Abstract
Background The aim of this study was to identify practice differences in the treatment of carbon monoxide (CO) poisoning with or without hyperbaric oxygen (HBO2) therapy in Japan. Materials and Methods Using an online survey website (Google form), we created a questionnaire and invited interested institutions to join the COP-J Study, a prospective observational study of CO poisoning in Japan. Results Forty-eight (63%) of 76 institutions replied to the questionnaire. Thirty-three institutions (69%) administered HBO2 therapy to patients with CO poisoning, and 15 institutions (31%) did not. Consciousness disturbance on arrival, exposure to CO for a long time, and elevation of arterial carboxyhemoglobin (CO-Hb) were the major indications for HBO2 therapy. The maximum therapeutic pressures were 2.0, 2.5, and 2.8 atmospheres absolute (ATA) at 19 (58%), 6 (18%), and 8 (24%) institutions, respectively. The number of HBO2 sessions on the first day was 1–3, and 1–7 sessions were administered on days 2–7. Seventeen (35%) institutions treated patients with delayed neurological sequelae (DNS) and 15 of them used HBO2 therapy for DNS. Conclusions This survey indicates that HBO2 therapy for CO poisoning was varied in both the indications and practice regimens used in Japan.
Highlights
Based on the results of a randomized controlled trial (RCT) reported by Weaver et al [1], hyperbaric oxygen (HBO2) therapy is thought to be essential to prevent delayed neurological sequelae (DNS) in patients with carbon monoxide (CO) poisoning
In the United States and Europe, the clinical use of HBO2 therapy for CO poisoning is reported to vary, despite several guidelines published by scientific institutions, such as the Undersea and Hyperbaric Medical Society (UHMS) and the European Committee for Hyperbaric Medicine (ECHM) [2, 3]
Thirty-three institutions (69%), including two institutions without an HBO2 chamber, administered HBO2 therapy to patients with CO poisoning, whereas 15 institutions
Summary
Based on the results of a randomized controlled trial (RCT) reported by Weaver et al [1], hyperbaric oxygen (HBO2) therapy is thought to be essential to prevent delayed neurological sequelae (DNS) in patients with carbon monoxide (CO) poisoning. In the United States and Europe, the clinical use of HBO2 therapy for CO poisoning is reported to vary, despite several guidelines published by scientific institutions, such as the Undersea and Hyperbaric Medical Society (UHMS) and the European Committee for Hyperbaric Medicine (ECHM) [2, 3]. A letter of invitation to the COP-J Study was sent to all 288 certified training institutions of the JSICM and to all councilors of the Japanese Undersea and Hyperbaric Medical Society Chugoku-Shikoku district meeting. This survey was performed before the COP-J. This survey indicates that HBO2 therapy for CO poisoning was varied in both the indications and practice regimens used in Japan
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