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.