Severe carbon monoxide poisoning: outcome after hyperbaric oxygen therapy

This paper reports the outcome after carbon monoxide poisoning in 31 consecutive patients treated with mechanical ventilation and hyperbaric oxygen therapy, compared with another study of mechanically ventilated patients treated with normobaric oxygen. We found 16.1% hospital mortality and 3.8% severe short-term memory loss, compared with 30% hospital mortality and 20% incidence of serious neurological deficit after treatment with normobaric oxygen; outcome was poor in 19.4% and 44.3% of those treated with hyperbaric and normobaric oxygen, respectively (P<0.05). Cerebral oedema caused three of five deaths despite hyperbaric therapy, occurring at 24-48 h after poisoning. Intracranial pressure monitoring and CT scan of the head before wakening should be considered in any severely poisoned patient.