Carbon Monoxide Poisoning: Mechanism, Clinical Presentation and Management

  • D. Mathieu
  • F. Wattel
  • R. Nevière
  • M. Mathieu-Nolf
  • N. B. Hampson
  • E. M. Camporesi
  • C. Gandini
  • M. Broccolino
  • S. Scarpini
  • A. Travaglia
  • C. Pirovano
  • S. Brenna
  • G. Oriani
  • C. Gandini
  • M. Michael
  • A. Peretti
  • D. Grioni
  • E. Triulzi
  • N. Colombo


Carbon monoxide (CO) poisoning is actually the first cause of accidental poisoning in Europe [1] and North America [2]. Despite efforts in prevention and public and medical education, this intoxication remains frequent, severe, and too often overlooked; frequent because carbon monoxide accounts for nearly 5000–8000 poisonings a year in France, and this number is likely to increase, because devices able to produce CO are used more and more by the general public. Besides, the energy crisis has led people to decreased air ventilation in homes. Thus, these two factors join together to increase the risk of CO production; severe because carbon monoxide is responsible for hundreds of deaths annually in Europe. But death is only one risk of carbon monoxide poisoning, and another one of major importance is neurological sequelae; underdiagnosed and thus inadequately managed. In 1979 a French Poison Control Center study [3] showed that nearly 30 % of CO poisoning was overlooked or misdiagnosed during the first visit to the hospital or by the general practitioner.


Carbon Monoxide Hyperbaric Oxygen Hyperbaric Oxygen Therapy Heart Damage COHb Level 
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  1. 1.
    Yenning H, Roberton D, Milner AD (1982) Carbon monoxide poisoning in an infant. Br Med J 284: 651CrossRefGoogle Scholar
  2. 2.
    Sanchez R, Fosarelli P, Felt B, Greene M, Lascovara J, Hackett F (1988) Carbon monoxide due to automobile exposure: disparity between carboxyhemoglobin levels and symptoms of victims. Pediatrics 82: 663–666PubMedGoogle Scholar
  3. 3.
    Benesch RE, Maeda N, Benesch R (1972) 2,3 diphosphoglycerate and the relative affinity of adult and fetal haemoglobin for oxygen and carbon monoxide. Biochim Biophys Acta 257: 178–182PubMedGoogle Scholar
  4. 4.
    Longo LD (1977) The biological effects of carbon monoxide on the pregnant woman, fetus and newborn infant. Am J Obstet Gynecol 129: 69–103PubMedGoogle Scholar
  5. 5.
    Kafer ER (1990) Neonatal gas exchange and oxygen transport. In: Long WA (ed) Fetal and neonatal cardiology. W.B. Saunders, PhiladelphiaGoogle Scholar
  6. 6.
    Speri W, Sengers RC et al. (1992) Enzyme activities of the mitochondrial energy generating system in skeletal muscle tissue of preterm and fullterm neonates. Ann Clin Biochem 29: 638–645Google Scholar
  7. 7.
    Brody BA, Kinney HC, Kloman AS, Gilles FH (1987) Sequence of central nervous system myelination in human infancy. An autopsy study of myelination. J Neuropathol Exp Neurol 46: 283–301PubMedCrossRefGoogle Scholar
  8. 8.
    Gilles FH, Shankle W, Doolong EC (1983) Myelination tracts: growth patterns. In: The developing human brain; growth and epidemiologic neuropathology. Giles FH, Leviton A, Doooling EC (eds) Wright, Boston. pp 117–183Google Scholar
  9. 9.
    Yakovlev PI, Lecours AR (1967) The myelinogenetic cycles of regional maturation of the brain. In: Minkowski A (ed) Regional development of the brain in early life. Blackwell, Oxford, pp 3–70Google Scholar
  10. 1o.
    Horowitz AL, Kaplan R, Gunseli S (1987) Carbon monoxide toxicity: MR imaging in the brain Radiology 162: 787–788Google Scholar
  11. 11.
    Vieregge P, Klostermann W, Blumm RG, Borgis KJ (1989) Carbon monoxide poisoning: clinical, neurophysiological and brain imaging observations in acute disease and follow-up. J Neurol 236: 478–481PubMedCrossRefGoogle Scholar
  12. 12.
    Tuchman RF, Moser FG, Moshé SL (1980) Carbon monoxide poisoning: bilateral lesions in the thalamus on the M-R imaging of the brain. Pediatr Radiol 20: 478–479CrossRefGoogle Scholar
  13. 13.
    Bruno A, Wagner W, Orrison WW (1993) Clinical outcome and brain MRI four years after carbon monoxide intoxication. Acta Neurol Scand 87: 205–209PubMedCrossRefGoogle Scholar
  14. 14.
    Valk J, Van der Knaap MS (1989) Magnetic resonance of myelin, myelination and myelin disorders. Springer, Berlin Heidelberg New York 9: 21Google Scholar
  15. 15.
    Gemelli F, Cattani R (1985) Carbon monoxide poisoning in childhood. Br Med J 291: 11–97CrossRefGoogle Scholar
  16. 16.
    Piatt JP, Kaplann AH, Bond GR, Berg RA (1990) Occult carbon monoxide poisoning in an infant. Pediatr Emerg Care 6: 21–23PubMedCrossRefGoogle Scholar
  17. 17.
    Raphael JC, Elkharrat D, Jars-Guincestre MC, Chastang C, Chasels V, Vercken JB, Gajdos P (1989) Trial of normobaric and hyperbaric oxygen for acute carbon monoxide intoxication. Lancet 2: 414–419PubMedCrossRefGoogle Scholar
  18. 18.
    Ellenor MJ, Barceloux DG (1988) Airborn toxins: carbon monoxide. In Medical toxicology, Elsevier, Amsterdam, pp 34, 820–829Google Scholar
  19. 1.
