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Updated: Mar 23, 2026

Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
Published on: January 29, 2011
The use of hyperbaric oxygen therapy for carbon monoxide poisoning in Europe
Background:
The aim of this survey was to identify practice differences in the treatment of carbon monoxide (CO) poisoning with hyperbaric oxygen (HBO₂) therapy among centers in Europe.
Materials And Methods:
Using a commercial online survey website (surveymonkey.com), we created a questionnaire and invited the medical directors of hyperbaric centers in Europe by email to complete the survey.
Results:
Sixty-eight centers from 23 countries participated in the survey. While transient or prolonged unconsciousness was unanimously recognized as an indication for HBO₂ therapy, positive neurological findings, ECG suggesting acute ischemia and pregnancy were considered important indications of HBO₂ therapy in more than 95% of the centers. Twenty-three (44%) centers reported that they used carboxyhemoglobin (COHb) levels as a criterion for patient selection. Among responders, 39% (18/46) reported delivering a single session within the first 24 hours of CO poisoning, and nine (19%) reported delivering three sessions in the first day. The majority of the centers (52%) replied that they initially gave a single session per patient, which was repeated if symptoms persisted. We identified a total of 21 different HBO₂ profiles used in European centers.
Conclusion:
Our results showed that the indications of CO poisoning for HBO₂ therapy are still not universally recognized. Additionally, HBO₂ therapy protocols used at European hyperbaric centers varied significantly, suggesting a need for more education regarding the published guidelines.
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