Complications and protocol considerations in carbon monoxide-poisoned patients who require hyperbaric oxygen therapy: Report from a ten-year experience

Part 12: Cardiac Arrest in Special Situations

“…370 Several studies have suggested that very few patients who develop cardiac arrest from carbon monoxide poisoning survive to hospital discharge, regardless of treatment administered following return of spontaneous circulation. [371][372][373] Routine care of patients in cardiac arrest and severe cardiotoxicity from carbon monoxide poisoning should comply with standard BLS and ACLS recommendations.…”

Carbon monoxide poisoning

“…Few complications occurred during HBOT. The authors concluded that most patients at risk for emergent cardiovascular decompensation can be identified before they enter the HBOT chamber [235]. Because of the significant controversy still surrounding the most appropriate treatment of a CO-poisoned patient, a standard of care regarding HBOT for COpoisoned patients is difficult to define.…”

Seizure During Hyperbaric Oxygen Therapy for Carbon Monoxide Toxicity: A Case Series and Five-year Experience

“…Although oxygen toxicity may contribute to seizures in HBO-treated CO-poisoned patients, the CO poisoning must also play a role, because the seizure risk increases substantially in CO-poisoned patients compared to nonpoisoned patients exposed to the same or greater oxygen pressures (Table 1). CO exposure by itself is a known risk factor for seizures, with seizure rates of 1-6% reported in severe exposures (4,7). A review of the literature regarding HBO-associated seizures was performed (Table 1).…”

“…Sloan et al provided the most comprehensive review of 297 CO-poisoned patients before, during, and after HBO treatment (7). These patients experienced a high mortality rate (6%), and complications such as seizure did occur with a high frequency.…”

“…Eighteen grand mal and five focal seizures occurred in these patients. Interestingly, of those patients experienc- ing grand mal seizures, 50% experienced them before HBO treatment (7). With two recurrences during therapy, only 7 of the 18 grand mal seizures had a first occurrence during therapy, and none after therapy; thus, the role of HBO as a cause of seizure in these cases must be questioned.…”