Carbon Monoxide and Cyanide Poisoning in the Burned Pregnant Patient: An Indication for Hyperbaric Oxygen Therapy

  title={Carbon Monoxide and Cyanide Poisoning in the Burned Pregnant Patient: An Indication for Hyperbaric Oxygen Therapy},
  author={Derek M. Culnan and Beretta Craft-Coffman and Genevieve H. Bitz and Karel Capek and Yiji Tu and William C. Lineaweaver and Maggie Kuhlmann-Capek},
  journal={Annals of Plastic Surgery},
Abstract Carbon monoxide (CO) is a small molecule poison released as a product of incomplete combustion. Carbon monoxide binds hemoglobin, reducing oxygen delivery. This effect is exacerbated in the burned pregnant patient by fetal hemoglobin that binds CO 2.5- to 3-fold stronger than maternal hemoglobin. With no signature clinical symptom, diagnosis depends on patient injury history, elevated carboxyhemoglobin levels, and alterations in mental status. The standard of care for treatment of CO… 

The Diagnosis and Treatment of Carbon Monoxide Poisoning.

High-quality, prospective, randomized trials that would enable a definitive judgment of the efficacy of HBOT are currently lacking, and there is no general recommendation for HBOT.

S2k guideline diagnosis and treatment of carbon monoxide poisoning

If CO poisoning is suspected, 100% oxygen breathing should be immediately initiated in the prehospital setting and hyperbaric oxygen therapy (HBOT) should be initiated within 6 h.

Open issues in management of carbon monoxide poisoning in pregnancy: practical suggestions

  • G. EleftheriouR. Butera V. Zanon
  • Medicine
    Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
  • 2022
Some practical suggestions for organizations wishing to develop their own protocols forHyperbaric oxygen therapy in pregnancy is proven to be safe and it is considered to be beneficial, reducing the severity of the fetal injuries.

Could Hydroxocobalamin Be of Use in the Treatment of Lactate Acidosis Induced by Propofol Infusion Syndrome? - A Case Report

The case of a 9-year-old, healthy boy who suffered an inhalative trauma after a fire in his parents’ apartment and developed laboratory findings consistent with propofol infusion syndrome, who received hydroxocobalamin and the lactate acidosis resolved seven hours after treatment.

Carbon Monoxide Toxicity.

Tips for avoiding common mistakes in out-of-hospital diagnosis of carbon monoxide poisoning

This study provides useful information to the doctor who comes first to the site of intoxication to reduce diagnostic and therapeutic errors in the pre- and intra-hospital phase as much as possible.

Hyperbaric Evaluation and Treatment Of Cyanide Toxicity

Cyanide toxicity occurs commonly in patients with smoke inhalation who have been removed from burning structures. Cyanide forms as a result of incomplete combustion of materials containing nitrogen

"CO in a pill": Towards oral delivery of carbon monoxide for therapeutic applications.



Acute carbon monoxide intoxication and hyperbaric oxygen in pregnancy

It is concluded that HBO may be carried out in pregnant women acutely intoxicated with carbon monoxide, irrespective of the clinical severity of the intoxication and of the age of pregnancy.

Hyperbaric oxygen treatment during pregnancy in acute carbon monoxide poisoning. A case report.

This case supports previously published recommendations for treating acute carbon monoxide poisoning during pregnancy with hyperbaric oxygen, and as more cases are gathered, a more widely accepted set of standards can be established.

Acute carbon monoxide intoxication during pregnancy. One case report and review of the literature

The case of one patient admitted for acute CO poisoning during pregnancy, a 31 year old at 21 weeks gestational age, exposed to CO, who delivered at term a healthy male infant weighing 3800 g is reported.

Effect of acute and delayed hyperbaric oxygen therapy on cyanide whole blood levels during acute cyanide intoxication.

The study indicates that HBO2 can move cyanide from tissue to blood, and may be of clinical importance, as combined HBO2 and antidote treatment, may accelerate detoxification.

Should hyperbaric oxygen be used to treat the pregnant patient for acute carbon monoxide poisoning? A case report and literature review.

T careful review of animal studies and human clinical experience indicates that the short duration of hyperoxic exposure attained during HBO therapy for CO poisoning can be tolerated by the fetus in all stages of pregnancy and reduces the risk of death or deformity to the mother and fetus.

Successful Treatment of Severe Carbon Monoxide Poisoning and Refractory Shock Using Extracorporeal Membrane Oxygenation

The successful use of venoarterial ECMO is reported in a patient with severe CO poisoning and multiple-organ failure, and hyperbaric oxygen therapy is considered for patients with evidence of neurological and myocardial injury.

Red cell exchange transfusion for severe carbon monoxide poisoning merits further study

This case series of severely carbon monoxide poisoned patients who were treated with therapeutic red cell exchange transfusion, erythrocytapheresis, suggests this therapy may be of benefit especially when therapy with hyperbaric oxygen is considered to be the appropriate choice but is either unavailable or contraindicated.

Carbon monoxide intoxication.

Central nervous system oxygen toxicity during hyperbaric treatment of patients with carbon monoxide poisoning.

This study reviews data from 900 CO-poisoned patients treated with HBO2 at Virginia Mason and Duke University Medical Centers from 1987 to 1996 to find the potential difference in seizure risk should be considered when selecting the HBO2 treatment pressure for CO poisoning.

Cyanide: an unreported cause of neurological complications following smoke inhalation

Clinical, biological, analytical and brain imaging data support the hypothesis of the toxic role of smoke-induced cyanide poisoning which may result in neurological sequelae and suggest that smoke inhalation in a residential fire may cause cyanides poisoning.