Non-Invasive CPAP Ventilation in Acute Carbon Monoxide Poisoning

2019 ◽  
Vol 34 (04) ◽  
pp. 454-455 ◽  
Author(s):  
Hasan Idil ◽  
Orkun Unek
Keyword(s):  
Carbon Monoxide ◽  
Male Patient ◽  
Oxygen Therapy ◽  
Carbon Monoxide Poisoning ◽  
Symptomatic Relief ◽  
Co Poisoning ◽  
Non Invasive ◽  
Cpap Ventilation ◽  
History Of

AbstractOxygen is the main treatment of carbon monoxide (CO) poisoning. In two simultaneous cases, the efficacy of conventional and continuous positive airway pressure (CPAP)-administered oxygen therapy was compared. A 63-year-old man and his 58-year-old wife were brought to the emergency department with complaints of dizziness, headache, and nausea. The man had a history of congestive heart failure and additionally had shortness of breath. Initial carboxyhemoglobin (COHb) values were 26% in the male patient and 24% in his wife. For the female patient, oxygen therapy was performed with a reservoir balloon mask; a CPAP device was used for the male patient. The COHb levels decreased below five percent after approximately two hours in the male patient and at the end of five hours in his wife. In follow-up, symptomatic relief was achieved in both patients and no additional complications were observed. According to our experience, CPAP ventilation can be a new and effective method for oxygen therapy in CO poisoning.

scholarly journals Urgent cesarean section in a pregnant woman with carbon monoxide poisoning

2014 ◽  
Vol 155 (22) ◽  
pp. 871-875
Author(s):  
Edit Gara ◽  
Éva Gesztes ◽  
Richárd Doroszlai ◽  
Gábor Zacher
Keyword(s):  
Carbon Monoxide ◽  
Pregnant Woman ◽  
Cesarean Section ◽  
Oxygen Therapy ◽  
Carbon Monoxide Poisoning ◽  
Chemical Properties ◽  
Heating Systems ◽  
Carbon Monoxide Intoxication ◽  
Non Invasive ◽  
Physical Chemical

Recognition of carbon monoxide is difficult due to its plain physical-chemical properties. Carbon and gas operating heating systems may cause severe poisoning. Carbon-monoxide intoxication may generate severe hypoxic damage and it may cause death. The authors present the case of severe carbon monoxide poisoning affecting one young child and five adults, including a pregnant woman. Because the availability of hyperbaric oxygen therapy is limited in Hungary, urgent cesarean section was performed to avoid intrauterine hypoxic damage. The authors note that there are no standardized non-invasive methods for measuring fetal carbon-monoxide level and that the level of carbon monoxide accumulation is higher and the clearance is longer in the fetus than in the mother. The pathophysiology of carbon monoxide intoxication and therapeutic options in pregnancy are discussed. Orv. Hetil., 2014, 155(22), 871–875.

scholarly journals Real-world effectiveness of hyperbaric oxygen therapy for delayed neuropsychiatric sequelae after carbon monoxide poisoning

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shu-Chen Liao ◽  
Shih-Chieh Shao ◽  
Kun-Ju Yang ◽  
Chen-Chang Yang
Keyword(s):  
Carbon Monoxide ◽  
Hyperbaric Oxygen ◽  
Real World ◽  
Roc Curve ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Carbon Monoxide Poisoning ◽  
Chang Gung Memorial Hospital ◽  
Co Poisoning ◽  
Delayed Neuropsychiatric Sequelae

