| False elevation of carboxyhemoglobin: case report. | |
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MedLine Citation:
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PMID: 21293225 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Carbon monoxide toxicity in infants and children, like adults, produce nonspecific symptoms with normal vital signs necessitating the serum measurement of carboxyhemoglobin (COHb). In infants, the COHb may be falsely elevated. OBJECTIVES: Our goal was to report a case of suspected carbon monoxide toxicity in an infant and the likely cause of the falsely elevated serum COHb. CASE: A previously healthy 3-month-old girl presented to the pediatric emergency department (ED) with smoke inhalation from a defective furnace. She was asymptomatic. On examination, she was alert, with Glasgow Coma Scale of 15 and normal vital signs. Cardiorespiratory and neurological examinations were completely normal. Because of concern regarding carbon monoxide poisoning, she was treated with normobaric oxygen therapy. Initial and subsequent serum COHb levels were persistently elevated, despite treatment and the infant appearing clinically well. As such, she had a prolonged stay in the ED. Further investigations found that fetal hemoglobin interferes with the spectrophotometric method used to analyze serum COHb levels. CONCLUSIONS: Carboxyhemoglobin serum level, in infants, may be falsely elevated due to the fetal hemoglobin interfering with standard methods of analysis. Knowledge of the false elevation using standard spectrophotometric methods of COHb in clinically well-appearing infants can decrease unnecessary oxygen therapy and monitoring time in the ED. |
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Authors:
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Shruti Mehrotra; Marcia Edmonds; Rodrick K Lim |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Pediatric emergency care Volume: 27 ISSN: 1535-1815 ISO Abbreviation: Pediatr Emerg Care Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-02-04 Completed Date: 2011-06-17 Revised Date: 2011-07-26 |
Medline Journal Info:
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Nlm Unique ID: 8507560 Medline TA: Pediatr Emerg Care Country: United States |
Other Details:
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Languages: eng Pagination: 138-40 Citation Subset: IM |
Affiliation:
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Division of Emergency Medicine, Children's Hospital at London Health Sciences Centre, London, Ontario, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Carbon Monoxide Poisoning
/
blood,
diagnosis*,
therapy Carboxyhemoglobin / analysis* Diagnosis, Differential Emergency Service, Hospital False Positive Reactions Female Fetal Hemoglobin / analysis* Humans Infant Oxygen Inhalation Therapy Risk Assessment Smoke Inhalation Injury / blood, diagnosis*, therapy Spectrophotometry |
| Chemical | |
Reg. No./Substance:
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9034-63-3/Fetal Hemoglobin; 9061-29-4/Carboxyhemoglobin |
| Comments/Corrections | |
Comment In:
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Pediatr Emerg Care. 2011 Jun;27(6):580
[PMID:
21642803
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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