    Faure J, Arsac P, Chalandre P (1983) Prospective study in carbon monoxide intoxication by gas water heaters. Hum Toxicol 2:422-425Google Scholar
  20. 2.
    Dolan M (1985) Carbon monoxide poisoning. Can Med Assoc J 133: 392-399Google Scholar
  21. 3.
    Barret L, Danel V, Faure J (1985) Carbon monoxide poisoning, a diagnosis frequently overlooked. Clin Toxicol 23:309-313CrossRefGoogle Scholar
  22. 4.
    Haldane J (1895) The relation of the action of carbonic oxide to oxygen tension. J Physiol 18: 201-217PubMedGoogle Scholar
  23. 5.
    Haldane J.(1927) Carbon monoxide as a tissue poison. Biochem J 21:1068-1075PubMedGoogle Scholar
  24. 6.
    Roughton F, Darling R (1944) The effect of carbon monoxide on the oxyhemoglobin dissociation curve. Am J Physiol 141:17-31Google Scholar
  25. 7.
    Pace N, Consolazio W, White W (1946) Formulation of the principal factors affecting the rate of uptake of carbon monoxide by normal man. Am J Physiol 174:352-359Google Scholar
  26. 8.
    Ginsberg M, Myers R, Mc Donagh B (1974) Experimental carbon monoxide encephalopathy in the primate. II. Clinical aspects, neuropathology, and physiologic correlation. Arch Neurol 30:209-216PubMedCrossRefGoogle Scholar
  27. 9.
    Luomanmaki K, Coburn R (1969) Effects of metabolism and distribution of carbon monoxide on blood and body stores. Am J Physiol 217:354-363PubMedGoogle Scholar
  28. 1o.
    Goldbaum L, Orenallo T, Dergal E (1976) Mechanism of the toxic action of carbon monoxide. Ann Clin Lab Sci 6:372-376PubMedGoogle Scholar
  29. 11.
    Yokoyama K (1978) Effect of perfluorochemical emulsion in acute carbon monoxide poisoning in rats. Jpn J Surg 4:342-352CrossRefGoogle Scholar
  30. 12.
    Coburn R, Mayers L (1971) Myoglobin O, tension determined from measurements of carbomyoglobin in skeletal muscle. Am J Physiol 220:66-74PubMedGoogle Scholar
  31. 13.
    Keilin D, Hartree E (1939) Cytochrome and cytochrome oxidase. Proc Roy Soc Lond Ser B 127:167-191CrossRefGoogle Scholar
  32. 14.
    Coburn R, Forman H (1987) Carbon monoxide toxicity. In Fishman A (ed) Handbook of physiology of the respiratory system, vol 4: gas exchange. American Physiological Society, Bethesda, pp 439-456Google Scholar
  33. 15.
    King C, Dodd S, Cain S (1987) O2 delivery to contracting muscle during hypoxic or CO hypoxia. J Appl Physiol 63:726-732PubMedGoogle Scholar
  34. 16.
    Hogan M, Bebout D, Gray P, Wagner J, West J, Haab P (1990) Muscle maximal O2 uptake at constant O2 delivery with and without CO in the blood. J Appl Physiol 69: 830-836PubMedGoogle Scholar
  35. 17.
    Corya B, Black M, Mc Henry P (1976) Echocardiographic findings after acute carbon monoxide poisoning. B Heart J 38:712-717CrossRefGoogle Scholar
  36. 18.
    Elkharrat D, Raphael JC, Tainturier C, Brunel D, De Truchis P, Goulon M (1986) Angioscintigraphie cardiaque au cours de l’intoxication ague par l’oxyde de carbone. Réan Soins Intens Med Urg 2:61-66Google Scholar
  37. 19.
    Piantadosi C (1987) Carbon monoxide, oxygen transport and oxygen metabolism. J Hyperb Med 2:27-44Google Scholar
  38. 20.
    Sylvia A, Piantadosi C, Jobsis-Vandervliet F (1985) Energy metabolism and in vivo cytochrome a oxidase redox relationships in hypoxic rat brain. Neurol Res 7:81-88PubMedGoogle Scholar
  39. 21.
    Brown S, Piantadosi C (1989) Reversal of carbon monoxide-cytochrome c oxidase binding by hyperbaric oxygen in vivo. Adv Exp Med Biol 248: 747-754PubMedCrossRefGoogle Scholar
  40. 22.
    Graser T, Vedernikiv Y, Li D (1990) Study on the mechanism of carbon monoxide induced endothelium-independent relaxation in porcine coronary artery and vein. Biochem Acta 4: 293-296Google Scholar
  41. 23.
    Piantadosi C, Lee P, Sylvia A (1988) Direct effects of CO on cerebral energy metabolism in bloodlees rats. J Appl Physiol 65:878-887PubMedGoogle Scholar
  42. 24.
    Brown S, Piantadosi C (1990) In vivo binding of carbon monoxide to cytochrome c oxidase in rat brain. J Appl Physiol 62:604-610Google Scholar
  43. 25.
    Zhang J, Piantadosi C (1992) Mitochondrial oxidative stress after carbon monoxide hypoxia in rat brain. J Clin Invest 90:1193-1199PubMedCrossRefGoogle Scholar
  44. 26.
    Pace N, Strajman E, Walker EL (1950) Acceleration of carbon monoxide elimination in man by high pressure oxygen. Science 11: 652-654CrossRefGoogle Scholar
  45. 27.
    Ginsberg M, Hedeley White E, Richardson E (1976) Hypoxic-ischemic leukoencephalopathy in man. Arch Neuro! 33:5-14CrossRefGoogle Scholar
  46. 28.
