence that CO may accelerate the resolution of ALI in a clinically relevant nonhuman primate pneumonia model. PMID:26320156

  15. An Outbreak of Carbon Monoxide Poisoning in Yamagata Prefecture Following the Great East Japan Earthquake

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    Ken Iseki


    Full Text Available Background: In the aftermath of the Great East Japan Earthquake, most of the areas in Yamagata prefecture experienced a serious power failure lasting for approximately 24 hours. A number of households were subsequently poisoned with carbon monoxide (CO due to various causes. In this study, we conducted a survey of CO poisoning during the disaster. Methods: A questionnaire regarding CO poisoning associated with the disaster was sent to 37 emergency hospitals in Yamagata prefecture. Results: A total of 51 patients were treated for unintentional CO poisoning in 7 hospitals (hyperbaric oxygen chambers were present in 3 of the hospitals. The patients (18 men, 33 women ranged in age from 0 to 90 years. The source of CO exposure was charcoal briquettes (23 cases; 45%, gasoline-powered electric generators (18 cases; 35%, electric generators together with oil stoves (8 cases; 16%, oil stoves (1 cases; 2%, and automobile exhaust (1 cases; 2%. Blood carboxyhemoglobin levels ranged from 0.5% to 41.6% in 49 cases. Of these, 41 patients were treated by normobaric oxygen therapy, while one was intubated for artificial respiration. Additionally, 5 patients (10% were treated by hyperbaric oxygen therapy, and 3 patients (6% experienced delayed neuropsychiatric sequelae. Conclusion: CO sources included gasoline-powered electric generators and charcoal briquettes during the disaster. Storm-related CO poisoning is well recognized as a disaster-associated accident in the United States, but not in Japan. We emphasize that public education is needed to make people aware of the dangers of CO poisoning after a disaster. In addition, a pulse CO-oximeter should be set up in hospitals.  


    Institute of Scientific and Technical Information of China (English)

    张晓静; 孟祥艳; 黄新莉; 戴鸿雁; 韦鹏; 凌亦凌


    目的 观察在脂多糖(lipopolysaccharide,LPS)诱导下,一氧化碳(carbon monoxide,CO)对硫化氢(hydrogen sulfide,H2S) 舒张肺动脉作用的影响.方法 气管内滴注生理盐水或LPS后,制备肺动脉环(pulmonary artery rings,PARs),应用血管环张力测定技术,分别在给予CO供体氯血红素(hemin,Hm) 或血红素氧合酶1抑制剂锌原卟啉9(zinc protoporphyrin-IX,ZnPP-IX)的条件下,从离体水平观察PARs对H2S供体硫氢化钠(sodium hydrosulfide,NaHS)舒张反应变化,同时检测出肺血(out-going pulmonary blood,OPB)和入肺血(in-flowing pulmonary blood,IPB)中碳氧血红蛋白(carboxyhemoglobin,COHb)含量,以其差值反映肺循环CO生成的水平.结果 滴注LPS 4 h和8 h后,用Hm孵育PARs后,PARs对NaHS的累积浓度舒张反应较孵育前显著增强(P0.05).结论 在LPS诱导下,CO可以增强H2S舒张肺动脉的作用.

  17. Assessing inhalation injury in the emergency room

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    Tanizaki S


    Full Text Available Shinsuke Tanizaki Department of Emergency Medicine, Fukui Prefectural Hospital, Fukui, Japan Abstract: Respiratory tract injuries caused by inhalation of smoke or chemical products are related to significant morbidity and mortality. While many strategies have been built up to manage cutaneous burn injuries, few logical diagnostic strategies for patients with inhalation injuries exist and almost all treatment is supportive. The goals of initial management are to ensure that the airway allows adequate oxygenation and ventilation and to avoid ventilator-induced lung injury and substances that may complicate subsequent care. Intubation should be considered if any of the following signs exist: respiratory distress, stridor, hypoventilation, use of accessory respiratory muscles, blistering or edema of the oropharynx, or deep burns to the face or neck. Any patients suspected to have inhalation injuries should receive a high concentration of supplemental oxygen to quickly reverse hypoxia and to displace carbon monoxide from protein binding sites. Management of carbon monoxide and cyanide exposure in smoke inhalation patients remains controversial. Absolute indications for hyperbaric oxygen therapy do not exist because there is a low correlation between carboxyhemoglobin levels and the severity of the clinical state. A cyanide antidote should be administered when cyanide poisoning is clinically suspected. Although an ideal approach for respiratory support of patients with inhalation injuries do not exist, it is important that they are supported using techniques that do not further exacerbate respiratory failure. A well-organized strategy for patients with inhalation injury is critical to reduce morbidity and mortality. Keywords: inhalation injury, burn, carbon monoxide poisoning, cyanide poisoning

