COMPARATIVE STUDY FOR INDICATION OF HYPERBARIC THERAPY ON CARBON MONOXIDE INTOXICATION

Yoo, Su Jin; Park, Jae Hwang

J Korean Soc Emerg Med > Volume 6(2); 1995 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 1995;6(2): 411-419.

COMPARATIVE STUDY FOR INDICATION OF HYPERBARIC THERAPY ON CARBON MONOXIDE INTOXICATION

Su Jin Yoo, Jae Hwang Park

Department of Emergency Medicine, WonKwang University School of Medicine, lksan, Korea

Published online: December 31, 1995.

ABSTRACT

Study objective: To comparative study the results between hyperbaric oxygen therapy and non-hyperbaric oxygen therapy in the these patients, because controversy exists regarding hyperbaric therapy in the drowsy patient with carbon monoxide intoxication Design: Retrospective study Setting: The WonKwang university hospital emergency department during January first 1991 through June 31th 1995 Method and result: According to history and carboxyhemoglobin level, we experienced 105 patients of carbon monoxide intoxication admitted to emergency department. Patients intoxicated by other gases and death patients before admission was excluded. According to the indication of the hyperbaric oxygen therapy on carbon monoxide intoxication, 15 patients among 16 patients with coma, semicorna, and stuporous mental state was done. Patient with drowsy mental state was 23 patients, 6 of these patients was done hyperbaric oxygen therapy and remainder was not. Charts of patients with carbon monoxide intoxication including patients with drowsy mental state was reviewed to determine the result between hyperbaric oxygen therapy and non-hyperbaric oxygen therapy. According to clinical features, we found sex ratio(1:1.6), mean age(35.1 土19.4years), age range from 1 to 85 years old, 4lcases(39%) in 1991, 66cases(62.9%) in alert mental state and 23cases(21.9%) in drowsy mental state The exposure time and time until alert mental status by mental status were 9.5土0.67hours, 18.8土28.3hours in coma mental status. The early laboratory findings were leukocytosis in 39cases(37.1%), increased hematocrit in 20 cases(19.1%), increased GOT in 14cases(13.3%), increased GPT in 12cases(11.4%), increased creatinine in 10 cases(9.5%), glucosuria in 17cases(16.2%) and normal arterial blood gas analysis findings except acidemia in drowsy and coma mental status, and most common abnormal findings were seen in stuporous mental status. The exposure time and time until alert mental status by carboxyhemoglobin concentration were no significant statistical result, and time until alert mental status between drowsy and stuporous mental status with hyperbaric oxygen therapy were 3.9 土3.04hours. In patients with drowsy mental status, the patients with hyperbaric oxygen therapy that was 3.9土3.04hours in time until alert mental status, 1cases(17%) in carboxyhernoglobin concentration( ≥20%), 5cases(83%) in carboxyhemoglobin concentration(< 20%), 1.43土2.11 days in admission period, and patients without hyperbaric oxygen therapy were 9.9土6.04hours in the time until alert mental status. Arterial blood gas analysis between patients with and without hyperbaric oxygen therapy in drowsy mental status were normal findings except acidemia before hyperbaric oxygen therapy. The com面 son between hyperbaric oxygen therapy and non-hyperbaric oxygen therapy in patients with drowsy mental status were significant statistical result in time until alert mental status.
Conclusion:
Although hyperbaric oxygen therapy was done according to the indication in carbon monoxide poisoning, these result imply that hyperbaric oxygen therapy is more important than the pure oxygen therapy in patients with drowsy mental status.

Key words: Carbon monoxide intoxication, Hyperbaric oxygen therapy