Abstract
To the Editor.— The recent report by Myers et al (1981;246:2478) on the value of hyperbaric oxygen therapy for carbon monoxide poisoning deserves some comment. The authors' case reports are impressive, and it does appear that hyperbaric oxygen therapy can shorten the length of coma after carbon monoxide poisoning, even when carboxyhemoglobin levels have already returned to normal. Whether this is due to residual carbon monoxide in the tissues or simply the result of cerebral hypoxia remains unclear. The contribution of direct cellular toxicity of carbon monoxide has not been well established. Animals whose blood was completely replaced by an oxygen-carrying perfluoro chemical emulsion remained asymptomatic indefinitely in a 90% oxygen and 10% carbon monoxide environment, while controls breathing a 95% oxygen and 5% carbon monoxide mixture died within five to ten minutes.1,2 More importantly, the implication that hyperbaric oxygen therapy will prevent long-term neurological sequelae is certainly not
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