  18. CO and NO pulmonary diffusing capacity during pregnancy: Safety and diagnostic potential (United States)

    Zavorsky, Gerald S.; Blood, Arlin B.; Power, Gordon G.; Longo, Lawrence D.; Artal, Raul; Vlastos, Emanuel J.


    This paper reviews the scientific evidence for the safety of carbon monoxide (CO) and nitric oxide (NO) inhalation to measure pulmonary diffusing capacity (DLCO and DLNO) in pregnant women and their fetuses. In eight earlier studies, 650 pregnant women had DLCO measurements performed at various times during pregnancy, with a minimum of two to four tests per session. Both pregnant subjects that were healthy and those with medical complications were tested. No study reported adverse maternal, fetal, or neonatal outcomes from the CO inhalation in association with measuring DLCO. Eleven pregnant women, chiefly with pulmonary hypertension, and 1105 pre-term neonates, mostly with respiratory failure, were administered various dosages of NO (5–80 ppm for 4 weeks continuously in pregnant women, and 1–20 ppm for 15 min to 3 weeks for the neonates). NO treatment was found to be an effective therapy for pregnant women with pulmonary hypertension. In neonates with respiratory failure and pulmonary hypertension, NO therapy improved oxygenation and survival and has been associated with only minor, transient adverse effects. In conclusion, maternal carboxyhemoglobin ([HbCO]) levels can safely increase to 5% per testing session when the dose-exposure limit is 0.3% CO inhalation for ≤3 min, and for NO, 80 ppm for ≤ 3 min. The risk of late fetal or neonatal death from increased HbCO from diffusion testing is considerably less than the risk of death from all causes reported by the Centers for Disease Control, and is therefore considered “minimal risk”. PMID:20149901

  19. Carbon monoxide inhibits proliferation of pulmonary smooth muscle cells under hypoxia

    Institute of Scientific and Technical Information of China (English)

    甄国华; 张珍祥; 薛峥; 徐永健


    Objective To investigate the expression of inducible heme oxygenase (HO-1) gene in pulmonary artery smooth muscle cells (PASMCs) exposed to hypoxia, and the influence of carbon monoxide (CO) on the proliferation of PASMCs under hypoxic conditions.Methods Primary culture of rat PASMCs were passed every 3 days, and the 3-5 passages were used. After exposure to hypoxic conditions (95% N2, 5% CO2) 0, 12, 24 and 48 hours, the level of HO-1 mRNA was examined by reverse transcriptase polymerase chain reaction (RT-PCR). The volume of COHb in the medium was measured spectrophotometrically. The cyclic guanosine mono-phosphate (cGMP) concentration of cell extracts was determined by radioimmunoassay. PASMCs were divided into 5 groups, cultured under normoxia and hypoxia and treated with hemin, hemoglobin (Hb) and exogenous CO respectively. Then 3-(4, 5-cimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide (MTT) colorimetric assay and immunocytochemical staining were used to study the energy metabolism and the expression of proliferating cell nuclear antigen (PCNA) in PASMCs. Flow cytometry was used to analyze the cell cycle of PASMCs.Results After exposure to hypoxic conditions for 12, 24, and 48 hours, the HO-1 mRNA increased by 2.7%, 5.7% and 27.1% respectively (P<0.01). The carboxy-hemoglobin (COHb) in the medium increased by 13.8%, 31.0% and 93.1% (P<0.01); the cGMP concentrations were 2.7, 4.0 and 6.8-fold compared with the control group (P<0.01 and P<0.05). In comparison with the control group, the value of MTT colorimetric assay, the immunocytochemical staining of PCNA and the percentages of PASMCs in S and G2M phases in the hypoxic group were significantly higher (P<0.01). After treatment with Hemin and CO, the results of the above analysis decreased significantly (P<0.01 and P<0.05), but increased significantly after treatment with Hb (P<0.01 and P<0.05).Conclusions The expression of HO-1 gene in PASMCs is upregulated by hypoxia and the production of endogenous CO

