Clinical Outcomes and Mortality Impact of Hyperbaric Oxygen Therapy in Patients With Carbon Monoxide Poisoning

Crit Care Med. 2018 Jul;46(7):e649-e655. doi: 10.1097/CCM.0000000000003135.

Abstract

Objectives: Carbon monoxide poisoning affects 50,000 per year in the United States alone. Mortality is approximately 3%, and up to 40% of survivors suffer from permanent neurocognitive and affective deficits. Hyperbaric oxygen therapy has shown benefit on reducing the long-term neurologic sequelae of carbon monoxide poisoning but has not demonstrated improved survival. The objective of this study is to assess the efficacy of hyperbaric oxygen for acute and long-term mortality in carbon monoxide poisoning using a large clinical databank.

Design: Retrospective analysis.

Setting: University of Pittsburgh Medical Center healthcare system (Pittsburgh, PA).

Patients: One-thousand ninety-nine unique encounters of adult patients with carbon monoxide poisoning.

Interventions: None.

Measurements and main results: Baseline demographics, laboratory values, hospital charge transactions, discharge disposition, and clinical information from charting were obtained from the electronic medical record. In propensity-adjusted analysis, hyperbaric oxygen therapy was associated with a reduction in inpatient mortality (absolute risk reduction, 2.1% [3.7-0.9%]; p = 0.001) and a reduction in 1-year mortality (absolute risk reduction, 2.1% [3.8-0.4%]; p = 0.013).

Conclusions: These data demonstrate that hyperbaric oxygen is associated with reduced acute and reduced 1-year mortality. Further studies are needed on the mortality effects of hyperbaric oxygen therapy in carbon monoxide poisoning.

MeSH terms

  • Adult
  • Carbon Monoxide Poisoning / mortality
  • Carbon Monoxide Poisoning / therapy*
  • Female
  • Humans
  • Hyperbaric Oxygenation*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome