Advanced search
Publication Cover
Expert Review of Respiratory Medicine Volume 7, 2013 - Issue 2
Submit an article Journal homepage
906
Views
60
CrossRef citations to date
0
Altmetric
Review

Carbon monoxide and cyanide toxicity: etiology, pathophysiology and treatment in inhalation injury

Todd F Huzar Department of Surgery, University of Texas Health Science Center – Houston, Houston, TX, USA. [email protected]
,
Tonya George Department of Surgery, University of Texas Health Science Center – Houston, Houston, TX, USA
&
James M Cross Department of Surgery, University of Texas Health Science Center – Houston, Houston, TX, USA
Pages 159-170 | Published online: 09 Jan 2014

References

  • Smith DL, Cairns BA, Ramadan F et al. Effect of inhalation injury, burn size, and age on mortality: a study of 1447 consecutive burn patients. J. Trauma 37(4), 655–659 (1994).
  • Kimmel EC, Still KR. Acute lung injury, acute respiratory distress syndrome and inhalation injury: an overview. Drug Chem. Toxicol. 22(1), 91–128 (1999).
  • Thompson PB, Herndon DN, Traber DL, Abston S. Effect on mortality of inhalation injury. J. Trauma 26(2), 163–165 (1986).
  • Finnerty CC, Herndon DN, Jeschke MG. Inhalation injury in severely burned children does not augment the systemic inflammatory response. Crit. Care 11(1), R22 (2007).
  • Prockop LD, Chichkova RI. Carbon monoxide intoxication: an updated review. J. Neurol. Sci. 262(1–2), 122–130 (2007).
  • Cobb N, Etzel RA. Unintentional carbon monoxide-related deaths in the United States, 1979 through 1988. JAMA 266(5), 659–663 (1991).
  • Kao LW, Nañagas KA. Toxicity associated with carbon monoxide. Clin. Lab. Med. 26(1), 99–125 (2006).
  • CDC. Carbon monoxide-related deaths – United States, 1999–2004. MMWR 56, 1309–1312 (2007).
  • CDC. Carbon monoxide exposures – United States, 2000–2009. MMWR 60(30), 1014–1017 (2011).
  • Qureshi ST, Mahajan P. Carbon monoxide poisoning: clues to unmasking the great masquerader. Consult Pediatr. 4, 477–482 (2005).
  • Lascaratos JG, Marketos SG. The carbon monoxide poisoning of two Byzantine emperors. J. Toxicol. Clin. Toxicol. 36(1-2), 103–107 (1998).
  • Pankow D. History of carbon monoxide toxicology. In: Carbon Monoxide Toxicology. CRC Press, FL, USA, 1–19 (2000).
  • Haldane J. The relation of the action of carbonic oxide to the oxygen tension. J. Physiol. 18, 201–217 (1896).
  • Haldane JB. Carbon Monoxide as a tissue poison. Biochem. J. 21(5), 1068–1075 (1927).
  • Haldane J. Medicolegal contributions of historical interest. The action of carbonic oxide on man. Forensic Sci. 1(4), 451–483 (1972).
  • Roughton FJW, Darling RC. The effect of carbon monoxide on the oxyhemoglobin dissociation curve. Am. J. Physiol. 141, 17–31 (1944).
  • Gorman D, Drewry A, Huang YL, Sames C. The clinical toxicology of carbon monoxide. Toxicology 187(1), 25–38 (2003).
  • Goldbaum LR, Ramirez RG, Absalon KB. What is the mechanism of carbon monoxide toxicity? Aviat. Space. Environ. Med. 46(10), 1289–1291 (1975).
  • Goldbaum LR, Orellano T, Dergal E. Mechanism of the toxic action of carbon monoxide. Ann. Clin. Lab. Sci. 6(4), 372–376 (1976).
  • Orellano T, Dergal E, Alijani M et al. Studies on the mechanism of carbon monoxide toxicity. J. Surg. Res. 20(5), 485–487 (1976).