    Okeda R, Funata N, Takano T, Miyazaki Y, Yokoyama K, Manabe M (1981) The pathogenesis of carbon monoxide encephalopathy in the acute phase physiological morphological correlation. Acta Neuropathe 54:1-10CrossRefGoogle Scholar
  47. 29.
    Okeda R., Funata N, Song SJ, Higashino F, Takano T, Yokoyama K (1982) Comparative study on pathogenesis of selective cerebral lesions in carbon monoxide poisoning and nitrogen hypoxia in cats. Acta Neuropathol (1982) 56:265-272CrossRefGoogle Scholar
  48. 30.
    Thom S (1990) Carbon monoxide-mediated brain lipid peroxidation in the rat. J Appl Physiol 68:997-1003PubMedGoogle Scholar
  49. 31.
    Thom S (1992) Dehydrogenase conversion to oxidase and lipid peroxidation in brain after carbon monoxide poisoning. J Appl Physiol 73:1584-1589PubMedGoogle Scholar
  50. 32.
    Brown S, Piantadosi C (1992) Recovery of energy metabolism in rat brain after carbon monoxide hypoxia. J Clin Invest 89:666-672PubMedCrossRefGoogle Scholar
  51. 33.
    Thom S (1993) Leucocytes in carbon monoxide mediated brain oxidative injury. Toxicol Appl Pharmacol 123: 234-247PubMedCrossRefGoogle Scholar
  52. 34.
    Thom S (1993) Functional inhibition of leukocyte B2 integrins by hyperbaric oxygen in carbon monoxide-mediated brain injury in rats. Toxicol Appl Pharmacol 123:248-256PubMedCrossRefGoogle Scholar
  53. 35.
    Barois A, Grosbuis S, Goulon M (1979) Les intoxications aigues par l’oxyde de carbone et les gaz de chauffage. Rev Prat 29:1211-1231PubMedGoogle Scholar
  54. 36.
    Sawada Y, Takahashi M, Ohashi N, Fusamoto H, Maemura K, Kobayashi H, Yoshiora T, Sugimoto T (1980) Computerized tomography as an indication of long-term outcome after acute carbon monoxide poisoning. Lancet 1:783-784PubMedGoogle Scholar
  55. 37.
    Ilano A, Raffin T (1990) Management of carbon monoxide poisoning. Chest 97:165-169PubMedCrossRefGoogle Scholar
  56. 38.
    Ducasse JL, Izard P, Celcis P (1988) Intoxication modérée à l’oxyde de carbone: oxygénothérapie normobare ou hyperbare. Etude randomisée avec mesure du débit sanguin cérébral. Réan Soins Intens Med Urg 4:364Google Scholar
  57. 39.
    Myers R, Snyder S, Linberg S, Cowley A (1981) Value of hyperbaric oxygen in suspected carbon monoxide poisoning. JAMA 246:2478-2480PubMedCrossRefGoogle Scholar
  58. 40.
    Smith J, Brandon S (1973) Morbidity from acute carbon monoxide poisoning at three years follow up. Br Med J 1:318-321PubMedCrossRefGoogle Scholar
  59. 41.
    Ginsberg R, Romano J (1976) Carbon monoxide encephalopathy. Need for appropriate treatment. Am J Psychol 133:317-320Google Scholar
  60. 42.
    Mathieu D, Nolf M, Durocher A, Saulnier F, Frimat P, Furon D, Wattel F (1985) Acute carbon monoxide intoxication. Treatment by hyperbaric oxygen and risk of late sequellae. Clin Toxico 123:315-324CrossRefGoogle Scholar
  61. 43.
    Raphael JC, Elkharrat D, Jars-Guincestre MC, Chastang C, Chasles V, Vercken JB, Gajdos Ph (1989) Trial of normobaric and hyperbaric oxygen for acute carbon monoxide intoxication. Lancet II:414-419CrossRefGoogle Scholar
  62. 44.
    Neviere R, Mathieu D, Mathieu-Nolf M, Durak C, Tempe JD, Bouachour G, Sainty JM, Chagnon JL, Wattel F (1994) Résultats intermédiaires d’une étude randomisée comparant l’efficacité d’une séance d’oxygénothérapie hyperbare à 12 heures d’oxygénothérapie normobare dans les intoxications à l’oxyde de carbone non comateuses. Proceeding of the 1st European Consensus Conference Hyperbaric Medicine, LilleGoogle Scholar
  63. 45.
    Longo L (1977) The biological effects of carbon monoxide on pregnant woman, fetus and newborn enfant. Am J Obstet Gynecol 129: 69-103PubMedGoogle Scholar
  64. 46.
    Zikria B, Weston G, Chodoff M (1972) Smoke and carbon monoxide poisoning in fire victims. J Trauma 12:641-645PubMedCrossRefGoogle Scholar
  65. 47.
    Hart G, Strauss M, Lennon P, Whitcraft D (1985) Treatment of smoke inhalation by hyperbaric oxygen. J Emerg Med 3:211-215PubMedCrossRefGoogle Scholar
  66. 1.
    Program Development Branch, Environmental Health Services Division, Center for Environmental Health, Centers for Disease Control (1982) Carbon monoxide intoxication: a preventable environmental health hazard. MMWR 31:529-531Google Scholar
  67. 2.
    Cobb N, Etzel RA (1991) Unintentional carbon monoxide-related deaths in the United States, 1979 through 1988. JAMA 266: 659-663PubMedCrossRefGoogle Scholar
  68. 3.
    Hampson NB, Dunford RG, Norkool DM (1991) Temporal epidemiology of emergency hyperbaric treatments. Undersea Biomed Res 18(Suppl):85Google Scholar
  69. 4.
    Hampson NB, Kramer CC, Dunford RG, Norkool DM (1994) Carbon monoxide poisoning from indoor burning of charcoal briquets. JAMA 271:52-53PubMedCrossRefGoogle Scholar
  70. 5.
