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Is elevated plasma lactate a useful marker in the evaluation of pure carbon monoxide poisoning?

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Abstract

Objective

To examine whether CO poisoning induces a significant increase in plasma lactate concentration.

Design and setting

Prospective observational clinical study in the emergency department and intensive care unit in a university-affiliated teaching hospital.

Patients

146 pure CO poisonings resulting from dysfunction of gas cookers or water heaters.

Measurements and results

Patients were classified into four neurological impairment groups: 37% were severely, 8% moderately, and 45% mildly intoxicated, while 1% were asymptomatic. We found only very mild increases in plasma lactate concentration (median 2.30 mmol/l) which, however, was significantly correlated with the severity of neurological impairment and blood CO concentration (1.41 mmol/l, Spearman's test r=0.3).

Conclusions

Plasma lactate is mildly elevated in pure CO-exposed patients. This mild increase and the extensive overlap between the groups of neurological impairment severity do not suggest the usefulness of systematic plasma lactate measurement in pure CO poisoning.

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Authors and Affiliations

  1. Réanimation Médicale et Toxicologique, Hôpital Lariboisière, Université Paris VII-INSERM U26, 2 rue Ambroise Paré, 5010, Paris, France

    M. Lamine Benaissa, Bruno Mégarbane & Frédéric J. Baud

  2. Department of Emergency Medicine and Medicine (Occupational and Environmental Health), School of Medicine and International Toxicology Consultants, George Washington University, LLC, Washington, DC, USA

    Stephen W. Borron

Authors
  1. M. Lamine Benaissa
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  2. Bruno Mégarbane
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  3. Stephen W. Borron
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  4. Frédéric J. Baud
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Corresponding author

Correspondence to Bruno Mégarbane.

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Benaissa, M.L., Mégarbane, B., Borron, S.W. et al. Is elevated plasma lactate a useful marker in the evaluation of pure carbon monoxide poisoning?. Intensive Care Med 29, 1372–1375 (2003). https://doi.org/10.1007/s00134-003-1866-0

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  • DOI: https://doi.org/10.1007/s00134-003-1866-0

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