False Elevation of Carboxyhemoglobin

Mehrotra, Shruti; Edmonds, Marcia L.; Lim, Rodrick

doi:10.1097/pec.0b013e318209f076

“…Further investigation revealed that her falsely elevated carboxyhemoglobin level was due to interference of fetal hemoglobin in spectrophotometric measurements of carboxyhemoglobin [5]. The exact duration of exposure was unknown.…”

Section: Case Reportmentioning

confidence: 98%

Common Poisonings Including Heavy Metal Poisoning

Dasgupta¹,

Wahed²

2014

Clinical Chemistry, Immunology and Laboratory Quality Control

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“…La mesure par spectrophotom etrie est populaire car il s'agit d'une m ethode simple, pr ecise, rapide et accessible [6]. Cependant, certains articles soulignent que la mesure spectrophotom etrique de la HbCO peutêtre sujette aux interf erences caus ees par l'h emoglobine foetale (HbF) [7,8]. L'h emoglobine foetale est structurellement similaire a l'h emoglobine adulte (HbA) mais peut se lier a l'oxyg ene avec une meilleure affinit e [2].…”

Section: Introductionunclassified

“…[7] et Mehrotra et al[8] rapportent que la mesure spectrophotom etrique de la HbCO est faussement elev ee par la pr esence de l'HbF, cr eant des faux positifs aussi elev es que 8% avec le CO-oxym etre. Zwart et al[13] et Variend et al[14] rapportent que dans la m ethode propos ee par Katsumata et al[4], la r eduction du sang avec le dithionite de sodium elimine l'interf erence de l'HbF, et donc devrait eliminer le biais positif lors de l'utilisation du spectrophotom etre.…”

unclassified

Interférence de l'hémoglobine fœtale dans la quantification de la carboxyhémoglobine par spectrophotométrie

Vaillancourt¹,

Desharnais

²

,

Goudreau³

et al. 2015

Canadian Society of Forensic Science Journal

0

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Determination of carboxyhemoglobin (HbCO) is routinely performed in suspected cases of carbon monoxide intoxication and unexplained deaths. However, some authors have suggested that measured HbCO may be falsely elevated in infants (0À12 months) due to the presence of fetal hemoglobin (HbF). The purpose of this study was to evaluate the impact of fetal hemoglobin on the spectrophotometric determination of carboxyhemoglobin. The interference of HbF in the determination of HbCO in infants aged from 0 to 12 months was evaluated using 16 ante-mortem and 19 post-mortem blood samples. The %HbCO was quantified spectrophotometrically by calculating the 560 nm/530 nm absorbance ratio, using a dual-beam spectrophotometer. The average measured HbCO in infants of 3 months of age or under was 17%, which is abnormally elevated. No significant difference in HbCO measurement was found between ante-mortem and postmortem samples. These results highlight the fact that care must be taken in interpretation of carboxyhemoglobin measurements in infants when using a spectrophotometric method. R ESUM ELa quantification de la carboxyh emoglobine (HbCO) est r eguli erement effectu ee lorsqu'une intoxication au monoxyde de carbone est soupçonn ee, ainsi que dans les cas de morts inexpliqu ees. Cependant, certains auteurs ont soulev e la probl ematique de la fausse el evation de la HbCO mesur ee chez les enfants (0 a 12 mois), due a la pr esence d'h emoglobine foetale (HbF). Le but de cette etude est d' evaluer l'impact de l'h emoglobine foetale sur la quantification de la carboxyh emoglobine par spectrophotom etrie. L'interf erence de l'HbF dans la quantification de la HbCO chez les enfantsâg es de 0 a 12 mois a et e evalu ee en utilisant 16 echantillons de sang ante-mortem et 19 echantillons de sang post-mortem. Le pourcentage de HbCO (%HbCO) a et e quantifi e par spectrophotom etrie en calculant le ratio d'absorbance 560 nm/530 nm, en utilisant un spectrophotom etre a double faisceau. La moyenne des mesures de HbCO chez les enfants de 3 mois et moins etait de 17%, ce qui est anormalement elev e. Aucune diff erence significative dans la mesure de la HbCO n'a et e d etermin ee entre les echantillons ante-mortem et post-mortem. MOTS-CL ES Toxicologie judiciaire; carboxyh emoglobine; h emoglobine foetale; spectrophotom etrie; enfants; faux positifsCes r esultats soulignent le fait que l'interpr etation des r esultats de la carboxyh emoglobine chez les enfants doitêtre faite avec circonspection lors de l'utilisation de la m ethode spectrophotom etrique.

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“…The spectrophotometric measurement is very popular because it is simple, accurate, rapid and accessible 6 . However, it is reported that spectrophotometric measurement of HbCO can be subject to interferences from fetal hemoglobin (HbF) 7,8 . Fetal hemoglobin is structurally similar to adult hemoglobin (HbA) but can bind oxygen with greater affinity 2 .…”

Section: Introductionmentioning

confidence: 99%

“…Studies on this topic yield contradictory results. Vreman et al 7 and Mehrotra et al 8 report that spectrophotometric measurement of HbCO is falsely elevated by the presence of HbF, giving false positive results up to 8% when using a CO-oximeter. Zwart et al 13 and Variend et al 14 report that in the method proposed by Katsumata et al 4 , reduction of blood with sodium dithionite eliminates the interference of HbF, and thus should not give positive bias when using a basic spectrophotometer.…”

Section: Introductionmentioning

confidence: 99%

Interference of fetal hemoglobin in the determination of carboxyhemoglobin by spectrophotometry

Vaillancourt¹,

Desharnais

²

,

Goudreau³

et al. 2015

Canadian Society of Forensic Science Journal

0

View full text Add to dashboard Cite

Determination of carboxyhemoglobin (HbCO) is routinely performed in suspected cases of carbon monoxide intoxication and unexplained deaths. However, some authors have suggested that measured HbCO may be falsely elevated in infants (0-12 months) due to the presence of fetal hemoglobin (HbF). The purpose of this study was to evaluate the impact of fetal hemoglobin on the spectrophotometric determination of carboxyhemoglobin. The interference of HbF in the determination of HbCO in infants aged from 0 to 12 months was evaluated using 16 ante-mortem and 19 post-mortem blood samples. The %HbCO was quantified spectrophotometrically by calculating the 560 nm/530 nm absorbance ratio, using a dual beam spectrophotometer. The average measured HbCO in infants of 3 months of age or under was 17%, which is abnormally elevated. No significant difference in HbCO measurement was found between ante-mortem and post-mortem samples. These results highlight the fact that care must be taken in interpretation of carboxyhemoglobin measurements in infants when using a spectrophotometric method.

show abstract

False Elevation of Carboxyhemoglobin

Cited by 11 publications

References 9 publications

Common Poisonings Including Heavy Metal Poisoning

Common Poisonings Including Heavy Metal Poisoning

Interférence de l'hémoglobine fœtale dans la quantification de la carboxyhémoglobine par spectrophotométrie

Interference of fetal hemoglobin in the determination of carboxyhemoglobin by spectrophotometry

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