How is carbon monoxide (CO) eliminated during the treatment of smoke inhalation injuries?

Updated: Oct 15, 2021
  • Author: Keith A Lafferty, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Assume elevated levels of carboxyhemoglobin in all fire victims. Carbon monoxide (CO) is not only responsible for most prehospital deaths due to smoke inhalation, it is also the leading cause of injury/death from all poisons worldwide. [10]

The half-life of CO is 320 minutes on room air, 90 minutes on 100% oxygen, and 23 minutes in a hyperbaric chamber at 3 atmospheres absolute (ATA). Elimination of CO depends primarily on the law of mass action, so alveolar PO2, rather than alveolar ventilation, is the critical factor in its removal.


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