  • Ramirez RG, Albert SN, Agostini JC, Basu AP, Goldbaum LR, Absolon KB. Lack of toxicity of transfused carboxyhemoglobin red blood cells and carbon monoxide inhalation. Surg. Forum 25(0), 165–168 (1974).
  • Hardy KR, Thom SR. Pathophysiology and treatment of carbon monoxide poisoning. J. Toxicol. Clin. Toxicol. 32(6), 613–629 (1994).
  • Zhang J, Piantadosi CA. Mitochondrial oxidative stress after carbon monoxide hypoxia in the rat brain. J. Clin. Invest. 90(4), 1193–1199 (1992).
  • Radi R, Rodriguez M, Castro L, Telleri R. Inhibition of mitochondrial electron transport by peroxynitrite. Arch. Biochem. Biophys. 308(1), 89–95 (1994).
  • Ernst A, Zibrak JD. Carbon monoxide poisoning. N. Engl. J. Med. 339(22), 1603–1608 (1998).
  • Choi IS. Carbon monoxide poisoning: systemic manifestations and complications. J. Korean Med. Sci. 16(3), 253–261 (2001).
  • Wittenberg BA, Wittenberg JB. Myoglobin-mediated oxygen delivery to mitochondria of isolated cardiac myocytes. Proc. Natl Acad. Sci. USA 84(21), 7503–7507 (1987).
  • Chance B, Erecinska M, Wagner M. Mitochondrial responses to carbon monoxide toxicity. Ann. N. Y. Acad. Sci. 174(1), 193–204 (1970).
  • Kumazawa T, Watanabe-Suzuki K, Seno H, Ishii A, Suzuki O. A curious autopsy case of accidental carbon monoxide poisoning in a motor vehicle. Leg. Med. (Tokyo) 2(3), 181–185 (2000).
  • Colomb-Lippa D. Acute carbon monoxide exposure: diagnosis evaluation, treatment. JAAPA 18(1), 41–46 (2005).
  • Loughridge LW, Leader LP, Bowen DA. Acute renal failure due to muscle necrosis in carbon-monoxide poisoning. Lancet 2(7042), 349–351 (1958).
  • Finely J, VanBeck A, Glover JL. Myonecrosis complicating carbon monoxide poisoning. J. Trauma 17, 536–540 (1977).
  • Quinn DK, McGahee SM, Politte LC et al. Complications of carbon monoxide poisoning: a case discussion and review of the literature. Prim. Care Companion J. Clin. Psychiatry 11(2), 74–79 (2009).
  • Raub JA, Benignus VA. Carbon monoxide and the nervous system. Neurosci. Biobehav. Rev. 26(8), 925–940 (2002).
  • Thom SR, Fisher D, Manevich Y. Roles for platelet-activating factor and *NO-derived oxidants causing neutrophil adherence after CO poisoning. Am. J. Physiol. Heart Circ. Physiol. 281(2), H923–H930 (2001).
  • Ischiropoulos H, Beers MF, Ohnishi ST, Fisher D, Garner SE, Thom SR. Nitric oxide production and perivascular nitration in brain after carbon monoxide poisoning in the rat. J. Clin. Invest. 97(10), 2260–2267 (1996).
  • Thom SR, Fisher D, Xu YA, Notarfrancesco K, Ischiropoulos H. Adaptive responses and apoptosis in endothelial cells exposed to carbon monoxide. Proc. Natl Acad. Sci. USA 97(3), 1305–1310 (2000).
  • Thom SR. Dehydrogenase conversion to oxidase and lipid peroxidation in brain after carbon monoxide poisoning. J. Appl. Physiol. 73(4), 1584–1589 (1992).
  • Thom SR, Xu YA, Ischiropoulos H. Vascular endothelial cells generate peroxynitrite in response to carbon monoxide exposure. Chem. Res. Toxicol. 10(9), 1023–1031 (1997).
