Carbon Monoxide Poisoning
Conditions
Keywords
intoxication, carbon monoxide, adults, domestic accident, 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 one session of HBO at 2 absolute atmosphere followed by 4 hours of normobaric oxygen therapy to 6 hours of normobaric oxygen therapy in adult victims of acute domestic carbon monoxide poisoning and without coma.
Interventions
oxygen therapy was delivered via a full face mask at high flow to achieve 100% of inspired oxygen fraction
OTHERHyperbaric oxygen therapy
Hyperbaric oxygen therapy was delivered in a hyperbaric chamber, pressurized at 2 absolute atmosphere (1 hour plateau) and the patient breathed high oxygen concentration via a full face mask followed by 4 hours of normobaric oxygen therapy
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. * had transient loss of consciousness (syncope, malaise) * carboxyhemoglobin level at presentation \>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 * coma * 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 |
|---|---|---|
| full recovery | at one month | Full 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 |
| variations in carboxyhemoglobin levels | at 12 hours from randomization | the difference in serum carboxyhemoglobin levels between baseline values and values recorded immeadiately after study treatment completion |
| serious adverse events | at one month | any complications of hyperbaric oxygen therapy |
Countries
France
Outcome results
None listed