CARBON-MONOXIDE POISONING - PRESENT ASPEC TS

Carbon monoxide (GO) poisoning still represents a frequent and severe casualty in France. Aside the well-known effect of CO on hemoglobin, t he role of CO binding to other hemoproteins like myoglobin and cytochr ome a3 have been more recently recognized, Moreover, in addition to th ese hypoxic injuries, the reoxygenation phase may itself induce toxic effects by a mechanism close to the ischemia-reperfusion phenomenon. C linical manifestations include neurologic disturbances, cardiac arryth mia, respiratory and circulatory failures which usually disappear with removal from toxic atmosphere and administration of oxygen. However, long term neurologic manifestations may occur and lead to important fu nctionnal impairment and disability. Hyperbaric oxygen is actually the treatment of choice to avoid the occurrence of delayed sequelae. HBO is advocated in every patient who remains comatose on hospital admissi on, who had lost consciousness during toxic exposure or with persistin g neurologic abnormabilities. CO poisoned pregnant women should also u ndergo HBO. Well designed prevention programs are urgently needed in o ur country to decrease the incidence and the consequences of CO poison ing.