HBO treatment CO poisoning

Patient is 55 yo male with CO level of 16, Dm2, Renal failure on Dialysis presented to ER with dizziness, blurred vision, Tropinine elevated to 84.5, CT remarkable for old lacunae infarcts. EKG rate 55 bpm no acute changes.

Nov 13, 2023 by David K Gustavison DO MPH,

2 replies

Mike White
MD, UHM, MMM, CWS

David,

I assume you're asking if this patient would be an appropriate candidate for HBO. From the information you have given, it is difficult to make that decision. I assume the patient is on high flow oxygen. I would point you to UHMS Hyperbaric Oxygen Therapy Indications Manual, 14th ed. On page 93, Lindell Weaver has very nice decision tree on when to treat CO poisoning with HBO. Additionally on page 86 there are recommendations for treating patients with serious signs CO poisoning (any LOC, neurologic signs, cardiovascular dysfunction, or severe acidosis) regardless of CO levels. So based on what you have written, if the patient meets those criteria, then I would lean towards treating them.

Nov 13, 2023

David K Gustavison DO MPH

Thank you.
Yes patient had blurred vision, dizziness and a code stroke was called. He had CT scan which was essentially negative. Venous CO level was 16. High sensitivityTroponin was elevated to 85. Patient was put on high flow oxygen when CO level discovered. Symptoms improved so it was decided not to dive.

Nov 13, 2023

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