Effects of Dichloromethane, Nitrate, and Sulfhemoglobin-Induced Substances on Carboxyhemoglobin Detection: A Comprehensive Review

Carbon monoxide (CO) is a common gaseous toxin that causes severe poisoning symptoms. Accurate detection of the formation of carboxyhemoglobin (COHb) in the blood is very important for the identification of CO poisoning. In this review, the effects of exogenous toxins, including dichloromethane (DCM), nitrite and hydrogen sulfide, on the determination of COHb by spectrophotometry were summarized by comparing epidemiological data, case studies and analytical methods. The mechanism of the effects of these exogenous poisons on COHb detection is described, and the extent of their influence on the clinical diagnosis and forensic identification of CO poisoning is discussed. We suggest that emergency medicine and forensic science practices need to improve the understanding of these toxins, and optimize clinical diagnosis and evaluation strategies to address the effects of toxins on the determination of COHb.