Carbon Monoxide Has 200 Times the Affinity of Oxygen for Hemoglobin
Carbon monoxide (CO) and oxygen bind to the same sites on hemoglobin, but CO is bound much more avidly. As a result of the high affinity of CO for hemoglobin, exposure to CO levels of less than 1% in air can eventually saturate hemoglobin and displace oxygen, leading to death.
Fortunately, such low levels of CO must be breathed for some time to deliver sufficient CO to saturate all the blood hemoglobin, so toxic effects are not immediate. CO not only reduces the oxygen content of the blood, but also displaces the oxyhemoglobin dissociation curve to the left. This shift indicates that with the onset of CO poisoning, hemoglobin has a higher affinity for the remaining bound oxygen; thus the release of oxygen into the tissues occurs at a tissue Po2 much lower than normal. Treatment of CO poisoning requires removal of the CO source and administration of oxygen to displace the carbon monoxide from hemoglobin.
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