Comparing high-flow nasal oxygen therapy and normobaric oxygen therapy on the treatment of carbon monoxide poisoning

AimWe aimed to investigate whether there is a difference in the rate of decrease in carboxyhemoglobin (COHB) values between high-flow nasal oxygen (HFNO) and normobaric oxygen (NBO) therapy.Material and methodThis retrospective observational study included patients with carbon monoxide poisoning who were treated with HFNO or NBO (control group). All patients were started on NBO therapy with a non-rebreather face mask at a rate of 15 L/min. In the NBO group, NBO treatment was continued until the COHB value fell below 10%. In the HFNO group, as soon as the preparation of the HFNO device was completed, NBO treatment was terminated and HFNO treatment was started and continued until the COHB value fell below 10%. The primary outcome of the study was the difference between HFNO and NBO in terms of COHB half-life rates.ResultsA total of 81 patients were included in the study, 44 in the HFNO group and 37 in the NBO group. The median of COHB t(1/2) values between HFNO and the NBO treatment groups were 47.3 (IQR: 25-75%: 31.5-65.4) and 46 (IQR: 25-75%: 32.3-56.2), respectively, but this difference was not statistically significant (p = 0.81).ConclusionThe results of this study suggest that HFNO treatment does not have a significant advantage over NBO treatment in the carbon monoxide elimination rate within the first 60 min of treatment.