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<< Carbon Monoxide Poisoning In Children: Diagnosis And Management In The Emergency Department

Special Populations And Circumstances

Newborns

Newborns may be especially vulnerable to CO poisoning due to their high metabolic rate and persistence of fetal hemoglobin.50 The immature central nervous system of neonates is more vulnerable to CO-induced hypoxia and lipid peroxidation.115 Fetal hemoglobin can persist until 6 months of life, and at 21 days of life, still represents about 70% of circulating hemoglobin.116 Fetal hemoglobin has a natural left shift compared to adult hemoglobin A and it accumulates and eliminates CO more slowly.52 Fetal hemoglobin may spuriously elevate laboratory COHb readings, especially in older-model CO-oximeters.117 Newer-model laboratory CO-oximeters that use multiple wavelengths of light are less susceptible to this artifact.118 

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