    Grace TW, Platt FW (1981) Subacute carbon monoxide poisoning: another great imitator. JAMA 246:1698-1700PubMedCrossRefGoogle Scholar
  71. 6.
    Barret L, Danel V, Faure J (1985) Carbon monoxide poisoning: a diagnosis frequently overlooked. Clin Toxicol 23:309-313CrossRefGoogle Scholar
  72. 7.
    MEDLINE Database, United States National Library of Medicine, Washington, DC, 1994Google Scholar
  73. 8.
    Maryland Institute of Emergency Medical Services System, Baltimore, MarylandGoogle Scholar
  74. 9.
    Hampson NB, Dunford RG, Kramer CC, Norkool DM (1995) Selection criteria utilized for hyperbaric oxygen treatment of carbon monoxide poisoning. Emerg Med 13:227-231CrossRefGoogle Scholar
  75. 10.
    Hampson NB, Dunford RG, Norkool DM (1992) Treatment of carbon monoxide poisonings in multiplace hyperbaric chambers. J Hyperb Med 7:165-171Google Scholar
  76. 11.
    Hyperbaric oxygen therapy: a committee report. Undersea and Hyperbaric Medical Society, Bethesda, 1992 pp 12-13Google Scholar
  77. 12.
    Thom SR, Taber RL, Mendiguren I, Clark JM, Fisher AB (1992) Delayed neuropsychiatric sequelae following CO poisoning and the role of treatment with 100% O2 or hyperbaric oxygen - a prospective, randomized clinical study. Undersea Biomed Res 19 (Suppl):47Google Scholar
  78. 13.
    Goulon M, Barois A, Rapin M, Nouailhat F et al. (1969) Intoxication oxycarbonee at anoxie gigue par inhalation de gay de charbon et d’hydrocarbures. Ann Med Interne (Paris) 120:335-349.Google Scholar
  79. Goulon M, Barois A, Rapin M, Nouailhat F et al. (1969) English translation: J Hyperb Med 1986;1:23-41Google Scholar
  80. 14.
    Skeen MB, Massey EW, Moon RE, Shelton DL et al. (1991) Immediate and long-term neurological sequelae of carbon monoxide intoxication. Undersea Biomed Res 18(Suppl):36Google Scholar
  81. 15.
    Myers RAM, Snyder SK, Emhoff TA (1985) Subacute sequelae of carbon monoxide poisoning. Ann Emerg Med 14:1163-1167PubMedCrossRefGoogle Scholar
  82. 16.
    Hopkins RO, Weaver LK (1991) Does late repetitive hyperbaric oxygen improve delayed neurologic sequelae associated with carbon monoxide poisoning? Undersea Biomed Res 18(Suppl):34Google Scholar
  83. 17.
    Van Hoesen KB, Camporesi EM, Moon RE, Hage ML, Piantadosi CA (1989) Should hyperbaric oxygen be used to treat the pregnant patient for acute carbon monoxide poisoning? JAMA 261:1039-1043PubMedCrossRefGoogle Scholar
  84. 18.
    Elkharrat D, Raphael JC, Korach JM, Jars-Guincestre MC et al. (1991) Acute carbon monoxide intoxication and hyperbaric oxygen in pregnancy. Intensive Care Med 17:289-292PubMedCrossRefGoogle Scholar
  85. 19.
    United States Air Force. Hyperbaric chamber operations. Air Force pamphlet 161-27; July 5, 1983:79-81Google Scholar
  86. 1.
    Winter PM, Miller JN (1976) Carbon monoxide poisoning. JAMA 236:1502-1504PubMedCrossRefGoogle Scholar
  87. 2.
    Van Hoesen KB, Camporesi EM, Moon RE, Hage ML, Piantadosi CA (1989) Should Hyperbaric O2 be used to treat the pregnant patient for acute carbon monoxide poisoning? A case report and literature review. JAMA 261:1039-1043PubMedCrossRefGoogle Scholar
  88. 3.
    Ginsberg MD, Myers RE (1976) Fetal brain injury after maternal carbon monoxide intoxication. Neurology 26:15-23PubMedCrossRefGoogle Scholar
  89. 4.
    Longo LD (1977) The biological effects of carbon monoxide on the pregnant woman, fetus and newborn infant. Am J Obstet Gynecol 129(1): 69-103PubMedGoogle Scholar
  90. 5.
    Muller GL, Graham S (1955) Intrauterine death of the fetus due to accidental carbon monoxide poisoning. N Engl J Med 252(25):1075-1078PubMedCrossRefGoogle Scholar
  91. 6.
    Hollander DI, Nagey DA, Welch R, Pupkin M (1987) Hyperbaric oxygen therapy for the treatment of acute carbon monoxide poisoning in pregnancy. J Reprod Med 32:615-617PubMedGoogle Scholar
  92. 7.
    Jennings RT (1987) Women and the hazardous environment: when the pregnant patient requires hyperbaric oxygen therapy. Aviat Space Environ Med 58(4):370-374PubMedGoogle Scholar
  93. 8.
    Margulies JL (1986) Acute carbon monoxide poisoning during pregnancy. Am J Emerg Med 4:516-519PubMedCrossRefGoogle Scholar
  94. 9.
    Marzella L, Myers RAM (1986) Carbon monoxide poisoning. Am Fam Physician 1; Nov 34(5):186-194Google Scholar
  95. 1o.
    Longo LD (1970) Carbon monoxide in the pregnant mother and fetus and its exchange across the placenta. Ann NY Acad Sci 174:313-341CrossRefGoogle Scholar
  96. 11.
    Kindwall E (1977) Carbon monoxide and cyanide poisoning, In: Davis JC, Hunt TK. (eds): Hyperbaric oxygen therapy. Undersea Medical Society, Bethesda, Md, pp 177-190Google Scholar
  97. 12.
