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Inhaled Carbon Monoxide: From Toxin to Therapy
Abstract
Carbon monoxide (CO) is usually recognized as a toxic gas that can be used to assess lung function in the pulmonary function laboratory. The toxicity of CO relates to its high affinity for hemoglobin and other heme molecules, producing carboxyhemoglobin (HbCO). Despite that blood HbCO levels are commonly measured in patients with CO poisoning, the clinical presentation often does not correlate with the HbCO level, and clinical improvement in the patient's condition does not correlate with HbCO clearance. In patients with CO poisoning, administration of 100% O 2 is standard practice. If available, hyperbaric O 2 can be used, although this is controversial. Measurement of exhaled CO might be useful to estimate HbCO, such as in smoking cessation programs, but assessment of HbCO using pulse oximetry can be misleading. Endogenous CO is generated as the result of heme oxygenase activity. It is becoming increasingly recognized that the results of heme oxygenase activity, specifically CO production, might have important physiologic functions. These include effects on vascular function, inflammation, apoptosis, cell proliferation, and signaling pathways. Given the abundance of basic science supporting a therapeutic role for CO, clinical trials are exploring this potential.
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“While workers are permitted exposure to 35–50 ppm of CO for a 40-h work week (increasing COHb to about 5%), these limits are designed for occupational safety and may not account for potential effects of long-term exposure or use for performance enhancement (Schmidt et al., 2020; Hess, 2017).”
From Low-dose carbon monoxide inhalation to increase total hemoglobin mass and endurance performance: scientific evidence and implications (2024) · cites this paper as Hess, 2017
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“for comparison regular smokers have COHb levels of around 3–8% and heavy smokers may reach levels >20% (Bansal et al., 2024; Hess, 2017).”
From Low-dose carbon monoxide inhalation to increase total hemoglobin mass and endurance performance: scientific evidence and implications (2024) · cites this paper as Hess, 2017
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“While workers are permitted exposure to 35–50 ppm of CO for a 40-h work week (increasing COHb to about 5%), these limits are designed for occupational safety and may not account for potential effects of long-term exposure or use for performance enhancement (Schmidt et al., 2020; Hess, 2017).”
From Low-dose carbon monoxide inhalation to increase total hemoglobin mass and endurance performance: scientific evidence and implications (2024) · cites this paper as Hess, 2017
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Breath Carbon Monoxide as an Indication of Smoking Habit
Middleton, E. T., & Morice, A. H. (2000) · Chest · doi:10.1378/chest.117.3.758 · Cited by 414
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Cited by
Gatterer, H., Dünnwald, T., Woyke, S., Faulhaber, M., Schumacher, Y. O., & Schobersberger, W. (2024) · Frontiers in Physiology · doi:10.3389/fphys.2024.1490205 · Cited by 13
Metadata
- Authors
- Hess, D. R.
- Affiliations
- Massachusetts General Hospital and Harvard Medical School. He is also Editor in Chief of R, espiratory C, are.
- Venue
- Respiratory Care
- Publisher
- SAGE Publications
- Published
- 2017-08-14
- Volume
- 62
- Issue
- 10
- Pages
- 1333-1342
- ISSN
- 0020-1324
- Cited by
- 55
- References
- 2
- Language
- en
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