Is elevated plasma lactate a useful marker in the evaluation of pure carbon monoxide poisoning?

• Published in: Intensive care medicine 2003-08, Vol.29 (8), p.1372-1375
• Main Authors: Benaissa, M Lamine, Mégarbane, Bruno, Borron, Stephen W, Baud, Frédéric J
• Format: Article
• Language: English
• Subjects: Acidosis; Adult; Asymptomatic; Biomarkers; Carbon monoxide poisoning; Carbon Monoxide Poisoning - blood; Cardiology and cardiovascular system; Cohort Studies; Consciousness; Emergency medical care; Emerging diseases; Fainting; Female; Gases; Human health and pathology; Humans; Infectious diseases; Intensive care; Lactic Acid - blood; Life Sciences; Male; Plasma; Prospective Studies; Pulmonology and respiratory tract; Toxicology; Water heaters
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-003-1866-0

To examine whether CO poisoning induces a significant increase in plasma lactate concentration. Prospective observational clinical study in the emergency department and intensive care unit in a university-affiliated teaching hospital. 146 pure CO poisonings resulting from dysfunction of gas cookers or water heaters. Patients were classified into four neurological impairment groups: 37% were severely, 8% moderately, and 45% mildly intoxicated, while 1% were asymptomatic. We found only very mild increases in plasma lactate concentration (median 2.30 mmol/l) which, however, was significantly correlated with the severity of neurological impairment and blood CO concentration (1.41 mmol/l, Spearman's test r=0.3). Plasma lactate is mildly elevated in pure CO-exposed patients. This mild increase and the extensive overlap between the groups of neurological impairment severity do not suggest the usefulness of systematic plasma lactate measurement in pure CO poisoning.