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A New Approach for the Carbon Monoxide (CO) Exposure Diagnosis: Measurement of Total CO in Human Blood Versus Carboxyhemoglobin (HbCO)
Authors:Vincent Varlet PhD  Emma Lagroy De Croutte MLM  Marc Augsburger PhD  Patrice Mangin MD  PhD
Institution:University Center of Legal Medicine Lausanne – Geneva, Forensic Toxicology and Chemistry Unit, , CH‐1011 Lausanne, Switzerland
Abstract:The aim of the study is to present the application of a headspace–gas chromatography–mass spectrometry (HS‐GC‐MS) method for the determination of the carbon monoxide (CO) blood concentration and to compare it with carboxyhemoglobin (HbCO) saturation. In postmortem cases, the HbCO measured by spectrophotometry frequently leads to inaccurate results due to inadequate samples or analyses. The true role of CO intoxication in the death of a person could be misclassified. The estimation of HbCO from HS‐GC‐MS CO measurements provides helpful information by determining the total CO levels (CO linked to hemoglobin (HbCO) and CO dissociated from hemoglobin). The CO concentrations were converted in HbCO saturation levels to define cutoff blood CO values. CO limits were defined as less than 1 μmol/mL for living persons, less than 1.5 μmol/mL for dead persons without CO exposure, and greater than 3 μmol/mL for dead persons with clear CO poisoning.
Keywords:forensic science  carbon monoxide  headspace gas extraction  carboxyhemoglobin  postmortem blood  putrefaction
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