Recent studies performed in our laboratory (1) have confirmed the finding of Sjdstrand (2, 3) that carbon monoxide is produced in normal man. In 10 normal subjects the average rate of production of carbon monoxide was found to be 0.42 (SE of mean + 0.02) ml per hour. The present study is an attempt to clarify the processes that result in the production of this gas in the body.A number of studies have been performed that suggest that CO may be an in vivo catabolic byproduct of hemoglobin. Sj6strand and associates have demonstrated that the blood carboxyhemoglobin concentration [COHb] becomes elevated in man after intramuscular or intravenous injection of blood or hemoglobin (3) and intravenous injection of damaged erythrocytes or nicotinic acid (4). Sj6strand (3) and later Engstedt (5) and Oski and Altman (6) noted that the blood [COHb] level is elevated in patients with hemolysis. Chemical studies by Sj6strand (7,8) and Ludwig, Blakemore, and Drabkin (9) have demonstrated that treatment of hemoglobin (7,8) and pyridine hemochromogen (9) with hydrogen peroxide and ascorbic acid results in CO formation. In the latter study the bridge and adjacent carbon atoms of heme were labeled with C14, and the CO formed was found to be radioactive, indicating that CO probably arose from a methene bridge carbon atom.* Submitted for publication November 18, 1963; ac- (10) have shown that coupled oxidation of heme is a different reaction than occurs physiologically during heme catabolism in that the porphyrin ring is apparently randomly opened at any of the four methene bridge carbon atoms rather than at the alpha position as occurs in vivo (11). Because of these uncertainties, our method for estimating in vivo CO production quantitatively was applied to this problem. This paper contains data on measurements of the rate of endogenous carbon monoxide production following the intravenous injection of damaged erythrocytes in man.
MethodsEndogenous CO production was measured by the "rebreathing method" described in greater detail elsewhere (1). The principle of this method is that CO excretion from the body, which occurs via the lungs, is inhibited by having the subject rebreathe in a closed system. Endogenous CO production is then calculated from the rate of increase in venous blood [COHb] during rebreathing and the effective blood volume, both of which are measured in every study. With this technique the production of CO per hour, calculated from two blood samples, drawn at the beginning and end of the period, could be estimated in each hour with an error of less than ± 0.2 ml. Greater precision was ob-1098