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Journals / Anatolian Journal of Emergency Medicine / 2026 / Cilt: 1 Sayı: 1

Comparing Noninvasive Pulse CO-Oximeter vs Blood Gas Analysis in Emergency Department Patients with Carbon Monoxide Poisoning

Karbonmonoksit Zehirlenmesi ile Acil Servise Başvuran Hastalarda Noninvaziv Nabız CO-oksimetre ile Kan Gazı Analizinin Karşılaştırılması

Sinan Kaya(ÖZEL MUŞ ŞİFA HASTANESİ)
Mehtap Bulut(İSTANBUL MEDİPOL ÜNİVERSİTESİ)
Behçet Varışlı(FINAL INTERNATIONAL UNIVERSITY)
Yalçın Katı(Bursa İnegöl Devlet Hastanesi)
Ulaş Karaoğlu(İSTANBUL MEDİPOL ÜNİVERSİTESİ)0000-0001-8769-1470
Pages
1–4
Publication Date
2018-09-21
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: When pulse CO-oximetry is compared with BGA, it appears to diagnose CO poisoning rapidly and accurately and therefore, it may be used both in pre-hospital period and EDs as a screening test for CO poisoning.

📌 3 Key Takeaways

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Objective & Hypothesis:Introduction: In order to diagnose carbon monoxide (CO) poisoning, clinical suspicion, a reliable history, and the detection of high level of carboxyhemoglobin (COHb) in blood gas analysis are required.
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Key Findings & Data:Methods : From the patients, who were 18 years of age or over, presenting with suspicion of CO poisoning and who were eligible for inclusion in the study, arterial/venous blood gas samples were collected and SpCO was measured by pulse CO-oximetry and recorded by the time of ED visit.
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Conclusion & Impact:Conclusion: When pulse CO-oximetry is compared with BGA, it appears to diagnose CO poisoning rapidly and accurately and therefore, it may be used both in pre-hospital period and EDs as a screening test for CO poisoning.
🔬Design:Klinik Araştırma
📍Scope:Comprehensive Sample
⚙️Variables:Karbon monoksit (CO) zehirlenmesi · noninvaziv nabız CO-oksimetre · kan gazı analizi

Abstract

Introduction: In order to diagnose carbon monoxide (CO) poisoning, clinical suspicion, a reliable history, and the detection of high level of carboxyhemoglobin (COHb) in blood gas analysis are required. The purpose of this study is to compare noninvasive pulse CO-oximetry versus blood gas analysis (BGA) in emergency department (ED) patients with CO poisoning. Methods : From the patients, who were 18 years of age or over, presenting with suspicion of CO poisoning and who were eligible for inclusion in the study, arterial/venous blood gas samples were collected and SpCO was measured by pulse CO-oximetry and recorded by the time of ED visit. Sensitivity and specificity percentages, positive and negative predictive values were determined with ROC analysis. Bland-Altman analysis was used to assess the agreement between two measurement methods. Results : The study was carried out prospectively on 213 patients in total, 133 (62%) of whom were female with a mean age of 38 ± 15. The limits of agreement were -6.5 to 9.9% COHb (bias 1.7%, precision 4.1%). Cut off value in CO measurement was 23, sensitivity was 97.2%, specificity was 80.4%, NPV was 96.6%, and PPV was 83%. Concordance coefficient value (0.868) between BGA, and pulse CO-oximetry was found out to be significantly high. Conclusion: When pulse CO-oximetry is compared with BGA, it appears to diagnose CO poisoning rapidly and accurately and therefore, it may be used both in pre-hospital period and EDs as a screening test for CO poisoning.

Özet

Giri ş : Karbon monoksit (CO) zehirlenmesinin tanısı için klinik ş üphe, güvenilir bir anamnez ve kan gazında yüksek karboksihemoglobin (COHb) düzeyinin saptanması gereklidir. Bu çalı ş mada CO zehirlenmesi ile acil servise ba ş vuran hastalarda noninvaziv nabız CO-oksimetre ile kan gazı analizinin kar ş ıla ş tırılması amaçlanmı ş tır. Metot: CO zehirlenmesi ş üphesi olan ve çalı ş maya dahil edilmeye uygun 18 ya ş ve üzeri hastalarda, acil servis ba ş vurusu esnasında arteriyel/venöz kan gazı örnekleri alınmı ş ve nabız CO- oksimetre ile SpCO düzeyleri ölçülmü ş tür. ROC analizi yapılarak sensitivite, spesifite, negatif prediktif de ğ er (NPD) ve pozitif prediktif de ğ er (PPD) saptanmı ş tır. İ ki ölçüm metodu arasındaki uyumu de ğ erlendirmek için Bland-Altman analizi kullanılmı ş tır. Bulgular: Çalı ş ma toplam 213 hasta üzerinde prospektif olarak yapılmı ş tır. Hastaların 133’ü (%62) kadın olup ortalama ya ş 38 ± 15’tir. Uyum sınırları -6.5 ila 9,9% COHb’dir (bias %1,7, kesinlik %4,1). CO ölçümü için sınır de ğ eri 23, sensitivite %97,2, spesifite %80,4, NPD %96,6, PPD %83 olarak hesaplanmı ş tır. Kan gazı analizi ile nabız CO-oksimetre arasındaki uyum katsayısı de ğ eri (0,868) anlamlı ölçüde yüksek bulunmu ş tur. Sonuç: Nabız CO-oksimetre, kan gazı ile kar ş ıla ş tırıldı ğ ında CO zehirlenmesinde hızlı ve hassas bir biçimde tanı koymaktadır ve hem hastane öncesi dönemde hem de acil servislerde CO zehirlenmesi için bir tarama testi olarak kullanılabilir.

