What Researchers Did
Emergency physicians documented a case where a newborn baby was transferred to a hospital with a falsely elevated carboxyhemoglobin (carbon monoxide) reading, triggering consideration of emergency HBOT, before doctors identified the true cause.
What They Found
The elevated carboxyhemoglobin level was caused by the natural breakdown of fetal hemoglobin in newborns by an enzyme called heme oxidase, not by carbon monoxide exposure. Once this was recognized, HBOT was appropriately withheld, avoiding unnecessary treatment and family stress.
What This Means for Canadian Patients
Canadian emergency physicians and pediatricians evaluating newborns for suspected carbon monoxide poisoning should be aware that normal newborn physiology can produce falsely elevated carboxyhemoglobin readings. This distinction prevents unnecessary HBOT in infants while ensuring that actual CO-exposed newborns are still treated promptly.
Canadian Relevance
Carbon monoxide poisoning is an OHIP-covered indication for HBOT in Ontario. This case demonstrates that careful diagnosis is essential before proceeding with HBOT, particularly in neonates.
Study Limitations
This is a single case report and does not provide data on how frequently this diagnostic error occurs across hospitals or emergency departments.