  20. Experimental model of smoking and simulation of reflux with acid and pepsin in rats Modelo experimental de tabagismo e simulação de refluxo com ácido e pepsina em ratos

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    José Hélio Zen Junior


    Full Text Available PURPOSE: To develop experimental models to evaluate the effects of hydrochloric acid associated with the pepsin instilled in the mucosa of the upper esophagus and the esophagogastric junction of young male rats Wistar, simulating injury caused by gastroesophageal reflux on the mucosa of aero-digestive tract in humans as well as the action of the risk exposure of mucosa to cigarette smoke. METHODS: Fifty young male Wistar rats divided in 5 groups with 10 animals each one, respectively simulating pharyngo-laryngeal reflux and gastroesophageal reflux, pharyngo-laryngeal reflux and smoking, smoking only, gastroesophageal reflux and control group. RESULTS: The histopathologic studies no recorded neoplasias, only mild changes and no significant alterations. The hemo-oximetry (carboxyhemoglobin and methemoglobim and CO2 concentration confirm that the animals were submitted to high intensity of exposure to carcinogens in tobacco and its derivatives. CONCLUSION: The experimental models were highly efficient, practical, easy to use and economical and can be employed in other similar studies to determine the harmful effects by smoking and reflux.OBJETIVO: Desenvolver modelos experimentais para avaliar os efeitos do ácido clorídrico associado a pepsina, instilados na mucosa da parte superior do esôfago e da junção esofagogástrica de jovens ratos Wistar, simulando lesão causada por refluxo gastroesofágico na mucosa do trato aero-digestivo em humanos, bem como a ação da exposição ao risco de mucosa, como a fumaça de cigarro. MÉTODOS: Cinqüenta jovens ratos Wistar divididos em cinco grupos com 10 animais cada um, respectivamente, simulando o refluxo faringo-laríngeo e refluxo gastroesofágico, refluxo faringo-laríngeo e tabagismo, tabagismo só, refluxo gastroesofágico e grupo controle. RESULTADOS: os estudos histopatológicos não registraram neoplasias, apenas leves alterações e não significativas. O hemo-oximetria (carboxiemoglobina e

  1. Potential for error when assessing blood cyanide concentrations in fire victims. (United States)

    Moriya, F; Hashimoto, Y


    The present study explores toxicologic significance of blood cyanide concentrations in fire victims. Headspace gas chromatography was used for cyanide detection. Analysis of blood samples from ten fire victims (postmortem interval = 8 h to 3 to 5 d) detected zero to 11.9 mg/L of cyanide and a large difference in cyanide concentrations among victims. Carboxyhemoglobin (COHb) saturation was in the range of 24.9 to 84.2%. To examine the effects of methemoglobinemia and postmortem interval on blood cyanide concentrations in fire victims, an experiment was carried out using rabbits as the animal model. The rabbits were sacrificed by intramuscular injection of 1 mL/kg 2% potassium cyanide 5 min after intravenous injection of 0.33 mL/kg of 3% sodium nitrite (Group A, n = 3) or physiological saline (Group B, n = 6). Average methemoglobin contents immediately before potassium cyanide administration were 6.9 and 0.8% in Groups A and B, respectively. Average cyanide concentrations in cardiac blood at the time of death were 47.4 and 3.56 mg/L, respectively. When blood-containing hearts of the rabbits (n = 3 for Group B) were left at 46 degrees C for the first 1 h, at 20 to 25 degrees C for the next 23 h and then at 4 degrees C for 48 h, approximately 85 and 46% of the original amounts of blood cyanide disappeared within 24 h in Groups A and B, respectively. After the 72-h storage period, 37 and 10%, respectively, of the original amounts of cyanide remained in the blood. When the other three hearts in Group B were left at 20 to 25 degrees C for the last 48 h without refrigeration, cyanide had disappeared almost completely by the end of the experiment. The present results and those published in the literature demonstrate that the toxic effects of cyanide on fire victims should not be evaluated based solely on the concentration in blood.

