A New Approach for the Carbon Monoxide (<scp>CO</scp>) Exposure Diagnosis: Measurement of Total CO in Human Blood Versus Carboxyhemoglobin (Hb<scp>CO</scp>)

Varlet, Vincent; Croutte, Emma Lagroy De; Augsburger, Marc; Mangin, Patrice

doi:10.1111/1556-4029.12130

Cited by 17 publications

(22 citation statements)

References 36 publications

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“…The three-way taps were then closed and the syringe, tap and needle from each reservoir were removed from the body. The gas samples were then individually transferred from the syringe into a 20 mL headspace vial containing water [4,21,22], where water was expelled to compensate for the introduction of gas volume. A residual water quantity was left in each vial to permit complete seal.…”

Section: Internal Gas Samplingmentioning

confidence: 99%

“…This procedure for collecting gas reservoirs has already been implemented during the medico-legal investigation of the bodies [4,21,22]. Thus, the samples for this study were collected in the same manner in order to allow several analyses to be performed on the same sample.…”

Section: Internal Gas Samplingmentioning

confidence: 99%

“…Whole body postmortem computed tomography (PMCT) is often used as the imaging technique in postmortem examination. It allows the visualization of internal characteristics of the body and can serve to detect the precise localization of gas reservoirs present inside the body and further allow their collection [1][2][3][4][5]. Routinely, the occurrence and the distribution of postmortem gases are used in medicolegal laboratories, often to provide information about the cause of death [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…For example, the chemical profile of this gas could potentially discriminate between putrefactive gas buildup and the occurrence of a gas embolism [6]. In 2015, Varlet et al demonstrated the possibility to chemically differentiate alteration gases and gas embolisms using gaseous compositions (e.g., O 2 , N 2 , CO 2 , CH 4 , and H 2 S) [5]. In order to obtain more information regarding the cause of death or the postmortem interval (PMI), a complete screening of the volatile organic compounds (VOCs) present in these gas reservoirs would be extremely valuable.…”

Section: Introductionmentioning

confidence: 99%

“…For the present study, internal gases were sampled under laser guidance and assisted by postmortem multi-detector computed tomography (MDCT) following an established procedure [4,5,20]. Solid-phase microextraction (SPME) was applied to concentrate and to introduce the VOCs into the chromatographic system.…”

Section: Introductionmentioning

confidence: 99%

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Postmortem Internal Gas Reservoir Monitoring Using GC×GC-HRTOF-MS

et al. 2016

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Forensic investigations often require postmortem examination of a body. However, the collection of evidence during autopsy is often destructive, meaning that the body can no longer be examined in its original state. In order to obtain an internal image of the body, whole body postmortem computed tomography (PMCT) has proven to be a valuable non-destructive tool and is currently used in medicolegal centers. PMCT can also be used to visually locate gas reservoirs inside a cadaver, which upon analysis can provide useful information regarding very volatile compounds that are produced after death. However, the non-targeted profiling of all potential volatile organic compounds (VOCs) present in these reservoirs has never been attempted. The aim of this study was to investigate the VOC profile of these reservoirs and to evaluate potential uses of such information to document circumstances surrounding death, cause of death and body taphonomy. Comprehensive two-dimensional gas chromatography coupled to time-of-flight high-resolution mass spectrometry (GC×GC-HRTOF-MS) was used for VOC measurements. This study demonstrated that the chemical composition of VOCs within the gas reservoirs differed between locations within a single body but also between individuals. In the future, this work could be expanded to investigate a novel, non-destructive cadaver screening approach prior to full autopsy procedures.

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Section: Internal Gas Samplingmentioning

confidence: 99%

Section: Internal Gas Samplingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Postmortem Internal Gas Reservoir Monitoring Using GC×GC-HRTOF-MS

et al. 2016

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Development of a Raman microspectrophotometric method to quantitate carboxyhemoglobin in blood

Melbourn

Brettell

Maldonado

et al. 2020

J Raman Spectroscopy

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Carboxyhemoglobin (COHb) quantitation is a routine toxicological analysis performed in cases of suspected acute carbon monoxide poisoning. Current methods available for COHb quantitation include spectrophotometric methods and gas chromatographic methods, both of which have advantages and disadvantages. The goal of the present study was to develop a Raman microspectrophotometric COHb quantitation method and assess its precision and accuracy. A strong linear correlation (average R2 = 0.98) was found to exist between COHb concentration and the ratio of the Raman intensities at approximately 1,552 and 1,580 cm−1. The limits of detection and quantitation were found to be 4.4% and 13.2% COHb, respectively. Intraday and interday studies of three calibrators indicated high precision, with the coefficient of variation ranging from 0.85% to 3.4%. The accuracy of this method was evaluated through the quantitation of blind samples, first using the proposed Raman microspectrophotometric method and then by a published UV–visible spectrophotometric method. For the proposed Raman method, 87.5% of the samples were quantitated with less than 20% error. The average variances of the two methods were found to be statistically different using a two‐sample F test, with the Raman microspectrophotometric method having a lower average variance. This study demonstrates that Raman microspectrophotometry may be used to quantitate the COHb concentration of blood samples. Furthermore, this method is comparable with established spectrophotometric methods while eliminating the need for time‐consuming sample preparation and limiting the use of consumables and the generation of waste.

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What are the limitations of methods to measure carbon monoxide in biological samples?

Oliverio

Varlet

2019

Forensic Toxicol

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Carbon monoxide (CO) is one of the most important toxic gases in the atmosphere. Its high affinity for hemoglobin made carboxyhemoglobin (COHb) the most appropriate biomarker for CO poisonings. COHb is measured using spectrophotometric (UV-spectrophotometry, CO-oximetry) or gas chromatographic (GC) methods hyphenated with flame ionization or mass spectrometry detectors. However, inconsistencies in many cases were reported between measured values and reported symptoms, raising doubts over the suitability of COHb as biomarker together with the accuracy and reliability of its measurement methods. Therefore, we aimed to review the accuracy of current methods to measure CO and to determine their sources of error and their effects on the interpretation process. MethodsA detailed search of PubMed was performed in November 2018 using relevant keywords. After exclusion criteria, 46 articles out of 191 initial hits were carefully reviewed. ResultsWhile optical methods are highly affected by changes of blood quality due to degradation of the samples during storage, GC methods are less affected. However, measurement of COHb does not quantify free CO, which is mainly responsible for toxicity mechanisms other than hypoxia such as inhibition of hemoproteins, thus underestimating the true CO burden. Therefore, measurement of COHb is insufficiently accurate for CO poisoning diagnosis. ConclusionsAn alternative biomarker is required, such as determining the total amount of carbon monoxide in blood. Even though further research is required, we recommend toxicologists to consider all sources of error that can alter COHb concentrations and, in more challenging cases, they should use GC-MS methods to confirm the results obtained by spectrophotometry.

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A New Approach for the Carbon Monoxide (CO) Exposure Diagnosis: Measurement of Total CO in Human Blood Versus Carboxyhemoglobin (HbCO)

Cited by 17 publications

References 36 publications

Postmortem Internal Gas Reservoir Monitoring Using GC×GC-HRTOF-MS

Postmortem Internal Gas Reservoir Monitoring Using GC×GC-HRTOF-MS

Development of a Raman microspectrophotometric method to quantitate carboxyhemoglobin in blood

What are the limitations of methods to measure carbon monoxide in biological samples?

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