This was a prospective randomised study comparing carboxyhaemoglobin concentrations between low-flow anaesthesia (fresh gas flow 1.0 L/min) and minimal-flow anaesthesia (0.5 L/min) using desflurane. Sixty (ASA 1 or 2) adult patients undergoing elective surgery under general anaesthesia were randomly allocated to receive either low-flow (Group 1) or minimal flow anaesthesia (Group 2). Venous blood samples for carboxyhaemoglobin levels were taken at baseline and at 10 mins intervals for 40 mins. Both groups showed significant increase in carboxyhaemoglobin concentrations within the first 10 mins when fresh gas flow of 4.0 L/min was used. Reduction in carboxyhemoglobin levels was seen after 20 mins of minimal or low flow anaesthesia. However, there was no significant difference in the magnitude of reduction of carboxyhemoglobin concentrations between the groups. The fractional inspired of oxygen (FiO2) showed no significant changes in either group. In conclusion, desflurane usage in anaesthesia with either low-flow or minimal-flow was not associated with increased carboxyhaemoglobin concentrations.
A comparative cross-sectional study was conducted to determine tollbooth carbon monoxide (CO) levels and carboxyhaemoglobin (COHb) levels among the tollbooth operators and office workers in the Klang Valley, Kuala Lumpur. All tollbooths were equipped with well functioning air-conditioning. The total number of respondents was 180: 90 toll operators and 90 office workers aged between 19 and 52 years. The highest peak of CO level recorded was 61 ppm. The highest average peak CO level within a shift was 30 ppm. The CO level was higher during peak traffic at 6.00 - 8.00 a.m. There was no significant correlation between average peak CO level with vehicle load (r = -0.007, p = 0.474). The toll operators' median COHb level (1.0%, IQR = 0.8%) was significantly higher (p = 0.008) compared to office workers (0.7%, IQR = 0.8). There was a weak and significant correlation between COHb levels with average peak CO levels (r = 0.228, p = 0.031). In conclusion, tollbooth operators were chronically exposed to CO leading to higher COHb levels compared to office workers.
The role of hemolysis in the pathophysiology of neonatal jaundice (NNJ) in patients with glucose 6-phosphate dehydrogenase (G6PD) deficiency has been questioned recently. The aim of the present study was to determine the contribution of hemolysis to the pathophysiology of jaundice in Malay neonates with G6PD deficiency and NNJ.