Raphael JC, Elkharrat D, Jars-Guincestre MC, Chastang C, Chasles V, Vercken JB, Gajdos P, et al.
Lancet (London, England). Date of publication 1989 Aug 19;volume 2(8660):414-9.
1. Lancet. 1989 Aug 19;2(8660):414-9.
Trial of normobaric and hyperbaric oxygen for acute carbon monoxide intoxication.
Raphael JC(1), Elkharrat D, Jars-Guincestre MC, Chastang C, Chasles V, Vercken
JB, Gajdos P.
Author information:
(1)Service de Réanimation Médicale, Hôpital Raymond Poincaré, Garches, France.
Comment in
Lancet. 1989 Sep 30;2(8666):799-80.
Lancet. 1989 Oct 28;2(8670):1032-3.
The value of hyperbaric oxygen in the treatment of acute carbon monoxide
intoxication was assessed in 629 adults who had been poisoned at home in the 12 h
before admission to hospital. In patients without initial impairment of
consciousness (group A) the effect of 6 h of normobaric oxygen (NBO) (group A0, n
= 170) was compared with that of 2 h of hyperbaric oxygen (HBO) at 2 atmospheres
absolute (ATA) plus 4 h NBO (group A1, n = 173). At the 1 month follow-up 66% of
A0 and 68% of A1 patients had recovered. In patients with initial impairment of
consciousness the effect of one session of HBO (group B1, n = 145) was compared
with that of two sessions (group B2, n = 141); all group B patients also received
4 h of NBO. At 1 month of follow-up 54% group B1 and 52% group B2 patients had
recovered. The 7 patients left with neuropsychiatric sequelae (3 B1, 4 B2) and
the 4 who died (2 B1, 2 B2) had all presented with coma. HBO was not useful in
patients who did not lose consciousness during carbon monoxide intoxication,
irrespective of their carboxyhaemoglobin level, nor were two sessions of HBO in
patients who sustained only a brief loss of consciousness. The prognosis is
poorest for those presenting with coma; the trial needs to be pursued in this
group of patients until the power of the study is sufficient to demonstrate the
value or otherwise of HBO.
DOI: 10.1016/s0140-6736(89)90592-8
PMID: 2569600 [Indexed for MEDLINE]
