Severe carbon monoxide poisoning: outcome after hyperbaric oxygen therapy

Area of Science:

• Toxicology
• Emergency Medicine
• Hyperbaric Medicine

Background:

• Carbon monoxide (CO) poisoning is a significant public health concern.
• Mechanical ventilation and oxygen therapy are standard treatments.
• The efficacy of hyperbaric oxygen versus normobaric oxygen in severe CO poisoning requires further elucidation.

Purpose of the Study:

• To compare the outcomes of carbon monoxide poisoning patients treated with mechanical ventilation and hyperbaric oxygen therapy versus those treated with normobaric oxygen.

Main Methods:

• Retrospective comparison of 31 patients treated with mechanical ventilation and hyperbaric oxygen therapy.
• Comparison with a historical cohort of mechanically ventilated patients treated with normobaric oxygen.
• Assessment of hospital mortality and neurological deficits, including short-term memory loss.

Main Results:

• Hyperbaric oxygen therapy group showed 16.1% hospital mortality and 3.8% severe short-term memory loss.
• Normobaric oxygen therapy group had 30% hospital mortality and 20% incidence of serious neurological deficit.
• Overall poor outcomes were significantly lower in the hyperbaric oxygen group (19.4%) compared to the normobaric group (44.3%) (P < 0.05).
• Cerebral edema was a cause of death in three patients despite hyperbaric therapy.

Conclusions:

• Hyperbaric oxygen therapy is associated with improved outcomes in carbon monoxide poisoning compared to normobaric oxygen.
• Intracranial pressure monitoring and CT scans before awakening may be beneficial for severely poisoned patients.
• Further research into managing cerebral edema in severe CO poisoning is warranted.