Document Detail


False elevation of carboxyhemoglobin: case report.
MedLine Citation:
PMID:  21293225     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Shruti Mehrotra; Marcia Edmonds; Rodrick K Lim
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pediatric emergency care     Volume:  27     ISSN:  1535-1815     ISO Abbreviation:  Pediatr Emerg Care     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-04     Completed Date:  2011-06-17     Revised Date:  2011-07-26    
Medline Journal Info:
Nlm Unique ID:  8507560     Medline TA:  Pediatr Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  138-40     Citation Subset:  IM    
Affiliation:
Division of Emergency Medicine, Children's Hospital at London Health Sciences Centre, London, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
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:
9034-63-3/Fetal Hemoglobin; 9061-29-4/Carboxyhemoglobin
Comments/Corrections
Comment In:
Pediatr Emerg Care. 2011 Jun;27(6):580   [PMID:  21642803 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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