Hostname: page-component-76fb5796d-vvkck Total loading time: 0 Render date: 2024-04-25T17:26:02.922Z Has data issue: false hasContentIssue false
  • English
  • Français

The Impact of Treatment with Continuous Positive Airway Pressure on Acute Carbon Monoxide Poisoning

Published online by Cambridge University Press:  22 October 2019

Bahadır Caglar Open the ORCID record for Bahadır Caglar [Opens in a new window] ,
Suha Serin ,
Gokhan Yilmaz Open the ORCID record for Gokhan Yilmaz [Opens in a new window] ,
Alper Torun  and
Ismet Parlak
Bahadır Caglar*
Affiliation:
Emergency Medicine Clinic, Elazig Training and Research Hospital, Elazig, Turkey
Suha Serin
Affiliation:
Emergency Medicine Clinic, Behcet Uz Training and Research Hospital, Izmir, Turkey
Gokhan Yilmaz
Affiliation:
Emergency Medicine Clinic, Kayseri City Hospital, Kayseri, Turkey
Alper Torun
Affiliation:
Emergency Medicine Clinic, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
Ismet Parlak
Affiliation:
Emergency Medicine Clinic, Aksaray University, Aksaray, Turkey
*
Correspondence: Bahadir Caglar, MD Emergency Medicine Clinic Elazig Training and Research Hospital Elazig, Turkey E-mail: mail@bahadircaglar.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Approximately 50,000 patients per year present at emergency departments (EDs) because of carbon monoxide (CO) intoxication. The hypothesis of this study was that the half-life of CO and the regression period of complaints could be reduced more rapidly by applying oxygen with the Continuous Positive Airway Pressure (CPAP) modality using a non-invasive mechanical ventilator.

Methods:

The patients were divided into Group 1 and Group 2 in terms of the treatment method applied. Patients in Group 1 received FiO2 1.0 15 l/minute oxygen at room temperature for at least 30 minutes with a non-rebreather mask. Patients in Group 2 received FiO2 1.0 oxygen at 12 cmH2O pressure with non-invasive mechanical ventilation for at least 30 minutes with an oronasal mask in the CPAP modality.

Results:

The median values (interquartile range) of carboxyhemoglobin (COHb) levels at zero and 30 minutes of patients were 19% (8) and 14% (6) in Group 1 and 22% (8) and nine percent (3) in Group 2; a median difference of six percent (2) was detected in Group 1 and of 13% (4) in Group 2 in the first 30 minutes (P <.001). When the symptoms of the patients were examined, the median values of Group 1 and Group 2 at zero minutes were both eight units and at 30 minutes were five and three units, respectively. A decrease of five units was determined in the median of Group 2 in the first 30 minutes, and a decrease of two units in the median of Group 1 (P <.001).

Conclusion:

The use of CPAP was determined to more rapidly reduce COHb level as opposed to high-flow oxygen therapy. It is also thought that it may enable earlier discharge by reducing the duration of the emergency follow-up since it provides a faster improvement in the symptoms of the patients.

Keywords

carbon monoxide poisoningnon-invasive ventilationtoxicology
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 34 , Issue 6 , December 2019 , pp. 588 - 591
Copyright
© World Association for Disaster and Emergency Medicine 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Hampson, NB, Weaver, LK. Carbon monoxide poisoning: a new incidence for an old disease. Undersea Hyperb Med. 2007;34(3):163–168.Google ScholarPubMed
Bleecker, ML. Carbon monoxide intoxication. Handb Clin Neurol. 2015;131:191–203.CrossRefGoogle ScholarPubMed
O’Donoghue, JL. Carbon monoxide, inorganic nitrogenous compounds, and phosphorus. In: O’Donoghue, JL, (ed). Neurotoxicity of Industrial and Commercial Chemicals. Volume 1. Boca Raton, Florida USA: CRC Press; 1985:193–203.Google Scholar
Iqbal, SI, Law, H, Clower, JH, Yip, FY, Elixhauser, A. Hospital burden of unintentional carbon monoxide poisoning in the United States, 2007. Am J Emerg Med. 2012;30(5):657–664.CrossRefGoogle ScholarPubMed
Prockop, LD, Chichkova, RI. Carbon monoxide intoxication: an updated review. J Neurol Sci. 2007;262(1–2):122–130.CrossRefGoogle ScholarPubMed
Roderique, JD, Josef, CS, Feldman, MJ, Spiess, BD. A modern literature review of carbon monoxide poisoning theories, therapies, and potential targets for therapy advancement. Toxicology. 2015;334:45–58.CrossRefGoogle ScholarPubMed