Carbon monoxide poisoning and treatment with hyperbaric oxygen in the subacute phase (original) (raw)
Related papers
2012
Delayed encephalopathy (DE) is a neuropsychiatric syndrome that can generally arise within 20 days of acute carbon monoxide (CO) intoxication after apparent recovery and involves variable degrees of cognitive deficits, personality changes, movement disorders and focal neurologic deficits. We report a 35-year-old female patient with delayed encephalopathy due to CO intoxication, presenting with cognitive impairment and mild parkinsonism despite receiving hyberbaric oxygen therapy (HBO). Magnetic resonance imaging (MRI) showed abnormal signal intensity and decreased diffusivity at both caudate nuclei and globus pallidus. She continued to receive additional HBO therapy and completely recovered within six months. The positive effects of early HBO therapy in selected patients on reversing the acute effects of CO intoxication is apparant. Here we also review the beneficial effect of HBO in preventing or limiting the late neurocognitive deficits associated with severe CO intoxication. (Tur...
The Medical journal of Australia, 1999
To assess neurological sequelae in patients with all grades of carbon monoxide (CO) poisoning after treatment with hyperbaric oxygen (HBO) and normobaric oxygen (NBO). Randomised controlled double-blind trial, including an extended series of neuropsychological tests and sham treatments in a multiplace hyperbaric chamber for patients treated with NBO. The multiplace hyperbaric chamber at the Alfred Hospital, a university-attached quarternary referral centre in Melbourne providing the only hyperbaric service in the State of Victoria. All patients referred with CO poisoning between 1 September 1993 and 30 December 1995, irrespective of severity of poisoning. Pregnant women, children, burns victims and those refusing consent were excluded. Daily 100-minute treatments with 100% oxygen in a hyperbaric chamber--60 minutes at 2.8 atmospheres absolute for the HBO group and at 1.0 atmosphere absolute for the NBO group--for three days (or for six days for patients who were clinically abnormal ...
Hyperbaric Oxygen Therapy for Carbon Monoxide Poisoning can Lead a Perfect Result: A Case Report
Canadian Journal of Medicine, 2021
Carbon monoxide poisoning (COP) is a common emergency worldwide, especially in the wintertime. It is known to cause serious morbidities, resulting in high mortality risk. COP is also reported to result in neurological complications for which hyperbaric oxygen therapy is likely to offer some benefits, which certainly makes it one of the potential treatment modalities. Here, Case in the paper is of a 64-year-old female patient with carbon monoxide poisoning. Her neurological symptoms nearly disappeared after the application of hyperbaric oxygen therapy (HBOT) and conventional medical treatment. Our case guides for the key role of HBOT in the treatment process of a 64-year-old female patient with COP. Our clinical experience revealed that hyperbaric oxygen therapy could successfully reverse the symptoms of delayed neurological findings caused by COP, a serious and preventable health problem.
Hyperbaric oxygen therapy in carbon monoxide poisoning: effects on neurological sequelae
Study conclusions Clinical signs of brain injury are insensitive indicators of ICI in infants. A substantial fraction of infants with ICI can be detected through plain x-ray imaging of all infants with significant scalp hematomas, even if they are otherwise asymptomatic. Asymptomatic infants older than 3 months of age without significant scalp hematoma may be safely managed without any imaging.
Successful Reversal of Carbon Monoxide Induced Coma: Does Delayed Hyperbaric Oxygen Have a Role?
Early hyperbaric oxygen (HBO) is reported to reduce mortality and morbidity in severe carbon monoxide (CO) poisoning. However, the use of HBO after the initial 24 hours is still controversial. We report two cases with CO induced coma who were successfully treated with HBO therapy in the subacute period. Case report: Two patients with serious CO poisoning showed some initial recovery but developed coma on day 2 and 3, respectively. Both patients remained comatose despite several days of intensive care. They were transferred to our department for HBO therapy on day 5 and 11, respectively. The patients received repetitive HBO therapy in the subacute period. The total number of HBO therapy sessions were 15 and 32, respectively. Both patients responded favorably to HBO therapy and their neurological status improved dramatically. Conclusion: HBO may have beneficial effects in the subacute period in comatose CO poisoned patients unresponsive to other treatments. However, randomized controlled trials are needed to further confirm the efficacy of HBO in subacute period of CO poisoning.
Treatment of carbon monoxide poisoning with hyperbaric oxygen and therapeutic hypothermia
Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc
We present a preliminary case report series of severe, acute carbon monoxide poisoning in which both hyperbaric oxygen (HBO2) and therapeutic hypothermia (TH) were used to ameliorate neurological sequelae. Carbon monoxide poisoning is a standard indication for HBO2. While typically used postcardiac arrest, TH has been used for other types of hypoxic-ischemic brain injury. Four patients were found comatose from carbon monoxide exposure. They were intubated and treated with high-flow oxygen before transfer to our hospital for HBO2. All received three HBO2 treatments and 24 hours of TH with a goal temperature of 33 degrees C utilizing the CoolGard 3000 Intravascular Temperature Management System. While in the HBO2 chamber, cooling was maintained with ice bags in the groin, axillae and under the head. Three of the four cases were discharged home with normal neurological exams. One patient sustained severe, diffuse brain injury yet made a dramatic neurological recovery with only minor li...
Hyperbaric oxygen and carbon monoxide poisoning: a critical review
Neurological research, 2007
CO is likely to be the most common cause of poisoning worldwide and often results in persistent neuropathologic and cognitive sequelae. While the displacement of oxygen from hemoglobin by CO has overshadowed the myriad mechanisms by which CO causes injury, mere oxygen displacement has endured as the etiology of CO poisonings and perpetuated a cascade of misdiagnosis, misunderstandings and confusion regarding how and when to treat CO poisoning. Hyperbaric oxygen benefits the brain more than normobaric oxygen by, e.g. improving energy metabolism, preventing lipid peroxidation and decreasing neutrophil adherence. Randomized controlled trials have definitively shown hyperbaric oxygen as the only efficacious therapy for acute CO poisoning if delayed neurological sequelae are to be minimized. Normobaric oxygen should not be used between multiple hyperbaric oxygen treatments as this can contribute to toxicity. Hyperbaric oxygen seems to also have potential in the delayed treatment of CO poisoning using multiple treatments of low dose of oxygen; however, oxygen dosing issues are not yet fully understood for either acute or delayed treatment. It would behoove medical decision-makers to embrace this important tool and make it more accessible as well as helping to disseminate to the medical community what is now known from the available literature. [Neurol Res 2007; 29: 146-155]