Is Level of Serum Ischemia-Modified Albumin A Useful Biomarker in Carbon Monoxide Poisoning Cases?

Abstract

Ischemia-modified albumin (IMA) is an emerging diagnostic biomarker for many ischemic conditions. The study was conducted to investigate whether there is a change in IMA levels in carbon monoxide poisoning and, if so, the clinical relevance of IMA levels. This study was performed between October 2013 and April 2014 to compare levels of serum IMA drawn at the time of admission to the emergency department in 49 patients poisoned with carbon monoxide and 37 healthy controls. Serum IMA, blood carboxyhemoglobin, and lactate levels were analyzed. Ischemia-modified albumin levels of patients with carbon monoxide poisoning were higher than those of controls. In patient group, however, there was no correlation between serum IMA and carboxyhemoglobin levels (r = -0.244, P > 0.05), whereas a negative correlation was detected between serum IMA and lactate levels (r = -0.334, P < 0.05). After all, a positive correlation was present between carboxyhemoglobin and lactate levels (r = 0.399, P < 0.05). Results from this preliminary study suggest that IMA might have diagnostic value in carbon monoxide poisoning and may be a parameter to be used clinically together with carboxyhemoglobin levels in terms of reflecting tissue hypoxia. In addition, IMA may be a criterion, especially in delayed cases where carboxyhemoglobin level may be normal in deciding hyperbaric oxygen treatment. To clarify this issue, further studies with larger population are needed.