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Excerpt
Introduction: Carbon monoxide is the leading cause of poisoning deaths in the United States. Carbon monoxide is a colorless, odorless gas produced by incomplete combustion of carbon containing compounds. There is very limited information regarding the relationship between arterial, mixed venous, and internal jugular COHb levels. The purpose of this study is to evaluate the relationship between the arterial, mixed venous, and internal jugular COHb level in an immature animal model of pediatric carbon monoxide poisoning.
Methods: Piglets were anesthetized with pentobarbital. Tracheostomy, femoral arterial, pulmonary arterial and retrograde internal jugular venous pressure catheters were inserted. Over six hours, piglets received increasing concentration of carbon monoxide to achieve a level of 60% COHb. Blood samples were drawn at baseline and every thirty minutes throughout the study. Mixed venous and internal jugular COHb levels were drawn within five minutes of the arterial sample. Blood samples were measured with the Radiometer OSM 3 Hemoximeter. Results were expressed as percent carboxyhemoglobin.
Results: There were 250 arterial and mixed venous COHb levels obtained. There were 214 internal jugular COHb levels obtained. Samples compared included arterial-venous, arterial-internal jugular and venous-internal jugular. COHb results were evaluated using analysis of variance and correlation analysis. Data was then stratified into three groups, 0-10%, >10% to 40%, >40% COHb. There was no statistically significant difference between arterial, mixed venous and internal jugular COHb level. At all three levels of COHb, there was a correlation of greater than or equal to 0.96 Table 1
Conclusion: Arterial, mixed venous and internal jugular COHb measurements are highly correlated at all levels. Arterial or venous samples can be used to accurately measure COHb levels.
