Forensic Toxicology and Chemistry Unit, University Centre of Legal Medicine Lausanne-Geneva, Chemin de la Vulliette 4, 1000 Lausanne, Switzerland; College of Health and Life Sciences, Department of Environmental Sciences, Brunel University London, Kingston Lane, Uxbridge, Middlesex UB8 3PH, United Kingdom.
Forensic Toxicology and Chemistry Unit, University Centre of Legal Medicine Lausanne-Geneva, Chemin de la Vulliette 4, 1000 Lausanne, Switzerland.
J Chromatogr B Analyt Technol Biomed Life Sci. 2018 Jul 15;1090:81-89. doi: 10.1016/j.jchromb.2018.05.019. Epub 2018 May 18.
Carbon monoxide is one of the most abundant toxic air pollutants. Symptoms of a CO intoxication are non-specific, leading to a high number of misdiagnosed CO poisoning cases that are missing in the disease statistics. The chemical nature of the molecule makes it difficult to detect for long periods and at low levels, thus requiring a very accurate and sensitive method. Current methods capable of accurate and sensitive analyses are available, however an inconsistency between results and symptoms are frequently reported. Therefore, an improved method for the analysis of carbon monoxide in blood and in the headspace (HS) of the sampling tube with the use of Airtight Gas Syringe - Gas Chromatography - Mass Spectrometry (AGS-GC-MS) is hereby presented and validated, for CO concentrations in a range of 10-200 nmol/mL HS (2-40 μmol/mL blood). Analytical LOQ is found at 0.9 nmol/mL HS (0.18 μmol/mL blood) and LOD at 0.1 nmol/mL gas. Application to intoxicated samples from autopsies and comparison to previously published methods show that this method is more appropriate, since performed under fully controlled conditions. Results show higher CO concentrations compared to previous approaches, indicating that results might have been underestimating the true blood CO burden. Therefore, this approach has the potential to help reduce the misdiagnosed cases and the gap between measurement and diagnosis of CO poisonings.
一氧化碳是最丰富的有毒空气污染物之一。一氧化碳中毒的症状是非特异性的，导致大量一氧化碳中毒病例被误诊，这些病例在疾病统计数据中缺失。分子的化学性质使其难以长时间和低水平检测，因此需要非常准确和灵敏的方法。目前有能够进行准确和灵敏分析的方法，但经常报告结果和症状之间不一致。因此，提出并验证了一种使用密封气体注射器-气相色谱-质谱联用（AGS-GC-MS）分析血液和采样管顶空（HS）中一氧化碳的改进方法，用于分析 10-200nmol/mL HS（2-40μmol/mL 血液）范围内的 CO 浓度。分析 LOQ 在 0.9nmol/mL HS（0.18μmol/mL 血液）处，LOD 在 0.1nmol/mL 气体处。将该方法应用于尸检中毒样本，并与之前发表的方法进行比较，结果表明，该方法更合适，因为它是在完全控制的条件下进行的。结果显示 CO 浓度高于之前的方法，表明结果可能低估了真实的血液 CO 负担。因此，这种方法有可能帮助减少误诊病例，并缩小 CO 中毒的测量和诊断之间的差距。
