When is hyperbaric oxygen therapy indicated for the treatment of carbon monoxide (CO) toxicity?

Updated: Sep 18, 2018
  • Author: Guy N Shochat, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Presently, universal treatment criteria do not exist; however, a survey of directors of North American HBO facilities with 85% responding demonstrates some consensus. The most common selection criteria (regardless of HbCO level) include the following:

  • Coma (98%)
  • Transient loss of consciousness (77%)
  • Ischemic ECG changes (91%)
  • Focal neurologic deficits (94%)
  • Abnormal neuropsychiatric test results (91%).

Ninety-two percent of HBO facility directors use HBO for headache, nausea, and HbCO levels above 40%; yet only 62% have a specific minimum HbCO level in asymptomatic patients. One half of the centers place a time limit on delay of treatment in patients with transient loss of consciousness alone.

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