    Piantadosi CA (1982) Carbon monoxide, oxygen transport and oxygen metabolism. J Hyperb Med 2(1):27-44Google Scholar
  98. 13.
    Longo LD, Hill EP (1977) Carbon monoxide uptake and elimination in fetal and maternal sheep. Am J Physiol 232: H324-H330PubMedGoogle Scholar
  99. 14.
    Hill EP, Hill JR, Power GG, Longo LD (1977) Carbon monoxide exchanges between the human fetus and mother: a mathematical model. Am J Physiol 232:H311-H323PubMedGoogle Scholar
  100. 15.
    Ginsberg MD, Myers RE (1974) Fetal brain damage following maternal carbon monoxide intoxication: An experimental study. Acta Obstet Gynecol Scand 53:309-317PubMedCrossRefGoogle Scholar
  101. 16.
    Schwetz BA, Smith FA, Leong BKL, Staples RE (1979) Teratogenic potential of inhaled carbon monoxide in mice and rabbits. Teratology 19:385-392PubMedCrossRefGoogle Scholar
  102. 17.
    Cramer CR (1982) Fetal death due to accidental maternal carbon monoxide poisoning. J Toxicol Clin Toxicol 19(3):297-301PubMedCrossRefGoogle Scholar
  103. 18.
    Pace N, Strajman E, Walker EL (1950) Acceleration of carbon monoxide elimination in man by high pressure oxygen. Science 111:652-654PubMedCrossRefGoogle Scholar
  104. 19.
    Peterson JE, Stewart RD (1970) Absorption and elimination of carbon monxide by inactive young men. Arch Environ Health 21:165-171PubMedGoogle Scholar
  105. 20.
    Ferm VH (1964) Teratogenic effects of hyperbaric oxygen. Proc Soc Exp Biol Med 116: 975-976PubMedGoogle Scholar
  106. 21.
    Fujikura T (1964) Retrolental fibroplasia and prematurity in newborn rabbits induced by maternal hyperoxia. Am J Obstet Gynecol 90:854-858PubMedGoogle Scholar
  107. 22.
    Telford IR, Miller PD, Haas GF (1969) Hyperbaric oxygen causes fetal wastage in rats. Lancet 2:220-221PubMedCrossRefGoogle Scholar
  108. 23.
    Miller PD, Telford ID, Haas GR (1971) Effect of hyperbaric oxygen on cardiogenesis in the rat. Biol Neonate 17:44-52PubMedCrossRefGoogle Scholar
  109. 24.
    Cho SH, Yun DR (1982) The experimental study on the effect of hyperbaric oxygen on the pregnancy wastage of rats with acute carbon monoxide poisoning. Seoul J Med 23:67-75Google Scholar
  110. 25.
    Gilman SC, Bradley ME, Greene KM, Fischer GJ (1983) Fetal development: effects of decompression sickness and treatment. Aviat Spac Environ Med 1040-1042Google Scholar
  111. 26.
    Gilman SC, Greene KM, Bradley ME, Biersner RJ (1982) Fetal development: Effects of simulated diving and hyperbaric oxygen treatment. Undersea Biomed Res 9(4): 297-304PubMedGoogle Scholar
  112. 27.
    United States Navy Diving Manual. vol. 1, Chap 8. Best Publishing Co., San Pedro, 1985, p 36Google Scholar
  113. 28.
    Assali NS, Kirschbaum THL, Dilts PV (1968) Effects of hyperbaric oxygen on uteroplacental and fetal circulation. Cir Res 22:573-588Google Scholar
  114. 29.
    Aksenova A, Proshina IV, Smirnova LK, Titchenko LI (1979) Methods of prenatal diagnosis of fetal hypoxia and control of the effectiveness of its treatment with hyperbaric oxygen. Akush Ginekol (Mosk) Nov 11:15-18Google Scholar
  115. 30.
    Molzhaninov EV, Chaika VK, Domanova AI, Belousov GV, Zolotukhin NS, Akimova IK (1981, 1983) Experience and prospects of using hyperbaric oxygenation in obstetrics, In: Proceedings of the 7th International Congress on Hyperbaric Medicine, Moscow, vol. 1. Nauka, Moscow, pp 139-141Google Scholar
  116. 31.
    Pobedinskiy NM, Proshina IV, Fanchenko ND, Orlova VG (1981,1983) Hyperbaric oxygen in the treatment of reproductive function of women. In: Proceedings of the 7th International Congress on Hyperbaric Medicine, Moscow, vol.1. Nauka, Moscow, pp 133-136Google Scholar
  117. 32.
    Proshina IV, Kuzmina NV, Borisenko SS. Hyperbaric oxygenation in the prevention and treatment of toxemia of pregnancy and placental insufficiency. Akush Ginekol (Mosk) 1983 6:20-23Google Scholar
  118. 33.
    Stepanyants NA, Grinshpun EL, Popov VA, Golovko VD, Kiselyova LF (1981, 1983) Hyperbaric oxygenation in the complex treatment of late toxicosis of pregnancy, In: Proceedings of the 7 International Congress on Hyperbaric Medicine, Moscow, Vol. 1. Nauka, Moscow, pp 137-138Google Scholar
  119. 34.
    Vanina LV, Yefuni SN, Beilin AL, Giorgobiani TN, Pankratova NN, Slavin AG, Morozova TA (1981,1983) Obstetrics aid in hyperbaric conditions, in: Proceedings of the 7th International Congress on Hyperbaric Medicine, Moscow, vol.1. Nauka, Moscow, pp 26-28Google Scholar
  120. 35.