AbstractTo assess real-world effectiveness of hyperbaric oxygen therapy (HBOT) on delayed neuropsychiatric sequelae (DNS) after carbon monoxide (CO) poisoning we conducted a retrospective review of patients with CO poisoning admitted to Linkou Chang-Gung Memorial Hospital, Taiwan’s largest medical center, during 2009–2015. We included patients developing DNS after CO poisoning and compared improvements in neuropsychiatric function, with and without HBOT, after 12 months post-DNS to understand differences in recovery rates. DNS improvement-associated factors were also evaluated. We used receiver operating characteristic (ROC) curve analysis to assess the role of time elapsed between DNS diagnosis and HBOT initiation in predicting DNS improvement. A total of 62 patients developed DNS, of whom 11 recovered while the rest did not. Possible factors predicting DNS improvement included receiving HBOT post-DNS (72.7% vs 25.5%; P = 0.006), and treatment with more than three HBOT sessions during acute stage CO poisoning (81.8% vs 27.5%; P = 0.003). The relevant area under the ROC curve was 0.789 (95% CI 0.603–0.974), and the best cut-off point was 3 days post-DNS diagnosis, with 87.5% sensitivity and 61.5% specificity. Early HBOT in patients who developed DNS after CO poisoning significantly improved their DNS symptoms, with treatment effects sustained for 1 year after DNS diagnosis.

Acute carbon monoxide poisoning treatment by non-invasive CPAP-ventilation, and by reservoir face mask: Two simultaneous cases

2018 ◽  
Vol 36 (9) ◽  
pp. 1718.e5-1718.e6 ◽  
Author(s):  
Dominik Roth ◽  
Johannes Mayer ◽  
Wolfgang Schreiber ◽  
Harald Herkner ◽  
Anton N. Laggner
Keyword(s):  
Carbon Monoxide ◽  
Carbon Monoxide Poisoning ◽  
Face Mask ◽  
Non Invasive ◽  
Acute Carbon Monoxide Poisoning ◽  
Cpap Ventilation

scholarly journals Carbon Monoxide Poisoning due to Gas Water Heater

2018 ◽  
Vol 5 (2) ◽  
pp. 56-59
Author(s):  
Bidesh Bista ◽  
Dhiraj Manandhar ◽  
Rupesh Mishra ◽  
Pradeep Shrestha ◽  
Alok Dhungel
Keyword(s):  
Carbon Monoxide ◽  
Carbon Monoxide Poisoning ◽  
Cardiac Activity ◽  
Spontaneous Respiration ◽  
Co Poisoning ◽  
Water Heater ◽  
Medical College ◽  
Water Heaters ◽  
Healthy Female ◽  
History Of

Background and Objectives: Carbon Monoxide (CO) poisoning is a leading cause of injury and death due to poisoning in many parts of the world. Among numerous sources of CO, the gas water heater can be a potential under looked source causing an accidental Carbon monoxide poisoning. In the perspective of Kathmandu valley, where there are houses with small bathrooms, inadequate ventilation and absent CO detectors, gas water heaters can be extremely dangerous even if it liberates small amount of CO gas. Herein, we present a case of CO poisoning to increase awareness about the gas water heater use and the possible risk of CO poisoning in our community.Presentation of Case: A 34 years old healthy female from Patan, presented with the history of loss of consciousness for 15 minute while taking bath on a gas water heater. There was no spontaneous respiration, no cardiac activity and her body temperature was below normal.Discussion: CO is toxic to all aerobic forms to life. CO binds to hemoglobin 230 times faster than oxygen causing cellular hypoxic damage and death. CO poisoning is not uncommon in our society and many such cases are misdiagnosed for some other illness.Conclusion: Use of the gas water heaters and likelihood of CO poisoning should be notified as a public concern. People need to be aware of these hazards to prevent fatal events and likely death due to exploitation of gas water heaters. Janaki Medical College Journal of Medical Sciences (2017) Vol. 5(2): 56-59 

scholarly journals Urgent hyperbaric oxygen therapy for suicidal carbon monoxide poisoning: from a preliminary survey to a proposal for an integrated somatic-psychiatric protocol

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Alessandra Costanza ◽  
Julia Ambrosetti ◽  
Philippe Spagnoli ◽  
Andrea Amerio ◽  
Andrea Aguglia ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Carbon Monoxide Poisoning ◽  
Co Poisoning ◽  
University Hospitals ◽  
Practical Procedure ◽  
Number Of Patients ◽  
The University

