How is hyperbaric oxygen therapy administered for 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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Answer

HBO at 3 atm raises the amount of oxygen dissolved in the serum to 6.8%, enough to sustain cerebral metabolism. Elimination half-life is reduced to 15-23 minutes. Elimination half-life of CO from methylene chloride intoxication of 13 hours at room air temperature is reduced to 5.8 hours.

Chambers are small monoplace hulls, allowing space for a single patient in a supine position who can be viewed through a window at the head, or they are acrylic walled and allow full visualization. Many of these monoplace chambers allow for care of critically ill patients, including intravenous lines, arterial lines, and ventilator. Others are large multiplace chambers that permit ventilation equipment and allow medical teams to accompany the patient. A monoplace chamber is shown below.

Monoplace hyperbaric chamber. Courtesy JG Benitez, Monoplace hyperbaric chamber. Courtesy JG Benitez, MD, MPH.

Treatment regimens usually involve 100% oxygen at 2.4-3 atm for 90-120 minutes. Re-treatment, although controversial, may be performed for acutely and chronically persistent symptoms. One study suggests that degree of metabolic acidosis can predict the need for re-treatment. [40]


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