  2. Urban ectopy in the mountains: Carbon monoxide exposure at high altitude

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    Leaf, D.A. [Univ. of California Medical Center, Los Angeles, CA (United States); Kleinman, M.T. [Univ. of California, Irvine, CA (United States)


    Environmental exposure to inhaled carbon monoxide (CO) increases coronary artery disease risk. Sudden cardiac death, a frequent manifestation of coronary artery disease, is usually a result of ventricular dysrhythmia. The effect of exposure to CO at sea level (CO/SL) and simulated high (2.1 km) altitudes (CO/HA) on the incidence of cardiac ectopy in subjects with coronary artery disease was investigated. A double-blind crossover study was conducted, with random-order assignment, and each subject served as his own control. Seventeen men with documented coronary artery disease and stable angina pectoris performed cardiopulmonary exercise stress tests after random exposure to either CO or clean air (CA) at sea level (CA/SL) or at a simulated 2.1-km high altitude (CA/HA). The individual CO and HA exposure conditions were each selected to reduce the percentage of oxygen saturation of the subjects arterial blood by 4%. Subjects blood carboxyhemoglobin levels were increased form an average of 0.62% after clean-air exposure to 3.91% of saturation after CO exposure. The percentage of oxygen saturation in arterial blood was reduced from a baseline level of 98% to approximately 94% after CO/SL or CA/HA and to approximately 90% after CO/HA. Compared with the CA/SL the average incidence of exercise-induced ventricular ectopy was approximately doubled after all exposures and a significant trend (p {le} .05) of increased ectopy with decreased oxygen saturation in arterial blood was observed. Yet, among subjects who were free from ectopy (n=11) on CA/SL, only 2 subjects developed ectopy after CO/HA. No episodes of ventricular tachycardia or fibrillation occurred. The findings indicated that exposure to increased levels of hypoxemia, resulting from hypoxic and/or CO exposures, increased the susceptibility to ventricular ectopy during exercise in individuals with stable angina pectoris; however, this risk was nominal for those without ectopy. 26 refs., 1 fig., 2 tabs.

  3. Daño al ADN en mujeres expuestas al humo de la leña en Chiapas, México DNA damage in women exposed to firewod fuel smoke , in Chiapas, México

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    Crispín Herrera-Portugal


    Full Text Available Actualmente alrededor de la cuarta parte de la población mexicana, entre 25 y 28 millones de habitantes, cocina con leña, Sin embargo, el humo de la leña contiene una amplia gama de sustancias tóxicas, entre ellas el monóxido de carbono (CO cuyo impacto en la salud de la población rural debe ser estudiado. Por esto, el potencial daño al ADN asociado con la exposición a CO de 30 mujeres que cocinaban con leña en Chiapas, México, fue evaluado por el ensayo cometa. Los resultados se compararon con 30 controles comparables en edad y condiciones socioeconómicas, quienes cocinaban con gas licuado de petróleo (GLP. Se obtuvieron muestras de sangre total para medir carboxihemoglobina (COHb y llevar a cabo el ensayo cometa. Se encontró diferencia significativa (PCurrently, about a quarter of the Mexican population, between 25 and 28 million people, cook with firewood. However, wood smoke contains a wide range of toxic substances, including carbon monoxide (CO whose impact on health of the rural population should be studied. Therefore, the potential DNA damage associated with the exposition to CO of 30 women who cooked with wood in Chiapas, Mexico, was assessed using Comet Assay. Results were compared with 30 controls of similar age and socioeconomic status, who cooked with liquefied petroleum gas (LPG. We obtained whole blood samples to measure carboxyhemoglobin (% COHb and perform the comet assay. There was a significant difference (P <0.001 in the percentages of COHb between women who cooked with wood (mean= 6.6% and those who did it with LPG (mean=1.8% being 3.6 times higher in the former compared with the latter. There was a significant difference in comet tail length between the two groups examined (mean 18.5 +/- 4.21 versus 5.97 +/- 1.0 μm, P <0.001 and tail moment (mean 4.55 +/- 1.5 versus 1.5 +/- 0.40, P <0.001. The results of this study strongly suggest that exposure to carbon monoxide and compounds present in wood smoke can cause

