Treating Carbon Monoxide Poisoning Correctly

CPAP ventilation for COPD

Carbon monoxide poisoning: causes, symptoms and treatment

Every year, about 500 people in Germany lose their life to an invisible danger – carbon monoxide poisoning.1 Although it is the most frequent cause of fatal poisonings, the potential risk of this colorless and odorless gas is often underestimated.2 This is because the unspecific symptoms mean that the clinical condition often goes unnoticed, or is even incorrectly diagnosed, which results in valuable time being lost. Of particular concern is gradual carbon monoxide poisoning during sleep, which can be fatal.

In this article, we will explain what should be done in the event of CO poisoning and how modern ventilators from WEINMANN can make a decisive contribution to its treatment.

What is carbon monoxide poisoning?

Carbon monoxide poisoning is a dangerous and potentially fatal form of poisoning, which results from the inhalation of a high concentration of carbon monoxide (CO). It is also known as CO poisoning.

Carbon monoxide is primarily generated by incomplete combustion processes with an insufficient oxygen supply. When coal, wood, petrol, oil or gas are burned incompletely, some of the carbon combines with oxygen to form carbon monoxide. The chemical equation is:

2 C + O₂ → 2 CO 

Carbon monoxide has a 200-fold higher affinity for hemoglobin compared to oxygen, which leads to a preferential binding of carbon monoxide to the hemoglobin molecules. If it enters the blood circulation, it blocks the binding sites for oxygen on hemoglobin. This causes systemic hypoxia, characterized by an insufficient supply of oxygen to the body cells, which leads to metabolic and functional impairments at the cellular level.

Causes of carbon monoxide poisoning

The most common causes of carbon monoxide poisoning are:

  • Defective or incorrectly maintained heating systems: These include gas boilers, oil heaters, wood-burning stoves and instantaneous water heaters.
  • Blocked chimneys and flue pipes: These prevent carbon monoxide from being removed, which leads to a backflow in the building.
  • Barbecues: Charcoal and gas barbecues can produce carbon monoxide if they are used in enclosed areas.
  • Fires: Whenever something catches fires, carbon monoxide is produced due to the burning materials.
  • Exhaust fumes: Exhaust fumes are another significant source of carbon monoxide. If a car is running in a garage or enclosed area, there may be a build-up of carbon monoxide.

Important: Carbon monoxide can even penetrate concrete or stone, which means that house walls do not offer protection.

Symptoms of CO poisoning

The symptoms of CO poisoning are often variable, which makes diagnosis more difficult. This is because a build-up of carbon monoxide in the air tends to remain undetected, as CO is an odorless and colorless gas, so you cannot tell it is there. 

The insidious nature of carbon monoxide poisoning is also demonstrated by the similarity of the initial symptoms to other illnesses. This means that it can be confused with viral infections. The first symptoms include:

  • Headache
  • Nausea
  • Vomiting
  • Dizziness
  • Feeling weak

These indicators can easily be mistaken for flu or effects of tiredness. The serious symptoms of poisoning as it progresses include:

  • Impaired vision
  • Cardiovascular failure
  • Unconsciousness
  • Disorientation
  • Shortness of breath
  • Cardiac arrest

Treating serious carbon monoxide poisoning

When treating serious carbon monoxide poisoning, the priority is rapid reoxygenation of the patient using highly concentrated oxygen to dissociate the CO-hemoglobin complex and restore the capacity of the blood to transport oxygen.

In acute phases, invasive ventilation is required so as to maximize oxygenation and accelerate CO elimination. The duration of ventilation depends on the individual kinetics of toxicity and can take anything from several hours to several days.

In some cases, non-invasive ventilation may actually be more efficient than pure oxygen therapy. A study by Caglar B. et al in 2019 demonstrated that Continuous Positive Airway Pressure (CPAP) therapy can eliminate carbon monoxide more quickly than pure inhalation of oxygen in cases of acute carbon monoxide poisoning. 

After initial treatment, close monitoring of vital signs, such as respiratory rate, blood pressure and oxygen saturation in the blood, is essential to ensure that the poisoning has been overcome by the treatment and that the patient’s respiratory function is improving. 

Since poisoning can also affect the cardiovascular system, the heart values must be monitored by ECG to rule out secondary cardiac complications, or to address them preventively. As soon as the patient has stabilized, a blood gas analysis can establish the severity of the poisoning and provide the basis for assessing the further course of treatment.

In the event of serious CO poisoning, hyperbaric oxygenation (HBO) is recommended.3 By administering 100% oxygen at a pressure higher than atmospheric, hyperbaric oxygen therapy can quadruple the oxygen diffusion distance and increase tissue oxygenation.4

WEINMANN devices in the treatment of CO poisoning

In the event of CO poisoning, reliable and immediate treatment is crucial to stabilize vital functions and prevent long-term damage. WEINMANN ventilators support targeted therapy with their advanced ventilation and monitoring functions.

Ventilation needs to be adapted according to the severity of the poisoning. MEDUMAT Standard² and MEDUVENT Standard offer invasive and non-invasive ventilation modes and enable CPAP therapy to be carried out, which can significantly improve patient outcome. Integrated display of respiratory parameters for monitoring the respiratory rate allows patient data to be checked and the effectiveness of the therapy to be assessed.

MEDUMAT Standard² also provides the capacity for monitoring the CO₂ concentration in the blood.

Furthermore, MEDUCORE Standard² allows continuous observation of oxygen saturation via SpO₂ measurement and supports effective blood pressure monitoring with its automatic NIBP measurement. In addition, the integrated portable ECG device for 6- and 12-lead ECG enables extensive evaluation of cardiac function for early detection of cardiovascular complications.

The advantages of WEINMANN devices at a glance:

  • Invasive and non-invasive ventilation modes
  • CPAP therapy
  • Monitoring of vital signs
  • CO₂ measurement
  • SpO₂ measurement
  • NIBP measurement
  • 6- and 12-lead ECG
  • Compact and portable
  • Ideal for emergency medicine and emergency medical services