Carbon monoxide poisoning in childhood.

Every winter the prolonged use of poorly maintained gas stoves in badly ventilated houses gives rise to several cases of carbon monoxide poisoning. The formation of this gas is a severe hazard because of its affinity for haemoglobin, which is about 300 times more than that for oxygen.' Moreover, carbon monoxide shifts to the left the dissociation curve of any oxyhaemoglobin that remains -and hence the liberation of oxygen is further reduced. The resultant cellular anoxia affects those organs that are particularly susceptible to ischaemic damage, such as the central nervous system and the heart. In adults symptoms and signs include a red complexion, frontal headache, dizziness, semiconsciousness, and chest pains.2 The diagnosis is facilitated by the presence of a similar syndrome in people living in the same house and by the results of investigating its heating apparatus. Nevertheless, a particular problem in childhood is that the features may principally affect the bowel, at a time when, because of their higher tolerance, the adults living in the same house are showing no features of poisoning. Here we describe three children erroneously treated for gastroenteritis who were eventually found to be suffering from carbon monoxide poisoning.