Treatment of carbon monoxide poisoning with hyperbaric oxygen.

BACKGROUND

Carbon monoxide poisoning is a major cause of accidental morbidity and mortality in Taiwan. Utilization of hyperbaric oxygen in severely carbon monoxide intoxicated patients has been investigated widely. The object of this study was to determine the nature of carbon monoxide poisoning and to evaluate the effect of hyperbaric oxygen therapy for such patients.

METHODS

Retrospective analysis of 34 consecutive carbon monoxide intoxicated patients by review of medical records and clinical follow-up for the past three years.

RESULTS

Subjects were 10 males and 24 females, aged 12 to 82 years. The source of the poisoning in 25 cases was faulty-operating heating systems; in 4, incomplete combustion of automobile engine; in 3, use of alternative sources of energy for indoor cooking and heating; in 2, smoke inhalation in fire accidents. All had neurologic symptoms; five also had cardiovascular symptoms and one developed delayed neurologic sequelae. The group with poor outcome after hyperbaric oxygen therapy (n = 10) had higher serum CK values, lower Glasgow coma scale, longer delay in the first aid at emergency service and longer delay in provision of hyperbaric oxygen therapy.

CONCLUSIONS

It was concluded that hyperbaric oxygen therapy is an effective method in treating carbon monoxide intoxicated patients. Understanding the pathogenesis of carbon monoxide poisoning and indications for hyperbaric oxygen therapy will help physicians manage such patients earlier and more adequately. Information on currently available hyperbaric facilities in Taiwan is necessary for timely transfer.