Abstract
Carbon monoxide (CO) is one of the most toxic agents in clinical and forensic practices. Diagnosis of CO poisoning is a challenging task and needs a high level of suspicion. Carboxyhaemoglobin (COHb) level is considered the only established marker for diagnosis. The current work aims to determine the levels of COHb in blood samples collected from CO poisoned patients on admission and to re-estimate those levels after storage of samples for different periods and after incubation at various temperatures. The results showed that the mean concentrations of carboxyhaemoglobin at time of admission=23.05 ± 13.44. Levels demonstrated insignificant change after either refrigerated storage of samples for different periods (one, two and three years) or after their incubation at different temperatures (37°C, 40°C and 50°C). It can be concluded that COHb concentration remains stable in refrigerated stored blood samples for up to 3 years as well as those present in high temperatures. It is recommended to immediately collect and store blood samples from patients suspicious of CO poisoning. When CO oximetry is not available, samples could be transported and sent to outside laboratory for analysis even after a long time has been passed. This could have great toxicological and medicolegal implications in cases of CO poisoning whether intentional or due to accidents and fires.
Highlights
Carbon monoxide is considered one of the most toxic agents in both clinical and forensic practices
The concentrations of carboxyhaemoglobin (COHb) in refrigerated stored blood samples measured at different periods and after incubation at various temperatures and durations are demonstrated in table 2
Based upon the present results, it can be concluded that COHb concentration remains stable in both refrigerated stored blood samples for up to 3 years and those present in high temperatures for variable durations
Summary
Carbon monoxide is considered one of the most toxic agents in both clinical and forensic practices It is produced as a result of incomplete combustion of hydrocarbons either from industrial source, incompatible engines or poorly functioning heating systems [1]. It may be responsible for more than half of all fatal poisonings all over the world [2,3]. Diagnosis is a challenging task and needs a high level of suspicion as misinterpretation may lead to a fatal outcome [1,7,8] which would be later on a problem facing both clinical toxicologists and forensic practitioners concerning the cause of death
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