Elsevier

The Lancet

Volume 334, Issue 8660, 19 August 1989, Pages 414-419
The Lancet

TRIAL OF NORMOBARIC AND HYPERBARIC OXYGEN FOR ACUTE CARBON MONOXIDE INTOXICATION

https://doi.org/10.1016/S0140-6736(89)90592-8Get rights and content

Abstract

The value of hyperbaric oxygen in the treatment of acute carbon monoxide intoxication was assessed in 629 adults who had been poisoned at home in the 12 h before admission to hospital. In patients without initial impairment of consciousness (group A) the effect of 6 h of normobaric oxygen (NBO) (group A0, n = 170) was compared with that of 2 h of hyperbaric oxygen (HBO) at 2 atmospheres absolute (ATA) plus 4 h NBO (group A1, n = 173). At the 1 month follow-up 66% of A0 and 68% of A1 patients had recovered. In patients with initial impairment of consciousness the effect of one session of HBO (group B1, n = 145) was compared with that of two sessions (group B2, n = 141); all group B patients also received 4 h of NBO. At 1 month of follow-up 54% group B1 and 52% group B2 patients had recovered. The 7 patients left with neuropsychiatric sequelae (3 B1, 4 B2) and the 4 who died (2 B1, 2 B2) had all presented with coma. HBO was not useful in patients who did not lose consciousness during carbon monoxide intoxication, irrespective of their carboxyhaemoglobin level, nor were two sessions of HBO in patients who sustained only a brief loss of consciousness. The prognosis is poorest for those presenting with coma; the trial needs to be pursued in this group of patients until the power of the study is sufficient to demonstrate the value or otherwise of HBO.

References (37)

  • B. Blettery et al.

    L'intoxication aigue à l'oxyde de carbone en service d'urgence. Intérêt des signes début. 90 observations

    Ann Med Interne

    (1983)
  • Ph Gajdos et al.

    Epidemiologic investigation of acute carbon monoxide poisoning (A-CMP) in the Hauts-De-Seine departement. Results of a 3-year survey. 4th European Congress on Intensive Care Medicine

    (1988)

    Intensive Care Med

    (1988)
  • Dl Jackson et al.

    Accidental carbon monoxide poisoning

    JAMA

    (1980)
  • T. Meredith et al.

    Carbon monoxide poisoning

    Br Med J

    (1988)
  • Kf Michaelsen et al.

    Danger of gas water heaters

    Lancet

    (1983)
  • Dm Norkool et al.

    Treatment of acute carbon monoxide poisoning with hyperbaric oxygen: a review of 115 cases

    Ann Emerg Med

    (1985)
  • M. Goulon et al.

    Intoxications oxycarbonées et anoxies aigues par inhalation de gaz de charbon et d'hydrocarbures

    Rev Prat

    (1971)
  • Kw Kizer et al.

    Hyperbaric oxygen for carbon monoxide poisoning

    West J Med

    (1982)
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