Toxicity, Carbon Monoxide 中山医院急诊科姚晨玲
Toxicity, Carbon Monoxide 中山医院急诊科 姚晨玲
Background Carbon monoxide(Co)is a colorless odorless gas produced by incomplete combustion of carbonaceous material Co is formed as a by-product of burning organic compounds
Background ◼ Carbon monoxide (CO) is a colorless, odorless gas produced by incomplete combustion of carbonaceous material ◼ CO is formed as a by-product of burning organic compounds
Pathophysiology a co toxicity causes impaired oXygen delivery and utilization a Co reversibly binds hemoglobin resulting in relative anemia Co binds hemoglobin 230-260 times more avidly than oxygen dissociation of co from hbco is slow than that of o2 from Hbo2(1/3600)
Pathophysiology ◼ CO toxicity causes impaired oxygen delivery and utilization ◼ CO reversibly binds hemoglobin, resulting in relative anemia. – CO binds hemoglobin 230-260 times more avidly than oxygen. – dissociation of CO from HbCO is slow than that of O2 from HbO2 (1/3600)
Pathophysiology Resulting a leftward shift in the oxyhemoglobin dissociation curve a binds to cardiac myoglobin, resulting myocardial depression and hypotension a Co binds to cytochromes c and P450 impaired oxygen utilization at the cellular level
Pathophysiology ◼ Resulting a leftward shift in the oxyhemoglobin dissociation curve ◼ binds to cardiac myoglobin , resulting myocardial depression and hypotension ◼ CO binds to cytochromes c and P450, impaired oxygen utilization at the cellular level
100 196 CO 90 0.5%CO 血80 液中碳血 70 60 0.1%Co 红50 蛋40 0.05%CO 白 %30 20 0.01%CO 10 12345 6 10 时间(h) 图10-2-4血液中HbOO%与空气中 CO浓度和接触时间的关系