  4. The Protective Role of Carbon Monoxide (CO Produced by Heme Oxygenases and Derived from the CO-Releasing Molecule CORM-2 in the Pathogenesis of Stress-Induced Gastric Lesions: Evidence for Non-Involvement of Nitric Oxide (NO

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    Katarzyna Magierowska


    Full Text Available Carbon monoxide (CO produced by heme oxygenase (HO-1 and HO-2 or released from the CO-donor, tricarbonyldichlororuthenium (II dimer (CORM-2 causes vasodilation, with unknown efficacy against stress-induced gastric lesions. We studied whether pretreatment with CORM-2 (0.1–10 mg/kg oral gavage (i.g., RuCl3 (1 mg/kg i.g., zinc protoporphyrin IX (ZnPP (10 mg/kg intraperitoneally (i.p., hemin (1–10 mg/kg i.g. and CORM-2 (1 mg/kg i.g. combined with NG-nitro-l-arginine (l-NNA, 20 mg/kg i.p., 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ, 10 mg/kg i.p., indomethacin (5 mg/kg i.p., SC-560 (5 mg/kg i.g., and celecoxib (10 mg/kg i.g. affects gastric lesions following 3.5 h of water immersion and restraint stress (WRS. Gastric blood flow (GBF, the number of gastric lesions and gastric CO and nitric oxide (NO contents, blood carboxyhemoglobin (COHb level and the gastric expression of HO-1, HO-2, hypoxia inducible factor 1α (HIF-1α, tumor necrosis factor α (TNF-α, cyclooxygenase (COX-2 and inducible NO synthase (iNOS were determined. CORM-2 (1 mg/kg i.g. and hemin (10 mg/kg i.g. significantly decreased WRS lesions while increasing GBF, however, RuCl3 was ineffective. The impact of CORM-2 was reversed by ZnPP, ODQ, indomethacin, SC-560 and celecoxib, but not by l-NNA. CORM-2 decreased NO and increased HO-1 expression and CO and COHb content, downregulated HIF-1α, as well as WRS-elevated COX-2 and iNOS mRNAs. Gastroprotection by CORM-2 and HO depends upon CO’s hyperemic and anti-inflammatory properties, but is independent of NO.

  5. Interaction between hydrogen sulfide/cystathionine γ-lyase and carbon monoxide/heme oxygenase pathways in aortic smooth muscle cells

    Institute of Scientific and Technical Information of China (English)

    Hong-fang JIN; Jun-bao DU; Xiao-hui LI; Yan-fei WANG; Yin-fang LIANG; Chao-shu TANG


    Aim: To investigate the interaction between hydrogen sulfide (H2S)/cystathionine γ-lyase (CSE) and carbon monoxide (CO)/heme oxygenase (HO) pathways in aortic smooth muscle cells (ASMC). Methods: The ASMCs were divided into the following groups: (1) the control group; (2) the zinc protoporphyrin (ZnPP) 20 (μmol/L group; (3) the propargylglycine (PPG) 2 mmol/L, 4 mmol/L and 10 mmol/L groups; and (4) the sodium hydrosulfide (NaHS) 1×10-5 mol/L, 1×10-4 mol/L and 1×10-3 mol/L groups. Each of the groups was further divided into 6 h, 12 h, 18 h and 24 h subgroups. The CO level, represented by carboxyhemoglobin (HbCO) content was measured using a spectrophotometric method and H2S content was detected by a sensitive electrode method. CSE and HO-1 expressions were detected by Western blotting. Results: The H2S content in the medium and CSE expression by ASMC were markedly increased by ZnPP compared with the control group. HbCO content in the medium and HO-1 expression by the ASMC started strengthening following 24 h treatment with PPG at 2 mmol/L, but were further strengthened following 18 h and 24 h treatment with PPG at 4 mmol/L compared with the controls (P<0.01). PPG at 10 mmol/L increased the HbCO level in the medium following 18 h treatment and increased HO-1 expression by the ASMC following 12 h treatment. Moreover, NaHS at 1×10-5 mol/L and 1×10-4 mol/L decreased the HbCO level in the medium and HO-1 expression by the ASMC after 6 h and 12 h treatment, while NaHS at 1×10-3 mol/L decreased them at all time points of the treatments. Conclusion: The results suggested that endogenous CO/HO and H2S/CSE pathways inhibited each other in ASMC under physiological conditions.