  • Lapresle J, Fardeau M. The central nervous system and carbon monoxide poisoning. II. Anatomical study of brain lesions following intoxication with carbon monixide (22 cases). Prog. Brain Res. 24, 31–74 (1967).
  • Choi IS. Peripheral neuropathy following acute carbon monoxide poisoning. Muscle Nerve 9(3), 265–266 (1986).
  • Szabó C, Ischiropoulos H, Radi R. Peroxynitrite: biochemistry, pathophysiology and development of therapeutics. Nat. Rev. Drug Discov. 6(8), 662–680 (2007).
  • Thom SR, Taber RL, Mendiguren II, Clark JM, Hardy KR, Fisher AB. Delayed neuropsychologic sequelae after carbon monoxide poisoning: prevention by treatment with hyperbaric oxygen. Ann. Emerg. Med. 25(4), 474–480 (1995).
  • Bell JD. Molecular cross talk in traumatic brain injury. J. Neurosci. 27(9), 2153–2154 (2007).
  • Choi S. Delayed neurological sequelae in carbon monoxide intoxication. Arch. Neurol. 57, 1214–1218 (2000).
  • Parkinson RB, Hopkins RO, Cleavinger HB et al. White matter hyperintensities and neuropsychological outcome following carbon monoxide poisoning. Neurology 58(10), 1525–1532 (2002).
  • Dunham MD, Johnstone B. Variability of neuropsychological deficits associated with carbon monoxide poisoning: four case reports. Brain Inj. 13(11), 917–925 (1999).
  • Lam SP, Fong SY, Kwok A, Wong T, Wing YK. Delayed neuropsychiatric impairment after carbon monoxide poisoning from burning charcoal. Hong Kong Med. J. 10(6), 428–431 (2004).
  • Choi IS. Parkinsonism after carbon monoxide poisoning. Eur. Neurol. 48(1), 30–33 (2002).
  • Kwon OY, Chung SP, Ha YR, Yoo IS, Kim SW. Delayed postanoxic encephalopathy after carbon monoxide poisoning. Emerg. Med. J. 21(2), 250–251 (2004).
  • Shillito FM, Drinker CK, Shaughnessy TJ. The problem of nervous and mental sequelae in carbon monoxide poisoning. JAMA 106, 669–674 (1936).
  • Choi IS, Cheon HY. Delayed movement disorders after carbon monoxide poisoning. Eur. Neurol. 42(3), 141–144 (1999).
  • Myers RA, Linberg SE, Cowley RA. Carbon monoxide poisoning: the injury and its treatment. JACEP 8(11), 479–484 (1979).
  • Stoller KP. Hyperbaric oxygen and carbon monoxide poisoning: a critical review. Neurol. Res. 29(2), 146–155 (2007).
  • Rosenthal LD. Carbon monoxide poisoning: Immediate diagnosis and treatment are crucial to avoid complications. AJN 106(3), 40–46 (2006).
  • Lopez DM, Weingarten-Arams JS, Singer LP, Conway EE Jr. Relationship between arterial, mixed venous, and internal jugular carboxyhemoglobin concentrations at low, medium, and high concentrations in a piglet model of carbon monoxide toxicity. Crit. Care Med. 28(6), 1998–2001 (2000).
  • Touger M, Gallagher EJ, Tyrell J. Relationship between venous and arterial carboxyhemoglobin levels in patients with suspected carbon monoxide poisoning. Ann. Emerg. Med. 25(4), 481–483 (1995).
  • Prien T, Traber DL. Toxic smoke compounds and inhalation injury: a review. Burns 14(6), 451–460 (1988).
  • Vegfors M, Lennmarken C. Carboxyhaemoglobinaemia and pulse oximetry. Br. J. Anaesth. 66(5), 625–626 (1991).
  • Buckley RG, Aks SE, Eshom JL, Rydman R, Schaider J, Shayne P. The pulse oximetry gap in carbon monoxide intoxication. Ann. Emerg. Med. 24(2), 252–255 (1994).