AbstractA considerable number of patients who made a carbon monoxide (CO) suicidal attempt are treated with urgent hyperbaric oxygen therapy (HBOT). For these patients at potential persistent risk of suicide, the hyperbaric chamber is a dangerous environment and their management a complex challenge for the Emergency Department (ED) and Hyperbaric Medicine Unit (UMH) teams. We aimed to (1) identify cases of intentional CO poisoning treated with urgent HBOT in the UMH of the University Hospitals of Geneva (HUG) during 2011–2018 and (2) test a proposed operational and integrated somatic-psychiatric protocol based on acquired experience. A total of 311 patients with CO poisoning were treated using urgent HBOT, for which poisoning was assumed suicidal in 40 patients (12.9%). This percentage appears greater than in other European countries. Both the excess of cases of intentional CO poisonings and difficulties encountered in their management resulted in the implementation of an operational and integrated somatic-psychiatric protocol addressing the entire patient’s clinical trajectory, from the admission at ED-HUG to the treatment at the UMH-HUG. The established institutional protocol includes (1) clinical evaluation, (2) suicide risk assessment, and (3) safety measures. This is the first report—at our best knowledge—of a protocol detailing a practical procedure algorithm and focusing on multidisciplinary and mutual collaboration between the medical-nursing teams at the ED, psychiatric ED, and UMH. Improvements in patient’s safety and care team’s sense of security were observed. In conclusion, the opportunity to refer to a standardized protocol was beneficial in that it offers both reduced risks for suicidal patients and reduced stress for care teams operating in very acute and complex situations. Further studies are needed.

Carbon monoxide poisoning cases presenting with non-specific symptoms

2016 ◽  
Vol 33 (1) ◽  
pp. 53-60 ◽  
Author(s):  
Turgut Deniz ◽  
Hayati Kandis ◽  
Oguz Eroglu ◽  
Harun Gunes ◽  
Meral Saygun ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Carbon Monoxide Poisoning ◽  
Cross Sectional Study ◽  
Motor Vehicles ◽  
Co Poisoning ◽  
Cross Sectional ◽  
Heating Systems ◽  
Presenting Symptoms ◽  
Non Invasive ◽  
Specific Symptoms

Carbon monoxide (CO) is a colourless and odourless gas appearing as a result of incomplete combustion of carbon-containing fuels. Many domestic or occupational poisonings are caused by CO exposure. Malfunctioning heating systems, improperly ventilated motor vehicles, generators, grills, stoves and residential fires may be listed in the common sources of CO exposure. The aim of this study was to emphasize the significance of early diagnosis of CO poisoning with non-invasive measurement of CO levels of the patients with non-specific symptoms using a pulse oximeter device in the triage. Our study was a cross-sectional study. Patients who presented to the emergency department (ED) due to non-specific symptoms and had a Canadian Triage and Acuity scale level of 4 or 5 were included in the study; 106 (5.9%) of 1788 patients admitted during the study period were diagnosed with CO poisoning. Patients with CO poisoning and the other patients had statistically significant differences in terms of presenting symptoms, namely, headache, dizziness, nausea, and vomiting. More CO poisoning cases were admitted in the fall and winter compared to the spring and summer. The number of CO poisoning victims can be decreased if preventive measures like CO monitoring systems and well-designed ventilation systems are generalized at homes and workplaces. Measurement of carboxyhaemoglobin levels of patients presenting to ED due to non-specific symptoms like headache and dizziness during cold seasons and winter months using a pulse CO-oximeter should be a part of the routine of emergency medicine triage.

scholarly journals An Unusual Case of Carbon Monoxide Poisoning from Formic and Sulfuric Acid Mixture

2019 ◽  
Vol 4 (1) ◽  
pp. 51-54
Author(s):  
Muhammed Ershad ◽  
Athanasios Melisiotis ◽  
Zachary Gaskill ◽  
Matthew Kelly ◽  
Richard Hamilton
Keyword(s):  
Carbon Monoxide ◽  
Sulfuric Acid ◽  
Formic Acid ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Unusual Case ◽  
Carbon Monoxide Poisoning ◽  
Acid Mixture ◽  
Neurological Sequelae

