Hyperbaric or normobaric oxygen for acute carbon monoxide poisoning: a randomised controlled clinical trial

@article{Scheinkestel1999HyperbaricON,
  title={Hyperbaric or normobaric oxygen for acute carbon monoxide poisoning: a randomised controlled clinical trial},
  author={C D Scheinkestel and Michael Bailey and Paul S. Myles and K Jones and D. Jamie Cooper and Ian L. Millar and D. V. Tuxen},
  journal={Medical Journal of Australia},
  year={1999},
  volume={170}
}
Objective: To assess neurological sequelae in patients with all grades of carbon monoxide (CO) poisoning after treatment with hyperbaric oxygen (HBO) and normobaric oxygen (NBO). 
Hyperbaric Oxygen Therapy of No Benefit in CO Poisoning
TLDR
The results of the largest randomized, sham-controlled, double-blind study of hyperbaric oxygen therapy, which treated 191 patients with significant carbon monoxide poisoning, are reported.
3 hyperbaric oxygen treatments reduced cognitive sequelae of acute carbon monoxide poisoning
Source Citation Weaver LK, Hopkins RO, Chan KJ, et al. Hyperbaric oxygen for acute carbon monoxide poisoning. N Engl J Med. 2002;347:1057-67. 12362006 (All 2003 articles were reviewed for relevancy...
Assessing Hyperbaric Oxygen for Carbon Monoxide Poisoning in Trauma Patients: A Call for Representation in Future Studies.
  • J. Lund, Kathryn E. Samai
  • Medicine
    Journal of trauma nursing : the official journal of the Society of Trauma Nurses
  • 2018
TLDR
A multitude of retrospective reviews and prospective trials have attempted to establish evidence demonstrating the ideal modality for oxygen administration in CO-poisoned patients; however, a consensus recommendation has not been reached.
Neurologic complications of carbon monoxide intoxication.
Evaluation of Hyperbaric Oxygen Therapy as a First-Line Treatment for Carbon Monoxide Poisoning
TLDR
The prognosis of CO poisoning varies depending on the exposure situation of CO gas, and some suffer from disorientation, urinary incontinence, energy loss, or even death after a full recovery from CO poisoning.
Carbon monoxide poisoning
  • S. Doherty
  • Medicine
    Journal of accident & emergency medicine
  • 2000
TLDR
The authors correctly point out thathyperbaric therapy remains controversial, and that no controlled clinical trial had been conducted comparing hyperbaric oxygen with normobaric oxygen, but since the date of acceptance of their paper a prospective, blinded, randomised trial comparing NBO with HBO has been published.
Hyperbaric oxygen therapy for acute domestic carbon monoxide poisoning: two randomized controlled trials
TLDR
In patients with transient loss of consciousness, there was no evidence of superiority of HBO over NBO, and in comatose patients, two HBO sessions were associated with worse outcomes than one HBO session.
Treatment with normobaric or hyperbaric oxygen and its effect on neuropsychometric dysfunction after carbon monoxide poisoning
TLDR
Compared with CO poisoning patients treated with NBO, HBO treated patients have a lower incidence of neuropsychological sequelae, including headache, memory impairment, difficulty concentrating, disturbed sleep, and delayed neurological sequelae.
Hyperbaric oxygen for acute carbon monoxide poisoning.
TLDR
Three hyperbaric-oxygen treatments within a 24-hour period appeared to reduce the risk of cognitive sequelae 6 weeks and 12 months after acute carbon monoxide poisoning.
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References

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TLDR
Cognitive deficits demonstrated at the time of psychiatric assessment were successfully reversed by hyperbaric oxygen therapy despite the 1 week delay, placing emphasis on the need for a high index of suspicion for carbon monoxide poisoning in the clinical situation of profound memory disturbance.
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TLDR
Hyperbaric oxygen should be used for severe cases of suspected CO poisoning, regardless of the time between exposure and presentation, especially when the delay is sufficient to preclude a diagnosis by standard laboratory methods.
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TLDR
In this opinion, HBO should be used on much wider indications than is usual, not only because of the rapid relief from symptoms it provides but mainly because it may prevent severe delayed sequelae.
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TLDR
HBO reduces the time of initial recovery and the number of delayed functional abnormalities in non-comatose patients with acute CO poisoning and a practical scheme for the use of NBO and HBO in such patients is proposed.
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