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Multiple Choice

Carbon monoxide has how many times greater affinity for hemoglobin than oxygen?

Carbon monoxide’s ability to bind hemoglobin is dramatically stronger than oxygen’s, about 200–300 times higher. This means CO quickly saturates a large portion of the hemoglobin binding sites, forming carboxyhemoglobin and limiting the blood’s overall capacity to carry oxygen. In addition, CO binding pulls the oxygen dissociation curve to the left, so the hemoglobin that does bind oxygen holds onto it more tightly and releases less to tissues. The combination of reduced oxygen carrying capacity and impaired oxygen release leads to tissue hypoxia even if lung oxygen levels are normal. This 200–300x affinity figure is the standard way to quantify CO’s potency compared with oxygen.

Carbon monoxide’s ability to bind hemoglobin is dramatically stronger than oxygen’s, about 200–300 times higher. This means CO quickly saturates a large portion of the hemoglobin binding sites, forming carboxyhemoglobin and limiting the blood’s overall capacity to carry oxygen. In addition, CO binding pulls the oxygen dissociation curve to the left, so the hemoglobin that does bind oxygen holds onto it more tightly and releases less to tissues. The combination of reduced oxygen carrying capacity and impaired oxygen release leads to tissue hypoxia even if lung oxygen levels are normal. This 200–300x affinity figure is the standard way to quantify CO’s potency compared with oxygen.