Hyperbaric Oxygen Treatment for Carbon Monoxide Poisoning in Italy: Retrospective Validation of a Data Collection Tool for the Italian Registry of Carbon Monoxide Poisonings (IRCOP)

Abstract

Background: Carbon Monoxide (CO) poisoning is a frequent cause of intoxication. However, CO poisoning incidence is globally underreported, as well as its features, especially in Italy. The aim of this study was to investigate such characteristics of CO intoxication and foster the creation of the Italian Registry of Carbon Monoxide Poisonings. Methods: A data collection tool was developed and organized in five sections: Patient’s characteristics; CO intoxication modality; emergency medical service and emergency department; hyperbaric facility; outcomes. The tool was validated through a retrospective analysis, including CO intoxicated patients treated in 14 Italian hyperbaric facilities between 2015 and 2016. Results: A total of 1383 patients were included. The high completion ratio (85%) of the collection tool suggests its feasibility in practical terms. CO intoxications were mostly accidental (93.64%) and caused by solid fuel (48.59%). There was not a uniform application of hyperbaric oxygen treatment protocols, but most of the patients were adequately treated at least at 2.5 ATA for more than 60 min (44.97%). Conclusion: This analysis provided new information that was previously unavailable in this country. Furthermore, this tool proved to be a valid base for future registry aiming to consolidate the body of knowledge about CO intoxications in Italy.

Delayed Neurological Sequelae Successfully Treated with Adjuvant, Prolonged Hyperbaric Oxygen Therapy: Review and Case Report

“…Among the other limitations of this paper, the MMSE scores were not retrieved for the first patient, and the rehabilitation therapies were different and not explicitly reported in the patients' charts. Still, these features will be added to the ongoing Italian Registry of Carbon Monoxide Poisoning (IRCOP) [9].…”

“…For example, a recent case review conducted by some of the authors detailed the epidemiology and treatment modalities of 1383 patients treated in Italian hyperbaric chambers in the years 2015-2016. Only 12 patients with DNS were reported upon admission, and the outcome was difficult to assess since all were lost to follow-up [9]. The diagnosis of DNS is also difficult due to lucid intervals -frequently delaying the appearance of neurological symptoms.…”