  • Barker SJ, Curry J, Redford D, Morgan S. Measurement of carboxyhemoglobin and methemoglobin by pulse oximetry: a human volunteer study. Anesthesiology 105(5), 892–897 (2006).
  • Hampson NB. Noninvasive pulse CO-oximetry expedites evaluation and management of patients with carbon monoxide poisoning. Am. J. Emerg. Med. 30(9), 2021–2024 (2012).
  • Maisel WH, Lewis RJ. Noninvasive measurement of carboxyhemoglobin: how accurate is accurate enough? Ann. Emerg. Med. 56(4), 389–391 (2010).
  • Touger M, Birnbaum A, Wang J, Chou K, Pearson D, Bijur P. Performance of the RAD-57 pulse CO-oximeter compared with standard laboratory carboxyhemoglobin measurement. Ann. Emerg. Med. 56(4), 382–388 (2010).
  • Kealey GP. Carbon monoxide toxicity. J. Burn Care Res. 30(1), 146–147 (2009).
  • Wolf SJ, Lavonas EJ, Sloan EP, Jagoda AS; American College of Emergency Physicians. Clinical policy: critical issues in the management of adult patients presenting to the emergency department with acute carbon monoxide poisoning. Ann. Emerg. Med. 51(2), 138–152 (2008).
  • Guzman JA. Carbon monoxide poisoning. Crit. Care Clin. 28(4), 537–548 (2012).
  • Smollin C, Olson K. Carbon monoxide poisoning (acute). Clin. Evid. (Online) 2010, pii: 2103 (2010).
  • Weaver LK, Hopkins RO, Chan KJ et al. Hyperbaric oxygen for acute carbon monoxide poisoning. N. Engl. J. Med. 347(14), 1057–1067 (2002).
  • Elkharrat D. Indications of normobaric and hyperbaric oxygen therapy in acute CO intoxication. Presented at: Satellite Meeting IUTOX VIII International Congress of Toxicology, Dijon, France, 3–4 July 1998.
  • Tibbles PM, Edelsberg JS. Hyperbaric-oxygen therapy. N. Engl. J. Med. 334(25), 1642–1648 (1996).
  • Piantadosi CA. Diagnosis and treatment of carbon monoxide poisoning. Respir. Care Clin. N. Am. 5(2), 183–202 (1999).
  • Weaver LK. Carbon monoxide poisoning. Crit. Care Clin. 15(2), 297–317, viii (1999).
  • Hampson NB. Hyperbaric oxygen therapy: 1999 committee report. Undersea and Hyperbaric Medical Society, Kensington, MD, USA (1999).
  • Roberts D, Buckley NA. Alkalinisation for organophosphorus pesticide poisoning. Cochrane Database Syst. Rev. 1, CD004897 (2005).
  • Buckley NA, Juurlink DN, Isbister G, Bennett MH, Lavonas EJ. Hyperbaric oxygen for carbon monoxide poisoning. Cochrane Database Syst. Rev. 4, CD002041 (2011).
  • Baud FJ, Barriot P, Toffis V et al. Elevated blood cyanide concentrations in victims of smoke inhalation. N. Engl. J. Med. 325(25), 1761–1766 (1991).
  • Breen PH, Isserles SA, Westley J et al. Combined carbon monoxide and cyanide poisoning: a place for treatment? Anesth. Analg. 80, 671–677 (1995).
  • Hall AH, Rumack BH. Clinical toxicology of cyanide. Ann. Emerg. Med. 15(9), 1067–1074 (1986).
  • Bronstein AC, Spyker DA, Cantilena LR Jr, Rumack BH, Dart RC. 2011 Annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 29th Annual Report. Clin. Toxicol. (Phila). 50(10), 911–1164 (2012).
  • Shepherd G, Velez LI. Role of hydroxycobalamin in acute cyanide poisoning. Ann Pharmacoth. 42(5), 661–669 (2008).
  • Hoppe-Roberts JM, Lloyd LM, Chyka PA. Poisoning mortality in the United States: comparison of national mortality statistics and poison control center reports. Ann. Emerg. Med. 35(5), 440–448 (2000).
