Carboxyhemoglobin ($\mathrm{COHb}$)

Carboxyhemoglobin is hemoglobin with carbon monoxide bound at a haem site. Carbon monoxide competes with oxygen for binding; a CO-occupied site is unavailable for oxygen while CO remains bound.^[ref] This differs from methemoglobin, where the defining change is oxidation of haem iron. Binding carbon monoxide is not itself the same operation as converting an available ferrous site into a ferric site.

An original independent-site equilibrium model illustrates competition. Let oxygen and carbon-monoxide binding weights be $u=p_{{\mathrm{O}}_2}/K_{{\mathrm{O}}_2}$ and $v=p_{\mathrm{CO}}/K_{\mathrm{CO}}$, with $K$ values defined on the same pressure basis. For empty, oxygen-bound and CO-bound states,With stipulated $u=9$ and no carbon monoxide, the oxygen-bound fraction is $9/10$. Adding a competing weight $v=9$ changes it to $9/19$ and gives CO the same fraction. These weights are hypothetical; this model omits the cooperative and conformational behavior of real hemoglobin.

The calculation explains why knowing the oxygen partial pressure alone does not identify the amount bound to hemoglobin. Available-site count, competing ligands and binding properties also enter. Even a high occupied fraction among the remaining oxygen-capable sites does not imply that all haem sites are oxygenated.

Co-oximetry separates carboxyhemoglobin from other derivatives using their spectral responses. The 1991 fetal/adult hemoglobin study quantified derivative absorptivities and emphasized that even small spectral differences affect multicomponent analysis.^[ref] Identifying a derivative therefore requires a suitable measurement model; total hemoglobin concentration alone leaves its ligand composition unresolved.