K. Tetzlaff et al., ACUTE CARBON-MONOXIDE INTOXICATION - INDI CATION FOR HYPERBARIC-OXYGEN, Anasthesiologie und Intensivmedizin, 36(12), 1995, pp. 336-342
Citations number
29
Categorie Soggetti
Anesthesiology,"Emergency Medicine & Critical Care
Carbon monoxide intoxication continues to pose a differential diagnost
ic gnostic and therapeutic problem. I Since the symptoms presenting ar
e often unspecific, the chances that the condition will be wrongly dia
gnosed, or the diagnosis delayed, are good, resulting in submaximal tr
eatment. The measured COHb level in the blood frequently does not corr
elate with the symptoms, and, in particular, permits no prediction to
be made about the likelihood of Inter neurological deficits. Hyperbari
c oxygen therapy can rapidly eliminate the CO, and in comparison with
the administration of normobaric oxygen is accociated with a significa
nt lowering of both mortality and long-term morbidity. For all of thes
e reasons, the indication for hyperbaric oxygen treatment should be es
tablished early on. When neurological symptoms are present, or transie
nt loss of consciousness, and in pregnant victims, treatment with hype
rbaric oxygen is indicated. Should the emergency physician receive ons
ite hints of CO poisoning (information from victim or witnesses) or se
e evidence of its possibility (smouldering fire in flat, victim in gar
age, etc), he/she should contact the medical rescue centre to request
suitable means of ensuring transport of the victim under oxygen treatm
ent (helicopter, emergency ambulance) to the nearest specialised treat
ment centre.