Formic acid, when combined with sulfuric acid, gets dehydrated to form carbon monoxide (CO). A 27-year-old female was found unconscious inside a car, next to a container with a mixture of sulfuric acid and formic acid. Concentrations of up to 400 parts per million of CO were measured inside the car post ventilation. Serum carboxyhemoglobin level was 15% after receiving 100% oxygen for two hours. The patient received hyperbaric oxygen therapy after which she was extubated with normal mental status. On follow-up after three months, she demonstrated neurocognitive abnormalities suggestive of delayed neurological sequelae from CO exposure.

scholarly journals A Case of Carbon Monoxide-Induced Delayed Neurological Sequelae Successfully Treated with Hyperbaric Oxygen Therapy, N-Acetylcysteine, and Glucocorticoids: Clinical and Neuroimaging Follow-Up

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Vincenzo Spina ◽  
Francesco Tomaiuolo ◽  
Lorenzo Celli ◽  
Luca Bonfiglio ◽  
Luca Cecchetti ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Carbon Monoxide ◽  
Hyperbaric Oxygen ◽  
Cognitive Abilities ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Carbon Monoxide Poisoning ◽  
Cerebral White Matter ◽  
High Dose ◽  
Co Poisoning

Carbon monoxide (CO) poisoning is a leading cause of intentional and unintentional poisoning worldwide, associated with mortality and severe morbidity. Some survivors of CO poisoning develop, after a lucid interval, a potentially permanent encephalopathy in the form of cognitive impairment and movement disorders, such as Parkinsonism. One of the most frequent neuroimaging findings is a cerebral white matter damage, but so far its precise cause and specific therapy are still debated. We here report the case of a 33-year-old woman with severe carbon monoxide poisoning who, after a period of lucid interval, presented symptoms of declining motor and cognitive functions. She was treated with 40 sessions of Hyperbaric Oxygen Therapy (HBOT). The therapeutic use of oxygen at supraphysiological pressures might either increase systemic oxidative stress or cause an overproduction of oxygen free radicals as drawbacks. Concurrent use of antioxidants and anti-inflammatory drugs may prevent the side effects of oxygen therapy at supraphysiological pressure due to oxidative stress. For this reason, the patient was also treated with high-dose N-Acetylcysteine and glucocorticoids. Here, we describe the longitudinal monitoring of patient’s cognitive abilities and leukoencephalopathy associated with her positive clinical outcome.

scholarly journals Delayed neuropsychiatric syndrome after carbon monoxide poisoning: inclusion of hyperbaric oxygen therapy in the recovery protocol

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Dante Lo Pardo ◽  
Davide Amedola ◽  
Giuliana Senatore ◽  
Alberto Damiano ◽  
Gabriela Pezzuti ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Case Report ◽  
Diagnostic Imaging ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Carbon Monoxide Poisoning ◽  
Neuropsychological Rehabilitation ◽  
Psychological Recovery

The delayed neuropsychiatric syndrome can arise in the period from 4 days to 5 weeks following carbon monoxide poisoning, and is characterized by neuropsychological deficits, which in some cases become chronic. This case report describes an adult female who apparently suffered self-inflicted carbon monoxide poisoning. She was not treated with hyperbaric oxygen and developed delayed sequelae on day 20. The treatment started with 40 sessions of hyperbaric oxygen therapy and subsequently with neuropsychological rehabilitation and physiotherapy. The treatment resulted in a progressive and almost complete physical and psychological recovery as evidenced by neuropsychometric tests and diagnostic imaging performed in the follow-up. Recovery was attributed to hyperbaric oxygen therapy. Although further research is required, we propose hyperbaric oxygen therapy also in the recovery protocol in the treatment of delayed neuropsychiatric syndrome.

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