Fatal carbon monoxide intoxications

Otrovanja ugljikovim monoksidom (CO) među vodećim su uzrocima smrti kada je riječ o slučajnim otrovanjima. Iako su relativno rijetka (pretražujući arhivu Zavoda za sudsku medicinu i kriminalistiku, pronašao sam samo 30 slučajeva u posljednjih 5 godina), predstavljaju značajnu potencijalnu opasnost u svakodnevnom životu. Ugljikov monoksid je plin bez boje, okusa i mirisa, neznatno lakši od zraka. Blokira stanično disanje na razini mitohondrija. CO je uobičajeno produkt nepotpunog izgaranja organskih tvari. Uzevši to u obzir, jasno je da su glavni izvori ovih otrovanja motori automobila, kućni požari, štednjaci i grijači vode, ali i cigarete i cigare, koje mogu značajno podignuti razine karboksihemoglobina (COHb) u krvi. Poznato je da se CO veže na slobodni hemoglobin s 200-300 puta većim afinitetom od kisika. Otrovanja ugljikovim monoksidom su opasna, jer nema jasnih znakova ni simptoma koji bi upozorili osobu da napusti mjesto izlaganja. Na obdukciji, najizraženija karakteristika je boja kože, koja se opisuje kao svijetloružičasta. Spektrofotometrija ugljikovog monoksida radi se kao potvrda otrovanja ugljikovim monoksidom. Na samom početku 21. stoljeća, otrovanja ugljikovim monoksidom postala su iznimno popularan način za okončanje života, pogotovo u dalekoistočnim zemljama. Zaključno, otrovanja ugljikovim monoksidom jedan su od vodećih uzroka smrti zbog nesretnog slučaja, a mogu biti i način završetka života suicidalne osobe.Carbon monoxide (CO) intoxications are amongst the leading causes of death when it comes to accidental poisonings. Although they are relatively rare (while searching through the archive in Zagreb's Institute of Forensic Medicine, there were only 30 cases found in the last 5 years), they represent significant danger in everyday life. Carbon monoxide is an odorless, colorless, non-irritating gas, slightly lighter than air. It blocks respiration at the mitochondrial level. Usually it is a product of incomplete combustion of organic compounds. That being said, it is clear that the main sources of these poisonings are car motors, housefires, stoves and water heaters, but also smoking cigarettes and cigars, which can significantly raise the percentage of carboxyhemoglobin (COHb). It is known that carbon monoxide is 200-300 times more likely to bind to unsaturated hemoglobin than oxygen. These intoxications are dangerous, as there are no clear signs and symptoms which would alert the person to leave the place of danger. At autopsy, the most striking appearance is the color of the skin, which is commonly described as cherry-red. Spectrophotometry of carbon monoxide is usually done to confirm the diagnosis. At the very beginning of 21st century carbon monoxide poisonings became an enormously popular way to end one's own life, especially in the Far East. In conclusion, carbon monoxide intoxications are one of the leading causes of accidental deaths, but may also be the method of committing suicide