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 90 o.5po co 液80 70 碳氧 60 0.1%CO 血L 红50 蛋40 0.05%CO 白 %30 20 0.01%CO 10 345 8 910 寸间(h) 图10-2-4血液中HbOO%与空气中 CO浓度和接触时间的关系