Metabolic changes during carbon monoxide poisoning: An experimental study

• Published in: Journal of cellular and molecular medicine Vol. 25; no. 11; pp. 5191 - 5201
• Main Authors: Simonsen, Carsten, Magnusdottir, Sigriður Olga, Andreasen, Jan Jesper, Wimmer, Reinhard, Rasmussen, Bodil Steen, Kjærgaard, Benedict, Maltesen, Raluca Georgiana
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01-06-2021; John Wiley and Sons Inc
• Subjects: Acidosis; Antioxidants; Blood; Blood gas analysis; Brain research; Carbon monoxide; carboxyhaemoglobin; Catheters; Choline; Citric acid; Data analysis; Energy balance; Experiments; Glutathione; Glycerol; Hemoglobin; Hogs; Hypoxanthine; Intoxication; Laboratory animals; Lactic acid; Lipid metabolism; Medical research; Metabolic acidosis; Metabolites; mild and severe poisoning; NMR; Nuclear magnetic resonance; Original; Oxidants; Oxygen therapy; Physiology; Poisoning; Principal components analysis; Pyruvic acid; Software; Statistical analysis; Toxicity; Variance analysis; Ventilators; mild and severe poisoning; carbon monoxide; carboxyhaemoglobin; metabolites
• ISSN: 1582-1838; 1582-4934
• DOI: 10.1111/jcmm.16522

Carbon monoxide (CO) is the leading cause of death by poisoning worldwide. The aim was to explore the effects of mild and severe poisoning on blood gas parameters and metabolites. Eleven pigs were exposed to CO intoxication and had blood collected before and during poisoning. Mild CO poisoning (carboxyhaemoglobin, COHb 35.2 ± 7.9%) was achieved at 32 ± 13 minutes, and severe poisoning (69.3 ± 10.2% COHb) at 64 ± 23 minutes from baseline (2.9 ± 0.5% COHb). Blood gas parameters and metabolites were measured on a blood gas analyser and nuclear magnetic resonance spectrometer, respectively. Unsupervised principal component, analysis of variance and Pearson's correlation tests were applied. A P‐value ≤ .05 was considered statistically significant. Mild poisoning resulted in a 28.4% drop in oxyhaemoglobin (OHb) and 12‐fold increase in COHb, while severe poisoning in a 65% drop in OHb and 24‐fold increase in COHb. Among others, metabolites implicated in regulation of metabolic acidosis (lactate, P < .0001), energy balance (pyruvate, P < .0001; 3‐hydroxybutyrc acid, P = .01), respiration (citrate, P = .007; succinate, P = .0003; fumarate, P < .0001), lipid metabolism (glycerol, P = .002; choline, P = .0002) and antioxidant‐oxidant balance (glutathione, P = .03; hypoxanthine, P < .0001) were altered, especially during severe poisoning. Our study adds new insights into the deranged metabolism of CO poisoning and leads the way for further investigation.