    Ledingham IM, McBride TI, Jennett WB, Adams JH, Tindal SAP (1968) Fatal brain damage associated with cardiomyopathy of pregnancy with notes on caesarean section in a hyperbaric chamber. British Med J 4:285-287CrossRefGoogle Scholar
  121. 36.
    Kindwall EP, Goldmann RW (1970) Hyperbaric medicine procedures. St. Luke’s Hospital, Milwaukee, Wis., pp 60, 90-98Google Scholar
  122. 37.
    Hyperbaric oxygen therapy: a committee report. Undersea and Hyperbaric Medical Society, Bethesda, Md, 1986, pp 33-36Google Scholar
  123. 1.
    Hayes JM, Hall (1964) The myocardial toxicity of carbon monoxide. Med J Aust 1:865-868PubMedGoogle Scholar
  124. 2.
    Myers RAM (1990) Carbon Monoxide Poisoning. In: Haddad LM, Winchester JF (ed) Poisoning and drug overdose, 2nd edn. WB Saunders Company, PhiladelphiaGoogle Scholar
  125. 3.
    Cosby RS, Bergeron M (1963) Electrocardiographic changes in carbon monoxide poisoning. Am J Cardiol 11:93PubMedCrossRefGoogle Scholar
  126. 4.
    Walden SM, Gottlieb SO (1990) Urban angina, urban arrhythmias: carbon monoxide and the heart. Ann Intern Med 113:337-338PubMedGoogle Scholar
  127. 5.
    Proudfoot AT (1990) Carbon monoxide poisoning - recent advances. Acta Clin Belg Suppl 13:61-68PubMedGoogle Scholar
  128. 6.
    Penney DG (1990) Acute carbon monoxide poisoning: animal models: a review. Toxicology 60:123-160CrossRefGoogle Scholar
  129. 7.
    Marius Nunez AL (1990) Myocardial infarction with normal coronary arteries after acute exposure to carbon monoxide. Chest 97: 491-494CrossRefGoogle Scholar
  130. 8.
    Adams JD, Erickson HH (1973) Myocardial metabolism during exposure to carbon monoxide in the conscious dog. J. Appl Physiol 34:238-242PubMedGoogle Scholar
  131. 9.
    Strauer BE (1990) The significance of coronary reserve in clinical heart disease. J Am Coll Cardiol 15:775-783PubMedCrossRefGoogle Scholar
  132. 10.
    Snow TR, Vanoli E et al. (1988) Response of cytochrome a,a3 to carbon monoxide in canine hearts with prior infarcts 42:927-931Google Scholar
  133. 11.
    Uren NU, Melin JA et al. (1994) Relation between myocardial blood flow and the severity of coronary artery stenosis. N Engl J Med 330:1782-1788PubMedCrossRefGoogle Scholar
  134. 12.
    Einzig S, Nicoloff DM et al. (1980) Myocardial perfusion abnormalities in carbon monoxide poisoned dogs. Can J Physiol Pharmacol 58:396-405PubMedCrossRefGoogle Scholar
  135. 13.
    Kleinert HD, Scales JL, et al. (1980) Effects of carbon monoxide or low O2 gas mixture inhalation on regional O2 saturation, blood flow, and small vessel blood content of the rabbit heart. Pflugers Arch 383:105-111PubMedCrossRefGoogle Scholar
  136. 14.
    Cox BD, Whichelow MJ (1985) Carbon monoxide levels in the breath of smokers and nonsmokers: effect of domestic heating. J Epidemiol Commun Health 39:75-78CrossRefGoogle Scholar
  137. 15.
    Beck HG, Suter GM (1938) Role of carbon monoxide in the causation of myocardial disease. JAMA 110:1982-1986CrossRefGoogle Scholar
  138. 16.
    Aronow WS (1979) Effects of carbon monoxide on cardiovascular disease. Prey Med 8:271-278CrossRefGoogle Scholar
  139. 17.
    Gandini C, Pirovano C et al. (in press) Hyperbaric oxygen treatment for heart damage caused by carbon monoxide poisoningGoogle Scholar
  140. 18.
    Elkharrat D, Raphael JC et al. (1986) Angioscintigraphie Cardiaque au Cours de l’Intoxication Aigue par l’Oxyde de Carbone. Réan Soin intens Méd Urg 2:61-66Google Scholar
  141. 19.
    Ohishi H, Binette JP et al. (1986) Myocardial chondroitin sulfates D and E in a case of acute carbon monoxide poisoning. Clin Chim Acta 156:157-164PubMedCrossRefGoogle Scholar
  142. 20.
    Verrier RL, Mills AK et al. (1990) Acute effects of carbon monoxide on cardiac electrical stability. Res Repir Health Eff Inst 35:1-14Google Scholar
  143. 21.
    Hinderliter AL, Adams KF et al. (1989) Effects of low-level carbon monoxide exposure on resting and exercise induced ventricular arrhythmias in patients with coronary artery disease and no baseline ectopy. Arch Environ Health 44:89-93PubMedCrossRefGoogle Scholar
  144. 22.
    Sheps DS, Herbst MC et al. (1990) Production of arrhythmias by elevated carboxyhemoglobin in patients with coronary artery disease. Ann Intern Med 113:343-351PubMedGoogle Scholar
  145. 23.
    Stern FB, Halperin WE et al. (1988) Heart disease mortality among bridge and tunnel officers exposed to carbon monoxide. Am J Epidemiol 128:1276-1288PubMedGoogle Scholar
  146. 24.
    Ehrich WE, Bellet S et al. (1944) Cardiac changes from carbon monoxide poisoning. Am J Med Sci 208:511-521CrossRefGoogle Scholar
  147. 25.
    Anderson RF, Allensworth DC et al. (1967) Myocardial toxicity from carbon monoxide poisoning. Annals Int Med 67:1172Google Scholar
  148. 26.
