Supplemental oxygen, at normal or hyperbaric pressures, is the primary treatment for carbon monoxide poisoning. Hyperbaric oxygen therapy (HBOT) dissolves additional oxygen in the blood plasma and has been shown to block all known cellular mechanisms of CO toxicity. HBOT is also FDA cleared and UHMS approved to treat smoke inhalation in firefighters and other fire victims who suffer carbon monoxide poisoning complicated by cyanide poisoning.
CO poisoning remains an active area of HBOT clinical research. From our new commentary:
Every year CO poisoning accounts for some 50,000 emergency room visits and kills about 450 Americans by accidental exposure alone. US fire departments respond to seven nonfire CO incidents every hour [NFPA, 2005]. For more than 50 years emergency physicians have been increasing their use of hyperbaric oxygen to treat acute carbon monoxide poisoning, yet access to emergency-ready hyperbaric chambers remains a public health crisis in the US today. Since 2008 the UHMS has participated in the CDC national surveillance system for carbon monoxide poisoning. Findings from nearly 2,000 cases at 87 hyperbaric facilities in 39 states are just now emerging for careful analysis and publication. These data will make a welcome addition to the medical literature, which currently lacks the strongest evidence, from randomized controlled trials (RCTs), to support the routine use of hyperbaric oxygen for acute CO poisoning [Cochrane Collaboration, 2011].Regular readers of this blog know this topic is dear to our hearts. Once again, we do not consider it unreasonable for the US healthcare community to demand access to an emergency-ready and professionally staffed hyperbaric chamber in every hospital. Yet we're eager to see new evidence in the months and years ahead to support or challenge our views of HBOT for carbon monoxide poisoning and other trauma indications.