Inhalational Poisoning. Rama B. Rao, MD Bellevue Hospital Center/NYU Medical Center New York City Poison Control Center. Classes. Simple asphyxiants Pulmonary irritants. Particulates Mitochondrial toxins. Simple Asphyxiants. Alveolar displacement O 2 Non-irritating
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Rama B. Rao, MD
Bellevue Hospital Center/NYU Medical Center
New York City Poison Control Center
CO + Hb
CO + Mb
CO + cytochrome oxidase
(1. displaces O
delivery to myocyte)
2. shifts O
Inhibits electron transport
ATP and O
CO binds to heme-containing
PMNs adhere to vascular endothelium
Xanthine dehydrogenase Xanthine oxidase
(inhibitors: tungsten, allopurinol)
Weaver LK, et al: Hyperbaric oxygen for acute carbon monoxide poisoning. N Engl J Med 2002; 347:1057-67
Jim Jones, The People’s Temple
Zyklon B, WWII Auschwitz
Caution if diagnosis is uncertain or if COHb is also suspected.
Can omit nitrites if uncertain exposure.