[abstract] Outcome of acute carbon monoxide poisoning treated with hyperbaric or normobaric oxygen

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[abstract] Outcome of acute carbon monoxide poisoning treated with hyperbaric or normobaric oxygen

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Title: [abstract] Outcome of acute carbon monoxide poisoning treated with hyperbaric or normobaric oxygen
Author: Weaver, LK; Hopkins, RO; Churchill, S; Chan, KJ; Morris, AH; Clemmer, TP; Elliott, CG; Orme, JF; Thomas, FO; Haberstock, D
Abstract: Introduction: Decisions regarding use of hyperbaric oxygen therapy (HBO2) in acute carbon monoxide (CO) poisoning are difficult because of lack of double-blind randomized clinical trial (RCT) data. Methods: Double-blind RCT in acute CO poisoning. Inclusions: less than 23 hrs from CO exposure to randomization, age greater than 15 years, not pregnant. Stratification on: Age less than or greater than 40 yrs); hrs from CO poisoning to chamber ( less than or greater than 6); history of unconsciousness (LOC). All patients were treated 3x at 6-12 hr intervals in a monoplace chamber with HBO2 or normobaric oxygen (NBO2). Neuropsychological tests (NPT) were administered immediately after treatments 1 and 3. CO poisoning questionnaires, functional outcome tests and the NPT were given at 2 and 6 weeks after CO poisoning. Results: 152 patients were enrolled in the RCT (LOC=49percent, mean COHb=25percent). 95percent completed follow-up. HBO2-treated patients had decreased neuropsychological sequelae (25percent v. 46percent, p = 0.007), self-reported memory difficulties (45percent v. 61percent, p = 0.058), and Attention / Concentration problems (47percent v. 64percent, p = 0.039). Pre-chamber cerebellar dysfunction was associated with neuropsychological sequelae (Odds ratio = 5.71, p = 0.004). HBO2 decreased neuropsychological sequelae after adjustment for pre-chamber cerebellar dysfunction and stratification (Odds ratio = 0.45, p = 0.029). In patients with any of the following: LOC, COHb greater than 25percent, Age greater than 50 yrs, a metabolic acidosis (base excess less than -2 mEq/L), HBO2 improved outcome. In patients with none of these 4 criteria, HBO2 did not improve outcome. The NBO2 group tolerated chamber therapy better (96percent v. 82percent, p = 0.002). Conclusions: HBO2 improved outcome following acute CO poisoning. We recommend HBO2 therapy in acute CO poisoning in symptomatic patients who are less than 24 hrs from poisoning, plus any of the following: LOC, COHb greater than 25percent, Age greater than 50 yrs, or a metabolic acidosis. Supported by Desert Foundation (Grants #247, 275 and 305), LDS Hospital
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/1022
Date: 2001

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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