Carbon Monoxide Poisoning
Conditions
Keywords
domestic accident, coma, carbon monoxide, intoxication, acute domestic carbon monoxide poisoning
Brief summary
Carbon monoxide poisoning still places a burden on the healthcare system worldwide. While oxygen therapy is the cornerstone treatment, the role and practical modalities of hyperbaric oxygen therapy (HBO) remain controversial. This study aimed at comparing two sessions of HBO at 2 absolute atmosphere and one session of HBO at 2 absolute atmosphere followed by 4 hours of normobaric oxygen therapy in comatose adult victims of acute domestic carbon monoxide poisoning.
Interventions
OTHERHyperbaric oxygen therapy
one dive at 2 absolute atmosphere (1-hour plateau) with 30 min time for compression and decompression - oxygen was delivered via a full face mask at high concentration to achieve a 100% inspired fraction of oxygen or via mechanical ventilation
OTHERhyperbaric oxygen therapy
two dives at 2 absolute atmosphere (1-hour plateau) with 30 min of compression and 30 min of decompression - oxygen being delivered via a full face mask at 100% inspired oxygen fraction or via mechanical ventilation
Sponsors
Assistance Publique - Hôpitaux de Paris
University of Versailles
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
15 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patients older than 15 years of age * admitted for domestic CO poisoning within 12 hours after the end of CO exposure * initial coma, regardless of consciousness at hospital admission * carboxyhemoglobin level at presentation greater than 10% or 5%, in smokers and non-smokers, respectively
Exclusion criteria
* poisoning by more than one compound (e.g., CO plus a drug or CO plus other toxic gases such as those found in fire smoke) * suicide attempt * pregnancy * contraindications to HBO (circulatory collapse or pneumothorax) * technical obstacles to HBO * non domestic CO poisoning * difficulty in determining whether the patient experienced initial loss of consciousness or initial coma * consent refusal
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| complete recovery | at one month | Complete recovery was defined as an absence of symptoms reported on the self-assessment questionnaire with a normal physical exam (including normal neuropsychological functions). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| persistent neurological sequels | at one month | Neurological sequels were considered persistent (PNS) if they were present both at hospital discharge and at one-month evaluation, regardless of the type of manifestation. |
| delayed neurological sequels | at one month | Delayed neurological sequelae (DNS) were any neurological manifestations that appeared between hospital discharge and one-month evaluation, regardless of their severity. Patients with DNS were those considered fully recovered at hospital discharge but with neurological manifestations at one-month evaluation. |
| the difference in carboxyhemoglobin levels before/after treatment completion | at 12 hours from randomization | the difference between serum levels of carboxyhemoglobin at baseline and those recorded immedaitely after study treatment completion |
| serious adverse events | at one month | any complication of hyperbaric oxygen therapy |
Countries
France
Outcome results
None listed