Acute and Chronic Carbon Monoxide Toxicity from Tobacco Smoking
Acute and Chronic Carbon Monoxide Toxicity from Tobacco Smoking
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DOI：
10.1093/milmed/usz280
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发表时间：
2020-01-01
影响因子：
1.2
通讯作者：
Albertson, Timothy
中科院分区：
文献类型：
--
作者：
Dorey, Alyrene;Scheerlinck, Pieter;Albertson, Timothy
一氧化碳（CO）是由碳氢化合物的不完全燃烧产生的，是吸烟的副产品。长期吸烟者的碳氧血红蛋白（COHb）浓度通常高达10%。我们报告了一例严重升高的COHb和红细胞增多症，因为吸烟，并提供了一个关于吸烟者COHb升高的文献综述，材料和方法PubMed和谷歌学术进行了全面的搜索，寻找关于吸烟和CO，COHb，CO中毒，香烟，烟斗，结果经常吸烟者的COHb水平一般在吸烟前的4.2%到吸烟后的8.6%之间。一名重度吸烟者两次出现CO中毒症状，发现其水平为21.8%至24.2%。在病例报告中发现吸烟者的COHb高达13.0 - 38.6%。水管或“水烟”吸烟者的COHb水平一般为10.1%+/-2.5%，有病例报告，一系列与CO中毒症状相关的更高水平是常见的。水烟吸烟者已被发现有COHb水平高达39.2%smoking.ConclusionsMany现役军人和退伍军人烟草吸烟者和这些患者和他们的医疗保健提供者应该知道的CO毒性烟草吸烟的不良影响。在急性CO中毒的情况下，患者可能会出现头痛、晕厥和共济失调等症状;然而，CO的慢性效应可能尚未完全了解。未来的工作可以探索慢性CO毒性及其对军事人员力量和运动耐量的影响，并为服务人员，退伍军人和医疗保健提供者提供教育。
IntroductionCarbon monoxide (CO) is produced from incomplete combustion of hydrocarbons and is a by-product of tobacco smoking. Chronic cigarette smokers often have carboxyhemoglobin (COHb) concentrations as high as 10%. We report a case of severely elevated COHb and polycythemia because of tobacco smoking and provide a review of the literature regarding elevated COHb in smokers.Materials and MethodsA comprehensive search of PubMed and Google Scholar was performed looking for articles on tobacco smoking and CO, COHb, CO poisoning, cigarettes, pipes, cigars and water pipes/hookah smokers.ResultCOHb levels in frequent cigarette smokers generally range from 4.2% presmoking to 8.6% postsmoking. A heavy cigarette smoker presented twice with symptoms of CO toxicity and was found to have levels 21.8 to 24.2%. Cigar smokers have been found to have COHb ranging as high as 13.0 to 38.6% in case reports. Waterpipe or "hookah" smokers generally have COHb levels 10.1%+/-2.5% and case reports, and series of even higher levels associated with CO toxicity symptoms are common. Waterpipe smokers have been found to have COHb levels as high as 39.2% after smoking.ConclusionsMany active duty military and military veterans are tobacco smokers and these patients and their health care providers should be aware of the adverse effects of CO toxicity from tobacco smoking. Patients may have symptoms such as headaches, syncope, and ataxia in the setting of acute CO toxicity; however, the chronic effects of CO may not be completely understood. Future work could explore chronic CO toxicity and its effects on strength and exercise tolerance in military personnel and provide education to service members, veterans, and health care providers.