Carbon Monoxide Poisoning: Mechanism, Clinical Presentation and Management

Carbon monoxide (CO) poisoning is actually the first cause of accidental poisoning in Europe [1] and North America [2]. Despite efforts in prevention and public and medical education, this intoxication remains frequent, severe, and too often overlooked; frequent because carbon monoxide accounts for nearly 5000–8000 poisonings a year in France, and this number is likely to increase, because devices able to produce CO are used more and more by the general public. Besides, the energy crisis has led people to decreased air ventilation in homes. Thus, these two factors join together to increase the risk of CO production; severe because carbon monoxide is responsible for hundreds of deaths annually in Europe. But death is only one risk of carbon monoxide poisoning, and another one of major importance is neurological sequelae; underdiagnosed and thus inadequately managed. In 1979 a French Poison Control Center study [3] showed that nearly 30 % of CO poisoning was overlooked or misdiagnosed during the first visit to the hospital or by the general practitioner.