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Therapeutics
3 hyperbaric oxygen treatments reduced cognitive sequelae of acute carbon monoxide poisoning

https://doi.org/10.1136/ebm.8.3.87

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    (2002) N Engl J Med 347, 1057. Weaver LK, Hopkins RO, Chan KJ, et al.. Hyperbaric oxygen for acute carbon monoxide poisoning.. ;. :. –67.
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 QUESTION: In patients with carbon monoxide poisoning, is hyperbaric oxygen (HBO) more effective than normobaric oxygen for reducing cognitive sequelae?

    Design

    Randomised (allocation concealed*), blinded (patients, outcome assessors, and statisticians),* controlled trial with follow up at 6 weeks, 6 months, and 1 year.

    Setting

    Emergency departments in Utah, Idaho, and Wyoming, USA.

    Patients

    152 patients (mean age 36 y, 62% men) with documented or obvious exposure to carbon monoxide and any of 11 predetermined symptoms. Patients were excluded if they were <16 years of age, moribund, or pregnant or if >24 hours had elapsed since exposure. Follow up at 6 weeks was 97%.

    Intervention

    All patients had 3 hyperbaric chamber sessions at intervals of 6–12 hours starting within 24 hours after carbon monoxide exposure. All non-intubated patients received oxygen, 15 l/min via a non-rebreathing face mask and reservoir. Intubated patients were mechanically ventilated with 100% …

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    Footnotes

    • Source of funding: not stated.

    • For correspondence: Dr L K Weaver, LDS Hospital, Salt Lake City, UT, USA. lweaver{at}ihc.com

    • Abstract and commentary also appear in ACP Journal Club.

    • ↵* See glossary.