Annane D, Chadda K, Gajdos P, Jars-Guincestre MC, Chevret S, Raphael JC, et al.
Intensive care medicine. Date of publication 2011 Mar 1;volume 37(3):486-92.
1. Intensive Care Med. 2011 Mar;37(3):486-92. doi: 10.1007/s00134-010-2093-0. Epub
2010 Dec 2.
Hyperbaric oxygen therapy for acute domestic carbon monoxide poisoning: two
randomized controlled trials.
Annane D(1), Chadda K, Gajdos P, Jars-Guincestre MC, Chevret S, Raphael JC.
Author information:
(1)Medical Intensive Care Unit and Hyperbaric Center, Raymond Poincaré Teaching
Hospital, University of Versailles SQY, Garches, 92380, France.
djillali.annane@rpc.aphp.fr
Comment in
Intensive Care Med. 2011 Jul;37(7):1218; author reply 1219.
INTRODUCTION: Although hyperbaric oxygen therapy (HBO) is broadly used for carbon
monoxide (CO) poisoning, its efficacy and practical modalities remain
controversial.
OBJECTIVES: To assess HBO in patients poisoned with CO.
DESIGN: Two prospective randomized trial on two parallel groups.
SETTING: Critical Care Unit, Raymond Poincaré Hospital, Garches, France.
SUBJECTS: Three hundred eighty-five patients with acute domestic CO poisoning.
INTERVENTION: Patients with transient loss of consciousness (trial A, n = 179)
were randomized to either 6 h of normobaric oxygen therapy (NBO; arm A0, n = 86)
or 4 h of NBO plus one HBO session (arm A1, n = 93). Patients with initial coma
(trial B, n = 206) were randomized to either 4 h of NBO plus one HBO session (arm
B1, n = 101) or 4 h of NBO plus two 2 HBO sessions (arm B2, n = 105).
PRIMARY ENDPOINT: Proportion of patients with complete recovery at 1 month.
RESULTS: In trial A, there was no evidence for a difference in 1-month complete
recovery rates with and without HBO [58% compared to 61%; unadjusted odds ratio,
0.90 (95% CI, 0.47-1.71)]. In trial B, complete recovery rates were significantly
lower with two than with one HBO session [47% compared to 68%; unadjusted odds
ratio, 0.42 (CI, 0.23-0.79)].
CONCLUSION: In patients with transient loss of consciousness, there was no
evidence of superiority of HBO over NBO. In comatose patients, two HBO sessions
were associated with worse outcomes than one HBO session.
DOI: 10.1007/s00134-010-2093-0
PMID: 21125215 [Indexed for MEDLINE]
