Abstract
BackgroundCarbon monoxide (CO) poisoning can be a life threatening condition. Systemic hyperbaric oxygen (HBO) therapy is used to induce CO detoxification. However, little is known about the hemodynamic response to HBO in severely intoxicated patients.MethodsWe retrospectively analyzed the medical records of 6 CO-poisoned patients treated with propofol, rocuronium bromide, and HBO. The HBO protocol comprised 3 HBO treatments (HBOT1 to HBOT3) within 24 hours. During all HBO sessions heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse blood pressure (ΔBP) were measured every five minutes. Non-parametric tests were used to compare data between HBO sessions.ResultsHR increased significantly as the number of HBOT increased, from 68 beats per minute (bpm) during HBOT1 to 77 and 86 bpm during HBOT2 and HBOT3, respectively (p < 0.05). In addition, while no significant change was found for DBP, both SBP and ΔBP showed a transient and significant increase during HBOT2, compared to HBOT1, that did not return to basal values during HBOT3.ConclusionBased on previous studies that have established the respective effects of rocuronium bromide, propofol, HBO, and CO alone on HR, SBP, and ΔBP, it is concluded that the hemodynamic responses observed in the present study are likely to be due to CO. If such, given that neither HR nor SBP and ΔBP returned to basal values by the end of HBOT3, it is suggested that more than 3 HBOT sessions could be necessary to provide full hemodynamic recovery in CO-poisoned patients.
Highlights
Carbon monoxide (CO) poisoning can be a life threatening condition
We examined the effects of HBOT on the hemodynamic parameters of these CO-poisoned patients
We found that heart rate (HR) increased significantly as the number of HBOT increased from 68 beats per minute during HBOT1 to 77 and 86 bpm during HBOT2 and HBOT3, respectively (F = 7, p < 0.05)
Summary
Carbon monoxide (CO) poisoning can be a life threatening condition. Little is known about the hemodynamic response to HBO in severely intoxicated patients. Carbon monoxide (CO) poisoning can be a life threatening condition that is associated with a long-term increased risk of mortality in severely intoxicated patients [1,2]. Because of the ability of oxygen to dissociate carboxyhemoglobin, high flow normobaric 100 vol% oxygen is used as a first-line therapy [3,4] As another therapeutic strategy, systemic hyperbaric oxygen (HBO) therapy with 100 vol% oxygen is often used, when available, as a second line treatment in moderate to severe CO-poisoned patients to accelerate and improve the detoxification process [4,5,6]. The purpose of this retrospective study was to assess the effects of HBO on the hemodynamic parameters of critically ill CO-poisoned patients.
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