[Treatment of carbon monoxide poisoning. Background and guidelines for oxygen therapy]

Treatment of carbon monoxide (CO) poisoning is still controversial. Standard treatment is pure oxygen either by means of a nasal catheter or oral-facial mask (normobaric oxygen treatment). Since 1960, hyperbaric oxygen (HBO) therapy has been applied in various centres, i.e. treatment in hyperbaric chambers with 100% O2 at 2-2.8 bars absolute pressure. Physically dissolved oxygen at this pressure is sufficient to maintain normal life functions at rest. HBO causes fast reoxygenation of tissues and accelerates the elimination of CO. In this paper, two cases treated with hyperbaric oxygen are reported. Aetiology, pathogenesis and possible sequelae of CO poisoning are reviewed. It is recommended, that all CO-victims, who have been or are unconscious at admission to the emergency ward, should be treated with HBO. In spite of there being comprehensive clinical literature concerning treatment of CO poisoning, there is still a great need for clinically controlled studies.