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[Risk of underestimating blood carbon monoxide by certain analytic methods].

OBJECTIVE
Study the effect of delay to assay on the measurement of carboxyhemoglobin (HbCO) in total blood samples.


METHODS
Carbon monoxide (CO) and carboxyhemoglobin were measured on 75 blood samples drawn from healthy subjects (smokers and non smokers) and in subjects with carbon monoxide (CO) poisoning. Blood samples were drawn on lithium heparinate in perfectly closed tubes with no head space and stored at 4 infinity C until assay. The samples were pooled into 4 classes for 4 delays to assay: immediate, less than one hour, 3 hours, 12 hours. Infrared spectrometry was used to assay CO and order 4 and 5 derived spectrophotometry using CO-oximeters (AVL 912, IL 482, Corning 270, Radiometer OSM 3, Radiometer ABL 520) for HbCO.


RESULTS
Regression lines for CO versus HbCO suggested that oxycarbonemia was underestimated using techniques measuring HbCO. This underestimation varied from 3 to 40% for delays to assay of 0 to 3 hours.


CONCLUSION
Clinicians should be aware that the underestimation in oxycarbonemia related to HbCO assays is sensitive to delay to assay.