  6. Effects of heme oxygenase-1 on pulmonary function and structure in rats with liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    GUO Shi-bin; DUAN Zhi-jun; LI Qing; SUN Xiao-yu


    Background The hepatopulmonary syndrome (HPS) is a severe vascular complication in lungs resulting in systemic hypoxemia in patients with cirrhosis and portal hypertension. The underlying structural change in HPS is intrapulmonary vasodilation, which can lead to impaired oxygenation of pulmonary venous blood. It has been demonstrated that the heme oxygenase-1/carbon monoxide (HO-1/CO) system plays an important role in the control of vascular tone. The aim of this study was to further investigate the role of HO-1 in the pathogenesis of HPS in animal model.Methods Totally 35 rats were divided into liver cirrhosis, zinc protoporphyrin Ⅸ (ZnPP), cobalt protoporphyrin (CoPP)and sham groups. Biliary cirrhosis was established in the first three groups by bile duct ligation. Rats in the ZnPP and CoPP groups received once intraperitoneal injection of ZnPP and CoPP, respectively, 24 hours before sample collection.Expression of HO-1 mRNA in lung was detected by reverse-transcription polymerase chain reaction, while protein expression was determined by immunohistochemical analysis. Hematoxylin and eosin staining was performed to confirm the presence of liver cirrhosis and intrapulmonary vasodilation. Arterial blood gases, mean arterial pressure and portal vein pressure were also measured. Analysis of variance or Wilcoxon statistical methods were used to determine statistical significance.Results Compared with the sham group, the cirrhotic group demonstrated increased expression of pulmonary HO-1 mRNA and protein (P<0.01). The level of arterial carboxyhemoglobin (COHb), alveolar-arterial oxygen gradient (A-aPO2),mean arterial pressure, portal vein pressure (P<0.05, respectively), and intrapulmonary vasodilation were also significantly increased. Compared with the cirrhotic group, CoPP treatment increased pulmonary HO-1 mRNA and protein expression, the level of A-aPO2 (P <0.05 respectively), COHb (P <0.01), and intrapulmonary vasodilation, while ZnPP treatment

  7. 不同氧疗方式对急性一氧化碳中毒大鼠血气的影响%Effect of different oxygen therapy on blood gas in rats following acute carbon monoxide poisoning

    Institute of Scientific and Technical Information of China (English)

    马琳琳; 葛环; 高春锦; 宋鸿雁; 刘福佳; 侯晓敏


    目的 观察不同氧疗方式对急性一氧化碳中毒(acute carbon monoxide poisoning,ACOP)大鼠血气的影响.方法 将70只雄性Wistar大鼠随机分成健康对照组10只;染毒即刻组12只;余48只CO染毒后再分为4组,分别为空气组、鼻导管组、面罩组、HBO组各12只.制备ACOP动物模型,给予3种不同方式的氧疗,自腹主动脉取血行血气分析.结果 pH值:染毒即刻即出现明显下降(P0.05).PaO2及PaCO2:染毒后各组差异无统计学意义(P>0.05).乳酸及COHb%:染毒即刻即出现明显升高(P0.05).HCO3-:染毒后各组均明显低于正常(P0.05); PaO2 and PaCO2: no statistical significance in PaO2 or PaCO2 could be seen between the groups after ACOP(P >0.05); Lactic acid and COHb%: levels of lactic acid and COHb% in the COST group increased significantly, when compared with those of the control group (P 0.05); Bicarbonate (HCO3 -):statistical differences in HCO3 - between the groups could be noted after ACOP (P < 0. 05). Conclusions Various types of oxygen therapy could rectify hypoxia and metabolic acidosis in rats following ACOP. Compared with other two types of therapy, HBO could remove carboxyhemoglobin (COHb) from the body most significantly.