  • Blanc P, Hogan M, Mallin K, Hryhorczuk D, Hessl S, Bernard B. Cyanide intoxication among silver-reclaiming workers. JAMA 253(3), 367–371 (1985).
  • Wolnik KA, Fricke FL, Bonnin E, Gaston CM, Satzger RD. The Tylenol tampering incident – tracing the source. Anal. Chem. 56(3), 466A–470A, 474A (1984).
  • Cliff J, Muquingue H, Nhassico D, Nzwalo H, Bradbury JH. Konzo and continuing cyanide intoxication from cassava in Mozambique. Food Chem. Toxicol. 49(3), 631–635 (2011).
  • Miles D, Jansson E, Mai MC et al. A survey of total hydrocyanic acid content in ready-to-eat cassava-based chips obtained in the Australian market in 2008. J. Food Prot. 74(6), 980–985 (2011).
  • Cherian MA, Richmond I. Fatal methane and cyanide poisoning as a result of handling industrial fish: a case report and review of the literature. J. Clin. Pathol. 53(10), 794–795 (2000).
  • Cigolini D, Ricci G, Zannoni M et al. Hydroxocobalamin treatment of acute cyanide poisoning from apricot kernels. Emerg. Med. J. 28(9), 804–805 (2011).
  • Sang-A-Gad P, Guharat S, Wannukul W. A mass cyanide poisoning from pickling bamboo shoots. J. Clin. Toxicol. 49(9), 834–839 (2011).
  • Shragg TA, Albertson TE, Fisher CJ Jr. Cyanide poisoning after bitter almond ingestion. West. J. Med. 136(1), 65–69 (1982).
  • Barillo DJ. Diagnosis and treatment of cyanide toxicity. J. Burn Care Res. 30(1), 148–152 (2009).
  • Terrill JB, Montgomery RR, Reinhardt CF. Toxic gases from fires. Science 200(4348), 1343–1347 (1978).
  • Barillo DJ, Goode R, Esch V. Cyanide poisoning in victims of fire: analysis of 364 cases and review of the literature. J. Burn Care Rehabil. 15(1), 46–57 (1994).
  • Musshoff F, Schmidt P, Daldrup T, Madea B. Cyanide fatalities: case studies of four suicides and one homicide. Am. J. Forensic Med. Pathol. 23(4), 315–320 (2002).
  • Hamel J. A review of acute cyanide poisoning with a treatment update. Crit Care Nurs. 31(1), 72–82 (2001).
  • Nelson L. Acute cyanide toxicity: mechanisms and manifestations. J. Emerg. Nurs. 32(Suppl. 4), S8–11 (2006).
  • Kerns WP, Kirk MA. Cyanide and hydrogen sulfide. In: Goldfrank’s Toxicologic Emergencies (8th Edition). Flomenbaum NE, Goldfrank LR, Hoffman RS, Howland MA, Lewin N, Nelson LS (Eds). McGraw-Hill, NY, USA, 1498–1514 (2006).
  • Hall AH, Dart R, Bogdan G. Sodium thiosulfate or hydroxocobalamin for the empiric treatment of cyanide poisoning? Ann. Emerg. Med. 49(6), 806–813 (2007).
  • Persson SA, Cassel G, Sellström A. Acute cyanide intoxication and central transmitter systems. Fundam. Appl. Toxicol. 5(6 Pt 2), S150–S159 (1985).
  • Koschel MJ. Management of the cyanide-poisoned patient. J. Emerg. Nurs. 32(Suppl. 4), S19–S26 (2006).
  • Jones JS, Lloyd T, Cannon L. Persistent hiccups as an unusual manifestation of hyponatremia. J. Emerg. Med. 5(4), 283–287 (1987).
  • Baud FJ, Borron SW, Mégarbane B et al. Value of lactic acidosis in the assessment of the severity of acute cyanide poisoning. Crit. Care Med. 30(9), 2044–2050 (2002).
