Carboxyhemoglobin (COHB) Saturations in Sudden Unexpected Deaths of Children Under Two Years of Age in Ontario

Abstract

ABSTRACTCarbon monoxide (CO) saturation analysis is one of the routine toxicological examinations performed in the province of Ontario for all deaths involving children under 2 years of age where the cause of death is unknown. Carboxyhemoglobin (COHb) levels were measured in 116 cases that arrived at the Toxicology Section of the Centre of Forensic Sciences (CFS) between April 1996 and April 2000. COHb saturations in all cases were consistent with normal environmental exposure and averaged 3.0 ± 0.1% (range from 1.0% to 9.0%). There was no statistically significant effect of gender (males 3.0 ± 0.2% and females 3.0 ± 0.2%) or age group (neonates 2.8 ± 0.2%, infants 3.1 ± 0.2% and children 2.8 ± 0.3%) on COHb saturation. The present results suggest that a COHb level in a toxic range is a highly improbable finding (0 in 116 cases) in sudden unexpected deaths of children under the age of 2 years. Therefore, it is recommended that COHb levels be measured in pediatric deaths only if the case history suggests possible exposure to a CO source and/or postmortem examination reveals signs of possible CO intoxication.