    Ebisuno S, Yasuno M et al. (1986) Myocardial infarction after acute carbon monoxide poisoning: case report angiology 37 (8):621-624Google Scholar
  149. 27.
    Kjedlsen K, Thomsen HK (1974) The effects of carbon monoxide on myocardium. Ultrastructural changes in rabbits after a moderate chronic exposure. Circ Res 34:339-348Google Scholar
  150. 28.
    Fiorista F, Casazza F et al. (1993) Infarto Miocardico Silente da Intossicazione Acuta da Monossido di Carbonio. G Ital Cardiol 23:583-587PubMedGoogle Scholar
  151. 29.
    Thompson N, Henry JA (1983) Carbon monoxide poisoning: poison unit experience over five years. Human Toxicol 2:315-324CrossRefGoogle Scholar
  152. 30.
    Kindwall EP (1978) Carbon monoxide and cyanide poisoning. In: Davis JC, Hunt TK (eds.) Hyperbaric oxygen therapy. Undersea Medical Society 13:177-190Google Scholar
  153. 31.
    Ayres SM, Giannelli S et al. (1970) Myocardial and systemic response to carboxyhemoglobin. Ann NY Acad Sci 174:268-293PubMedCrossRefGoogle Scholar
  154. 32.
    Adams KF, Kokh G et al. (1988) Acute elevation of blood carboxyhemoglobin to 6% impairs exercise performance and aggravates symptoms in patients with ischemic heart disease. J Am Coll Cardiol 12:900-909PubMedCrossRefGoogle Scholar
  155. 33.
    Aronow WS, Rokaw SN et al. (1971) Carboxyhemoglobin caused by smoking nonnicotine cigarettes: Effects in angina pectoris. Circulation 44:782-788PubMedGoogle Scholar
  156. 34.
    Aronow WS, Isbell MW et al. (1973) Carbon monoxide effect on exercise induced angina pectoris. Ann Intern Med 79:392-395PubMedGoogle Scholar
  157. 35.
    Anderson EW, Andelman R.J et al. (1973) Effect of low level carbon monoxide exposure on onset and duration of angina pectoris. Ann Intern Med 79:46-50PubMedGoogle Scholar
  158. 36.
    Ginsberg MD, Myers RE et al. (1974) Experimental carbon monoxide encephalopathy in the primate. Arch Neurol 30:209PubMedCrossRefGoogle Scholar
  159. 37.
    Carnevali R, Omboni E et al. (1987) Alterazioni Elettrocardiografiche in Corso di Intossicazione Acuta da Monossido di Carbonio. Min Med 78:175-178Google Scholar
  160. 38.
    Bouvrain Y, Gaultier M et al. (1960) Les Accidents Cardiaques Retardes de l’Oxide de carbone. Sem Hop Paris 36:3163-3172Google Scholar
  161. 39.
    Barois A, Grosbuis S et al. (1979) Les Intoxications Aigues par l’Oxide de Carbone et les Gas de Chuffage. Rev Prat. 29:1211-1229PubMedGoogle Scholar
  162. 40.
    Frieberg CK, Zager A (1961) "Non-Specific" ST and T waves changes. Circulation 23:655-661Google Scholar
  163. 41.
    Abbot JA, Scheinman MM (1973) Non-Diagnostic eletctrocardiogram in patients with acute myocardial and anatomic correlations. Am J Med 55:608CrossRefGoogle Scholar
  164. 42.
    Klebs E (1865) Uber Die Wirkung Kohlenoxyds auf deu Thierische Organism. Virchows Arch Pathol Anat 32: 450-517Google Scholar
  165. 43.
    Shafer NS (1965) Primary myocardial disease in man resulting from acute carbon monoxide poisoning. Am J Med 38:316-320PubMedCrossRefGoogle Scholar
  166. 44.
    Corya BC, Black MJ et al. (1976) Echocardiographic findings after acute carbon monoxide poisoning. Br Heart J 38:712-717PubMedCrossRefGoogle Scholar
  167. 45.
    Williams J, Lewis RW et al. (1992) Carbon monoxide poisoning and myocardial ischemia in patients with burns. J Burn Care Rehabil 13(2):210-213PubMedCrossRefGoogle Scholar
  168. 46.
    Sharf SM (1974) Transmural myocardial infarction after exposure to carbon monoxide in coronary artery disease. N Engl J Med 291:85-86CrossRefGoogle Scholar
  169. 47.
    Ilano AL, Raffin TA et al. (1990) Management of carbon monoxide poisoning. Chest 97(1):165-169PubMedCrossRefGoogle Scholar
  170. 48.
    Neumeier D (1981) Tissue specific and subcellular distribution of creatinine kinase isoenzymes. In Lang H (ed): Creatine kinase isoenzymes. Berlin, Heidelberg, New York, Springer pp 85-131CrossRefGoogle Scholar
  171. 49.
    Katus HA, Looser S et al. (1992) Development and in vitro characterization of a new immunoassay of cardiac troponin T. Clin Chem 38:386-393PubMedGoogle Scholar
  172. 50.
    Katus HA, Remppis A et al. (1991) Diagnostic efficiency of troponin T measurement in acute myocardial infarction. Circulation 83:902-912PubMedGoogle Scholar
  173. 51.
    Ravkilde J, Horder M et al. (1993) Diagnostic performance and prognostic value of serum troponin T in suspected acute myocardial infarction. Scand J Clin Lab Invest 53:677-685PubMedCrossRefGoogle Scholar
  174. 52.
    Sobel BE, Shell WE et al. (1972) Serum enzyme determinations in the diagnosis and assessment of myocardial infarction. Circulation 45:471PubMedGoogle Scholar
  175. 53.
    Roberts R, Sobel BE et al. (1978) Creatine kinase isoenzymes in assessment of heart disease. Am Heart J 6:1304-1305Google Scholar
  176. 54.