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Cite This Article

Kaya, S., Bulut, M., Varışlı, B., Katı, Y., Karaoğlu, U. (2018). Comparing Noninvasive Pulse CO-Oximeter vs Blood Gas Analysis in Emergency Department Patients with Carbon Monoxide Poisoning. Anatolian Journal of Emergency Medicine, Cilt: 1 Sayı: 1, 1–4. https://ajindex.com/articles/1361517

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References (19)

  1. Van Weter KW. Carbon Monoxide Poisoning. In: Tintinalli JE, Kelen GD, Stapczynski JS, editors. Tintinalli’s Emergency Medicine 6th ed. New York: McGraw-Hill; 2004.p.1238–42.
  2. Iqbal S, Law HZ, Clower JH, et al. Hospital burden of unintentional carbon monoxide poisoning in the United States, 2007. Am J Emerg Med 2012;30:657-64.
  3. Besli G, Ergüven M, Karadoğan M,et al. Çocuklarda Karbon Monoksit Zehirlenmesi. Akademik Acil Tıp Dergisi 2010;9:26-30.
  4. Centers for Disease Control and Prevention (CDC). Nonfatal, unintentional, non–fire-related carbon monoxide exposures-United States, 2004-2006. MMWR 2008;57:896-9.
  5. Centers for Disease Control and Prevention (CDC). Carbon monoxide-related deaths-United States, 1999-2004. MMWR2007;56:1309-12.
  6. Hampson NB, Weaver LK. Carbon monoxide poisoning: a new incidence for an old disease. Undersea Hyperb Med2007;34:163-8.
  7. Roth D, Herkner H, Schreiber W,et al. Accuracy of Noninvasive Multiwave Pulse Oximetry Compared With Carboxyhemoglobin From Blood Gas Analysis in Unselected Emergency Department Patients. Ann Emerg Med 2011;58:74-9.
  8. Touger M, Birnbaum A, Wang J, et al. Performance of the RAD-57 PulseCO-oximeter Compared With Standard Laboratory Carboxyhemoglobin Measurement. Ann Emerg Med 2010;56:382-8.
  9. Prockop LD, Chichkova RI. Carbon monoxide intoxication: an updated review. Journal of the neurological sciences 2007;262(1):122-30.
  10. Hampson NB, Scott KL, Zmaeff JL. Carboxyhemoglobin measurement by hospitals: implications for the diagnosis of carbon monoxide poisoning. J Emerg Med 2006;31:13-6.
  11. Wilcox SR, Richards JB. Noninvasive carbon monoxide detection: insufficient evidence for broad clinical use. Respir Care 2013;58:376-9.
  12. Barker SJ, Curry J, Redford D, et al. Measurement of carboxyhemoglobin and methemoglobin by pulse oximetry: a human volunteer study. Anesthesiology 2006;105:892-7.
  13. Suner S, Partridge R, Sucov A, et al. Non-invasive pulse CO-oximetry screening in the emergency department identifies occult carbon monoxide toxicity. J Emerg Med 2008;34:441-50.
  14. Coulange M, Barthelemy A, Hug F, et al. Reliability of new pulse CO-oximeter in victims of carbon monoxide poisoning. Undersea Hyperb Med 2008;35:107-11.
  15. Piatkowski A, Ulrich D, Grieb G, et al. A new tool for the early diagnosis of carbon monoxide intoxication. Inhal Toxicol 2009;21:1144-7.
  16. Mottram CD, Hanson LJ, Scanlon PD. Comparison of the Masimo Rad 57 pulse oximeter with SpCO technology against a laboratory CO-oximeter using arterial blood. Respir Care 2005;50:1471.
  17. Zaouter C, Zavorsky GS. The measurement of carboxyhemoglobin and methemoglobin using a non-invasive pulse CO-oximeter. Respir Physiol Neurobiol 2012;182:88-92.
  18. Chee KJ, Nilson D, Partridge R, et al. Finding needles in a haystack: a case series of carbon monoxide poisoning detected using new technology in the emergency department. Clin Toxicol (Phila) 2008;46:461-9.
  19. Kot J, Sićko Z, Góralczyk P. Carbon monoxide pulse oximetry vs direct spectrophotometry for early detection of CO poisoning. Anestezjol Intens Ter 2008;40:75-8.