  • Silverman SH, Purdue GF, Hunt JL, Bost RO. Cyanide toxicity in burned patients. J. Trauma 28(2), 171–176 (1988).
  • Baud FJ. Cyanide: critical issues in diagnosis and treatment. Hum. Exp. Toxicol. 26(3), 191–201 (2007).
  • Lawson-Smith P, Jansen EC, Hyldegaard O. Cyanide intoxication as part of smoke inhalation – a review on diagnosis and treatment from the emergency perspective. Scand. J. Trauma Resusc. Emerg. Med. 19, 14 (2011).
  • Borron SW. Recognition and treatment of acute cyanide poisoning. J. Emerg. Nurs. 32(Suppl. 4), S12–S18 (2006).
  • Lawson-Smith P, Jansen EC, Hilsted L, Hyldegaard O. Effect of hyperbaric oxygen therapy on whole blood cyanide concentrations in carbon monoxide intoxicated patients from fire accidents. Scand. J. Trauma Resusc. Emerg. Med. 18, 32 (2010).
  • Chen KK, Rose CL, Clowes GHA. Comparative values of several antidotes in cyanide poisoning. Am. J. Med. Sci. 188, 767–781 (1934).
  • Chen KK, Rose CL. Treatment of acute cyanide poisoning. J. Am. Med. Assoc. 162(12), 1154–1155 (1956).
  • Chen KK, Rose CL, Clowes GHA. Amyl nitrite and cyanide poisoning. JAMA 100(24), 1920–1922 (1933).
  • Chen KK, Rose CL. Nitrite and thiosulfate therapy in cyanide poisoning. J. Am. Med. Assoc. 149(2), 113–119 (1952).
  • Gracia R, Shepherd G. Cyanide poisoning and its treatment. Pharmacotherapy 24(10), 1358–1365 (2004).
  • Meredith TJ, Jacobsen D, Haines JA, Berger JC, van Heijst ANP. IPCS/CEC Evaluation of Antidotes Series (Volume 2). Cambridge University Press, Cambridge, UK (1993).
  • Borron SW, Baud FJ, Barriot P, Imbert M, Bismuth C. Prospective study of hydroxocobalamin for acute cyanide poisoning in smoke inhalation. Ann. Emerg. Med. 49(6), 794–801, 801.e1 (2007).
  • Borron SW, Baud FJ, Mégarbane B, Bismuth C. Hydroxocobalamin for severe acute cyanide poisoning by ingestion or inhalation. Am. J. Emerg. Med. 25(5), 551–558 (2007).
  • Borron SW, Stonerook M, Reid F. Efficacy of hydroxocobalamin for the treatment of acute cyanide poisoning in adult beagle dogs. Clin Toxicol. 44(Suppl. 1), 1–5 (2006).
  • Ivankovich AD, Braverman B, Kanuru RP, Heyman HJ, Paulissian R. Cyanide antidotes and methods of their administration in dogs: a comparative study. Anesthesiology 52(3), 210–216 (1980).
  • Fortin JL, Ruttiman M, Domanski L, Kowalski JJ. Hydroxocobalamin: treatment for smoke inhalation-associated cyanide poisoning. Meeting the needs of fire victims. JEMS 29(8), S18–S21 (2004).
  • Erdman AR. Is hydroxocobalamin safe and effective for smoke inhalation? Searching for guidance in the haze. Ann. Emerg. Med. 49(6), 814–816 (2007).
  • DesLauriers CA, Burda AM, Wahl M. Hydroxocobalamin as a cyanide antidote. Am. J. Ther. 13(2), 161–165 (2006).
  • Lee J, Mukai D, Kreuter K, Mahon S, Tromberg B, Brenner M. Potential interference by hydroxocobalamin on cooximetry hemoglobin measurements during cyanide and smoke inhalation treatments. Ann. Emerg. Med. 49(6), 802–805 (2007).

Websites

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Order Reprints Request Corporate Permissions

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

Request Academic Permissions

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.

Related research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.