CHAPTER 83 HYPERBARIC OXYGEN IN CARBON MONOXIDE POISONING

Hyperbaric Oxygen for Acute Carbon Monoxide Poisoning

Weaver LK, Hopkins RO, Chan KJ, et al. N Engl J Med. 2002;347(14):1057–1067

BACKGROUND

Carbon monoxide (CO) poisoning was responsible for 40,000 ED visits around the time of this study with cognitive impairment resulting in up to a quarter of patients who had lost consciousness or had carboxyhemoglobin levels >25%. While some studies reported superior outcomes in patients treated with hyperbaric oxygen (HBO), at the time of this study the evidence around its efficacy was conflicting in comparison to 100% normobaric oxygen. As HBO is costly and can present a transport issue to select HBO centers, it was not clear that the evidence supported this therapy.

OBJECTIVES

To determine the effect of HBO on cognitive sequelae (changes in memory, attention, and effect) in patients with CO poisoning.

METHODS

Prospective, multicenter, double-blind, randomized trial conducted at a single referral center from 1992 to 1999.

Participants

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