Carbon Monoxide

Carbon Monoxide is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

Carbon monoxide (CO) is a colorless, odorless, and tasteless gas that is produced during incomplete combustion of carbon-containing fuels. It is the leading cause of poisoning morbidity and mortality in the United States.1

Etiology

Common sources of exposure include smoke inhalation in house fires, malfunctioning heaters and electric generators, automobile exhaust, smoking, forklifts, and chemicals such as methylene chloride.2

Pathophysiology

  • CO binds with hemoglobin to form carboxyhemoglobin, which causes a functional anemia and shifts the oxyhemoglobin dissociation curve to the left.
  • CO inhibits cellular respiration by binding to mitochondrial cytochrome oxidase and disrupting the electron transport chain.3
  • Nitric oxide levels, which cause vasodilation, are also increased (likely secondary to activation of nitric oxide synthase).2

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