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Carbon monoxide as a clinical marker of hemolysis

Jake Osborne1,2, Mohamad Sobh3, Guy Trudel1,2

  • 1Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.

American Journal of Hematology
|May 25, 2023
PubMed

Insights

Carbon monoxide (CO) tests precisely measure hemolysis by quantifying CO, a direct marker of heme breakdown. Gas chromatography detects mild to moderate hemolysis, aiding clinical hematology research.

Area of Science:

  • Clinical Hematology
  • Biomarker Discovery

Background:

  • Carbon monoxide (CO) has been a reliable marker for hemolysis for over 40 years.
  • End-tidal CO and carboxyhemoglobin are key indicators in hematology research.
  • CO production is directly proportional to heme degradation by heme oxygenases.

Purpose of the Study:

  • To highlight the utility of CO-based tests in quantifying hemolysis.
  • To discuss the application of gas chromatography for CO detection.
  • To explore the potential for bench-to-bedside technology transfer of CO-based hemolysis assays.

Main Methods:

  • Quantification of CO in alveolar air using gas chromatography.
  • Utilizing the stoichiometric relationship between heme degradation and CO production.
  • Evaluating CO levels as a direct marker for hemolysis.

Main Results:

  • Gas chromatography allows for the detection of mild and moderate hemolysis.
  • CO levels reflect the activity of heme oxygenases in heme breakdown.
  • Elevated CO can also indicate active bleeding, resorbing hematoma, or smoking.

Conclusions:

  • CO-based tests offer a precise method for measuring hemolysis.
  • Clinical judgment and additional markers are essential for diagnosing the cause of hemolysis.
  • CO quantification represents a valuable tool for advancing hematology diagnostics.

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