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    Full Text Available Gajah Mada street is the main road in Denpasar to access traditional market in Badung and Kumbasari Market. It iscrowded street with many vehicles pass through it. As a result, this could increase the level of emission gas such asambient monoxide carbon gas which could affect the concentration of carboxyhemoglobin, exposure time and subjectivecomplaints of sample.his was a cross sectional study of 12 parking man. Data was mainly collected from measurements including thedensity of vehicles, vehicles type, oil fuel type, vehicle age, ambient monoxide carbon gas, carboxyhaemoglobin,exposure time and subjective complaints of sample.The study found that the average of vehicle density mean per day was 91.338 unit or 3.805,8 unit per hour (veryhigh. The biggest type of vehicle percentage was motorbike 81%, followed by vehicles using premium fuel 93,7%. Theage of vehicles below 10 years was 55%. The mean of monoxide carbon gases concentration was 585,96 ?g/m³ per day(mean. The mean of weather situation including humidity was 82,7%, temperature 27,6ºC, eastward wind direction, faircloudy an wind speed about 1,76 m/second. The average of carboxyhaemoglobin concentration in 12 parking man was3.8% (very low. The mean of exposure time was 125 minutes. It was noted that there were 9 samples (75% withcomplaints and 3 samples (25% without any complaints.The study concluded that the highest numbers or vehicle density it is very high categories. Monoxide carbon gasconcentration it is mean categories and was under threshold limit value. The highest numbers or vehicle density and Monoxide carbon gas concentration between 14.00-16.00 pm and. There was a significant correlation between vehicledensity and ambient monoxide carbon gas. The measurement of carboxyhaemoglobin concentration it is very lowcategories. It also found that the exposure time correlated with the level carboxyhaemoglobin of parking mansignificantly.It is suggested that the Government of Denpasar

  9. Change and role of heme oxygenase-1 in injured lungs following limb ischemia/reperfusion in rats

    Institute of Scientific and Technical Information of China (English)

    周君琳; 朱晓光; 林源; 凌亦凌; 邵新中; 张桂生


    Objective: To study the change and role of hemeoxygenase-1 (HO-1) in injured lungs following limbischemia/reperfusion in rats.Methods: A total of 96 healthy male Sprague-Dawley rats, weighing 250-300 g, were used in this study. Hind limb ischemia was made on 40 rats through clamping the infrarenal aorta for 2 hours with a microvascular clip, then limb reperfusion for 0, 4, 8,16 and 24 hours(n =8 in each time point)was performed, respectively. Other 8 rats undergoing full surgical operation including isolation of the infrarenal aorta without occlusion were taken as the sham operation group. Lung tissues were obtained from the 48animals and Northern blotting and Western blotting were employed to measure the changes of HO-1 mRNA and protein expression, respectively. Immunohistochemistry technique was used to determine the cell types responsible for HO-1 expression after limb ischemia/reperfusion. Then hind limb ischemia was made on other 12 rats through clamping the infrarenal aorta for 2 hours with a microvascular clip, among whom, 6 rats were given zinc protoporphyrin (ZnPP), an inhibitor of HO. Then limb reperfusion for 16 hours was performed on all the 12 rats.And other 12 rats underwent full surgical operation including isolation of the infrarenal aorta without occlusion,among whom, 6 rats were then given ZnPP. Then lung tissues were obtained from the 24 animals and lung injury markers, lung histology, polymorphonuclear leukocyte (PMN) count and malondialdehyde (MDA) content were detected, respectively. HO activity was determined through measuring the carboxyhemoglobin (COHb) level in artery blood with a CO-oximeter after limb ischemia/reperfusion.And the animal mortality was observed on the other 24rats.Results: Northern blotting analysis showed that HO-1mRNA increased significantly at 4 hours after reperfusion,peaked at 16 hours, and began to decrease at 24 hours. In contrast, no positive signal was observed in the sham and simple ischemia animals. Increased HO

  10. Interferência da coloração de esmaltes de unha e do tempo na oximetria de pulso em voluntários sadios Interference of nail polish colors and time on pulse oximetry in healthy volunteers

