Diagnosis of carbon monoxide exposure in clinical research and practice: A scoping review.

<h4>Objective</h4>To undertake a scoping review to identify methods and diagnostic levels used in determining unintentional, non-fire related carbon monoxide exposure.<h4>Design</h4>Online databases and grey literature were searched from 1946 to 2023 identifying 80 papers whe...

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Bibliographic Details
Main Authors: Phil Moss, Natasha Matthews, Rosalie McDonald, Heather Jarman
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0300989
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Summary:<h4>Objective</h4>To undertake a scoping review to identify methods and diagnostic levels used in determining unintentional, non-fire related carbon monoxide exposure.<h4>Design</h4>Online databases and grey literature were searched from 1946 to 2023 identifying 80 papers where carbon monoxide levels were reported.<h4>Results</h4>80 papers were included; 71 research studies and 9 clinical guidelines. Four methods were described: blood carboxyhaemoglobin (arterial or venous blood analysis), carbon monoxide oximetry (SpO2), expired carbon monoxide, and ambient carbon monoxide sampling. Blood analysis methods predominated (60.0% of the papers). Multiple methods of measurement were used in 26 (32.5%) of the papers. Diagnostic levels for carboxyhaemoglobin were described in 54 (67.5%) papers, ranging between 2% and 15%. 26 (32.5%) papers reported diagnostic levels that were adjusted for the smoking status of the patient.<h4>Conclusions</h4>Four methods were found for use in different settings. Variability in diagnostic thresholds impairs diagnostic accuracy. Agreement on standardised diagnostic levels is required to enable consistent diagnosis of unintentional, non-fire related carbon monoxide exposure.
ISSN:1932-6203