Where to now with carbon monoxide poisoning?

Emergency Medicine Australasia : EMA
Carlos D ScheinkestelDavid V Tuxen

Abstract

The controversy regarding the role of hyperbaric oxygen (HBO) in the treatment of carbon monoxide (CO) poisoning has been re-ignited following the publication of a further randomized controlled trial by Weaver et al., the results of which appear to conflict with our findings. Comparative analysis suggests that the apparent outcome differences may be secondary to the design, analysis and interpretation of the results of the two studies. Following careful analysis of these two papers and further results from a study by Raphael et al on 385 CO-poisoned patients, we can still find no convincing evidence favouring HBO therapy. Pending further research to determine optimal oxygen therapy for CO-poisoning, current therapy should involve stratifying patients for risk of a poor outcome. This stratification may be aided by the evolving availability of biochemical markers of brain injury and the finding that patients with transient loss of consciousness and poor performance on neuropsychological tests of the supervisory attention system are at higher risk of neuropsychological sequelae. We propose that those patients most at risk be admitted and receive more prolonged normobaric oxygen therapy whilst those with more minor CO-poisoning sho...Continue Reading

References

Nov 1, 1991·Anaesthesia and Intensive Care·D F Gorman, W B Runciman
Mar 27, 1999·The Medical Journal of Australia·C D ScheinkestelD V Tuxen
Aug 19, 2000·BMJ : British Medical Journal·S Q Tighe
Oct 4, 2002·The New England Journal of Medicine·Lindell K WeaverAlan H Morris

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Citations

Oct 6, 2011·Chest·Daniel E BrooksSteven C Curry
Oct 29, 2011·Neurologic Clinics·Michael J Angel, G Bryan Young
Mar 25, 2008·Journal of Emergency Nursing : JEN : Official Publication of the Emergency Department Nurses Association·Stephen J WolfUNKNOWN American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Critical Issues in the Manage
Jan 22, 2008·Annals of Emergency Medicine·Stephen J WolfUNKNOWN American College of Emergency Physicians
Mar 19, 2011·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Giuseppe PepeStefano Grifoni
Jul 9, 2004·Emergency Medicine Australasia : EMA·Greg Emerson
Nov 13, 2004·Emergency Medicine Australasia : EMA·David Smart
Nov 13, 2004·Emergency Medicine Australasia : EMA·Neil B Hampson

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