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TREATING CARBON MONOXIDE IN A PRESSURE CHAMBER IS UNSETTLED
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OKAY BACK TO THE PRESSURE CHAMBER 🫧
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HOW THE 2002 TRIAL WAS RUN 🔬
Acute Carbon Monoxide Poisoning Commonly Has Cognitive Sequelae
The Word Means Consequences Of The Poisoning
A 2002 Trial Tested Hyperbaric Oxygen Against Those Sequelae
Hyperbaric Oxygen Means Oxygen Breathed Inside A Pressure Chamber
Normobaric Oxygen Means Oxygen Breathed At Normal Air Pressure
The 2002 Trial Was Double Blind And Randomized
Its Patients Had Symptomatic Acute Carbon Monoxide Poisoning
Patients Were Assigned To Two Groups In Equal Proportions
Each Patient Spent Three Sessions In The Chamber Within 24 Hours
One Group Received Three Hyperbaric Oxygen Treatments
The Other Group Received One Normobaric Oxygen Treatment
That Group Spent Its Other Two Sessions Breathing Room Air
Oxygen Came Through A Face Mask Or A Tube In The Windpipe
Testing Began Immediately After Chamber Sessions 1 And 3
More Tests Followed At 2 Weeks 6 Weeks 6 Months And 12 Months
The Primary Outcome Was Cognitive Sequelae Six Weeks Afterward
Four Early Looks At The Results Were Scheduled
The Trial Was Stopped After The Third Look
At That Point There Were 76 Patients In Each Group
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TWO TRIALS THAT FAVORED HYPERBARIC OXYGEN ⚖️
At Six Weeks 19 Of 76 Hyperbaric Patients Had Cognitive Sequelae
In The Normobaric Group The Count Was 35 Of 76
That Is 25.0 Percent Against 46.1 Percent
The Difference Remained After Adjusting For Coordination Problems
Cognitive Sequelae Were Also Less Frequent At 12 Months
That Result Counted Every Patient In The Group They Were Assigned
Its Authors Said Three Hyperbaric Sessions Appeared To Lower The Risk
An Earlier Trial Measured A Different Outcome
It Counted Delayed Neurological Sequelae
These Are Brain And Mental Problems That Appear Later
That Trial Enrolled Mild To Moderate Carbon Monoxide Poisoning Cases
They Had Arrived For Treatment Within 6 Hours
None Had A History Of Loss Of Consciousness Or Cardiac Instability
Its Patients Got Either Normobaric Or Hyperbaric Oxygen
Delayed Sequelae Developed In 7 Of 30 Normobaric Patients
That Comes To 23 Percent
None Of The 30 Hyperbaric Patients Developed Any
Its Authors Concluded That Hyperbaric Oxygen Reduced Those Sequelae
Both Trials Found Fewer Sequelae In The Hyperbaric Group
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WHAT OTHER TRIALS AND REVIEWS FOUND ❓
A Melbourne Trial Did Not Find The Same Benefit
It Included All Grades Of Carbon Monoxide Poisoning
Both Of Its Groups Received High Doses Of Oxygen
Delayed Sequelae Appeared Only In The Hyperbaric Group
Its Authors Wrote Hyperbaric Oxygen Did Not Help And May Have Hurt
They Could Not Recommend Its Use For Carbon Monoxide Poisoning
A 2018 Review Reported One Session Reduced Sequelae In Severe Cases
Those Patients Had Lost Consciousness Or Been In A Coma
Its Authors Also Questioned How Rigorous The Reviewed Trials Were
A 2019 Meta Analysis Pooled 2,023 Patients From Seven Trials
Hyperbaric Oxygen Significantly Lowered The Risk Of Memory Impairment
That Was Compared With Normobaric Oxygen
The Analysis Found No Significant Effect On Recovery Or Death
A 2026 Meta Analysis Of Six Studies Found No Significant Benefit
That Covered Both Deaths And Neurological Outcomes
The Quality Of Its Evidence Was Rated Low To Very Low
It Concluded The Benefit Of Hyperbaric Oxygen Remains Unproven
Its Authors Said Hyperbaric Oxygen May Still Hold Potential Benefits
So Treating Carbon Monoxide With Hyperbaric Oxygen Is Unsettled
Avoiding Poisoning Does Not Depend On The Trials Agreeing
A Florida Hurricane Report Said Generators Must Never Run Indoors
That Covers Garages And Outdoor Spots Near Doors Windows Or Vents
Medical Records Showed Some Generators Placed In Homes Or Garages
No Medical Record Mentioned A Home Carbon Monoxide Detector
