Carboxyhemoglobin Levels Induced by Cigarette Smoking Outdoors in Smokers

Autor: John Schwarz, Jonathan Schimmel, Jason B. Hack, Naomi George, Sami Yousif, Selim Suner
Rok vydání: 2017
Předmět:
Zdroj: Journal of Medical Toxicology. 14:68-73
ISSN: 1937-6995
1556-9039
DOI: 10.1007/s13181-017-0645-1
Popis: INTRODUCTION: Non-invasive screening of carboxyhemoglobin saturation (SpCO) in the emergency department to detect occult exposure is increasingly common. The SpCO threshold to consider exposure in smokers is up to 9%. The literature supporting this cutoff is inadequate, and the impact of active smoking on SpCO saturation remains unclear. The primary objective was to characterize baseline SpCO in a cohort of smokers outdoors. Secondary objectives were to explore the impact of active smoking on SpCO and to compare SpCO between smokers and non-smokers. METHODS: This was a prospective cohort pilot study in two outdoor urban public areas in the USA, in a convenience sample of adult smokers. SpCO saturations were assessed non-invasively before, during, and 2 min after cigarette smoking with pulse CO-oximetry. Analyses included descriptive statistics, correlations, and a generalized estimating equation model. RESULTS: Eighty-five smokers had mean baseline SpCO of 2.7% (SD 2.6) and peak of 3.1% (SD 2.9), while 15 controls had SpCO 1.3% (SD 1.3). This was a significant difference. Time since last cigarette was associated with baseline SpCO, and active smoking increased mean SpCO. There was correlation among individual smokers’ SpCO levels before, during, and 2 min after smoking, indicating smokers tended to maintain their baseline SpCO level. CONCLUSIONS: This study is the first to measure SpCO during active smoking in an uncontrolled environment. It suggests 80% of smokers have SpCO ≤ 5%, but potentially lends support for the current 9% as a threshold, depending on clinical context.
Databáze: OpenAIRE
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