    Lee TH, Goldman L (1986) Serum enzyme assays in the diagnosis of acute myocardial infarction. Ann Intern Med 105:221PubMedGoogle Scholar
  177. 55.
    Vasudevan G, Mercer DW et al. (1986) Lactic dehydrogenase isoenzyme determination in the diagnosis of acute myocardial infarction. Circulation 57:1055Google Scholar
  178. 56.
    Zaret BL, Strauss HW et al. (1971) A non-invasive scintiphotographic method for detecting regional ventricular dysfunction in man. N Engl J Med 284:1165PubMedCrossRefGoogle Scholar
  179. 57.
    Starling MR, Walsh RZ et al. (1987) Quantification of left ventricular regional dyssinergy by radionuclide angiography. J Nucl Med 28:1725PubMedGoogle Scholar
  180. 58.
    Baillet G, Mena IG et al. (1989) Simultaneous technetium 99m MIBI angiography and myocardial perfusion imaging. J Nucl Med 15:113Google Scholar
  181. 59.
    Budinger TF (1988) Single photon emission computed tomography. In Gottschalk A, Hoffer PB, Poche JE, (eds): Diagnostic nuclear medicine. William and Wilkins, Baltimore, p 108Google Scholar
  182. 60.
    Wynne J, Holman BL et al. (1980) Acute myocardial infarct scintigraphy with infarct-avid radiotracers. Med Clin North Am 64:119PubMedGoogle Scholar
  183. 61.
    Khan BA, Fallon JT et al. (1979) Specificity of localization of myosin specific antibody fragments in experimental myocardial infarction. Circulation 60:1527Google Scholar
  184. 62.
    Betriu A, Castagner A et al. (1982) Angiographic finding 1 month after myocardial infarction: a prospective study of 259 survivors. Circulation 65:1099PubMedCrossRefGoogle Scholar
  185. 63.
    Glover MV, Kuber MT et al. (1982) Myocardial infarction before age 36: risk factor and arteriographic analysis. Ann J Cardiol 49:1600CrossRefGoogle Scholar
  186. 64.
    Ambrose JA, Tannenbaum MA et al. (1988) Angiographic progression of coronary artery disease and the development of myocardial infarction. J Am Coll Cardiol 12:56-62PubMedCrossRefGoogle Scholar
  187. 65.
    Graybeal JM, Russel GB et al. (1991) Blood gas corner No 28-oxygenation of the carbon monoxide poisoned patient. Respir Care 36:57-62Google Scholar
  188. 66.
    Vegfors M, Lennmarken C (1991) Carboxyhaemoglobinaemia and pulse oximetry. Br J Anaesth 66:625-626PubMedCrossRefGoogle Scholar
  189. 67.
    Gonzalez A, Gomez Arnau J et al. (1990). Carboxyhemoglobin and pulse oximetry (letter). Anesthesiology 73:573PubMedCrossRefGoogle Scholar
  190. 68.
    Poisindex (1974-1994) Vol 81 topic: carbon monoxide micromedex, Inc. Denver, ColoradoGoogle Scholar
  191. 69.
    San Lorenzo IS, Chiesa M (1989) Aspetti Cardiologici dell’Intossicazione da Monossido di Carbonio. Cardiologia 34:439-446Google Scholar
  192. 70.
    Hart G, Ellestad M et al. Hyperbaric hoxygen and thrombolysis in myocardial infarction: The hot-my study-preliminary report 289-294Google Scholar

Copyright information

© Springer-Verlag Italia, Milano 1996

Authors and Affiliations

  • D. Mathieu
    • 1
  • F. Wattel
    • 1
  • R. Nevière
    • 1
  • M. Mathieu-Nolf
    • 1
  • N. B. Hampson
    • 2
    • 3
  • E. M. Camporesi
    • 4
  • C. Gandini
    • 5
  • M. Broccolino
    • 6
  • S. Scarpini
    • 6
  • A. Travaglia
    • 7
  • C. Pirovano
    • 7
    • 8
  • S. Brenna
    • 9
  • G. Oriani
    • 10
  • C. Gandini
    • 5
  • M. Michael
    • 11
  • A. Peretti
    • 11
  • D. Grioni
    • 11
  • E. Triulzi
    • 12
  • N. Colombo
    • 13
  1. 1.Service d’Urgences Respiratoires, de Réanimation et Médecine Hyperbare, Centre AntiPoisonHôpital A. Calmette, Centre Hospitalier Régional UniversitaireLille CedexFrance
  2. 2.Hyperbaric DepartmentVirginia Mason Medical CenterSeattleUSA
  3. 3.Section of Pulmonary and Critical Care MedicineVirginia Mason ClinicSeattleUSA
  4. 4.Department of AnaesthesiologySUNY Health Science CenterSyracuseUSA
  5. 5.National Toxicology Information Centre“Clinica del Lavoro” Foundation Pavia Medical CentrePaviaItaly
  6. 6.2nd Division of CardiologyH. Niguarda Cà GrandaMilanItaly
  7. 7.1st Service of Anaesthesia and ReanimationH. Niguarda Cà GrandaMilanItaly
  8. 8.Milan Poison CentreH. Niguarda, Cà GrandaMilanItaly
  9. 9.Biochemical LabH. Niguarda Cà GrandaMilanItaly
  10. 10.Anaesthesia, Intensive and Hyperbaric Care DepartmentGaleazzi Orthopaedic InstituteMilanItaly
  11. 11.Child Neuropsychiatric ClinicH. San GerardoMonzaItaly
  12. 12.Department of NeuroradiologyScientific Institute San RaffaeleMilanItaly
  13. 13.Department of NeuroradiologyH. Niguarda Cà GrandaMilanItaly

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