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    Mara Harumi Miyake


    Full Text Available INTRODUÇÃO: A oximetria de pulso é um método não invasivo de mensuração da saturação periférica da oxiemoglobina (SpO2. É freqüentemente utilizado em unidades de emergência, de terapia intensiva e em centro cirúrgico. A leitura da oximetria de pulso tem acurácia limitada na presença de metaemoglobina, carboxiemoglobina, anemia, vasoconstrição periférica, esmalte de unha, luz fluorescente e movimentação. OBJETIVO: Avaliar a interferência da coloração de esmalte de unha e do tempo sobre a SpO2 em indivíduos sadios. MÉTODO: Participaram do estudo 61 voluntárias sadias, com idades entre 18 e 32 anos. Foi avaliada SpO2 nas seguintes colorações de esmaltes: base (dedo mínimo, rosa claro (dedo anular, rosa claro com cintilante (dedo médio e vermelha (polegar. O indicador não recebeu esmalte. Foi analisado o tempo para cada coloração de esmalte, a cada minuto até completar cinco minutos. RESULTADOS: Quando comparadas as medidas da SpO2 com o controle, as colorações base (p = 0,56, rosa claro (p = 0,56 e rosa claro com cintilante (p = 0,37 não apresentaram diferença estatisticamente significante. A SpO2 apresentou variação significante na cor vermelha (p BACKGROUND: Pulse oximetry is a noninvasive method to measure the saturation of peripheral oxyhaemoglobin (SpO2. It's usually used in emergency, intensive care and operating room units. Pulse oximeter readings have limited accuracy in the presence of methemoglobin, carboxyhemoglobin, anaemia, peripheral vasoconstriction, nail polish, fluorescent light, and motion. OBJECTIVES: To evaluate the interferences of the color of nail polishes and time on SpO2 in healthy individuals. METHODS: Sixty-one healthy female volunteers, ages ranging from 18 to 32 years. The nail polish colors used to evaluate SpO2 were: base coat on the little finger, light pink on the ring finger, sparkling light pink on the medium finger and red on the thumb. The index finger was used as control

  11. 电刀与血液回收机联用对髋关节置换术患者血一氧化碳水平的影响%Effects of electrocautery plus cell saver on the blood levels of carbon monoxide in hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    陈燕涛; 何清; 刘尚礼; Ivo Michiels


    smoking history; ② history of anemia, hemoglobinopathy or coagulopathy; ③history of organ dysfunction, including lung, liver and kidney; ④ preoperative abnormal electrocardiogram (ECG), including cardiac ischemia and/or arrhythmia.Among all the enrolled patients, those who ultimately received the retransfusion of processed salvaged blood were counted as the observed group,whereas the others who did not receive any retransfusion for inadequate salvaged volume or possible contamination within salvaging were added as the control group, and no allogenic blood was transfused. All the patients agreed to participate in the study.METHODS: ① All the operations were performed under combined intravenous and inhalation general anesthesia. ② Electrocautery was used for coaluation during the incision of subcutaneous tissues, fascias, muscles as well as capsules. ③ A cell saver system (Haemonetics Cell Saver #5 System, manufactured by Haemonetics Corporation, U.S.A.) was applied during the operation. Salvaged blood were retransfused into the patients after the procedure of filtration and wash. ④ Blood CO-Oximetry: Blood CO levels were measured by carboxyhemoglobin (CO-Hb) concentration with a spectrophotometric blood gas analyzer (ABL 700 series, manufactured by Radiometer, Copenhagen, Denmark). In both groups, systemic blood samples were collected from a radial arterial catheter at 3 time points, including preoperatively, postoperatively and merely before the retransfusion of salvaged blood and at 6 hours postoperatively. In the observed group, additionally samples were collected instantly after skin incision from the aspirator connected to the cell saver reservoir, directly after femoral stem implantation also from the aspirator and immediately before retransfusion from the collecting sac, to reveal the trend of CO-Hb levels in salvaged blood.MAIN OUTCOMEMEASURES: CO-Hb levels in the systemic blood and salvaged blood at different time points were mainly observed