 Carbon monoxide also binds to the <unk> myoglobin . It has a high affinity for myoglobin , about 60 times greater than that of oxygen . Carbon monoxide bound to myoglobin may impair its ability to utilize oxygen . This causes reduced cardiac output and hypotension , which may result in brain ischemia . A delayed return of symptoms have been reported . This results following a recurrence of increased carboxyhemoglobin levels ; this effect may be due to a late release of carbon monoxide from myoglobin , which subsequently binds to hemoglobin . 
