The Impact of Treatment with Continuous Positive Airway Pressure on Acute Carbon Monoxide Poisoning

Abstract

Introduction:Approximately 50,000 patients per year present at emergency departments (EDs) because of carbon monoxide (CO) intoxication. The hypothesis of this study was that the half-life of CO and the regression period of complaints could be reduced more rapidly by applying oxygen with the Continuous Positive Airway Pressure (CPAP) modality using a non-invasive mechanical ventilator.Methods:The patients were divided into Group 1 and Group 2 in terms of the treatment method applied. Patients in Group 1 received FiO2 1.0 15 l/minute oxygen at room temperature for at least 30 minutes with a non-rebreather mask. Patients in Group 2 received FiO2 1.0 oxygen at 12 cmH2O pressure with non-invasive mechanical ventilation for at least 30 minutes with an oronasal mask in the CPAP modality.Results:The median values (interquartile range) of carboxyhemoglobin (COHb) levels at zero and 30 minutes of patients were 19% (8) and 14% (6) in Group 1 and 22% (8) and nine percent (3) in Group 2; a median difference of six percent (2) was detected in Group 1 and of 13% (4) in Group 2 in the first 30 minutes (P <.001). When the symptoms of the patients were examined, the median values of Group 1 and Group 2 at zero minutes were both eight units and at 30 minutes were five and three units, respectively. A decrease of five units was determined in the median of Group 2 in the first 30 minutes, and a decrease of two units in the median of Group 1 (P <.001).Conclusion:The use of CPAP was determined to more rapidly reduce COHb level as opposed to high-flow oxygen therapy. It is also thought that it may enable earlier discharge by reducing the duration of the emergency follow-up since it provides a faster improvement in the symptoms of the patients.

Case report of new-onset obstructive sleep apnea after carbon monoxide poisoning

“…Previous studies have also indicated that CPAP can be an effective treatment alternative to conventional oxygen therapy in patients with COP. [6][7][8] A clear limitation in this report is that the patient did not undergo an overnight PSG examination before COP to fully confirm that she did not have pre-existing OSA. However, her family denied that she had OSA symptoms before COP.…”

Terapi Non-Invasive Continuous Positive Airway Pressure (CPAP) Ventilation pada Keracunan Gas Karbon Monoksida

“…Kelompok terapi CPAP mengalami perbaikan keluhan nyeri kepala yang lebih baik dibandingkan kelompok NRM, namun untuk keluhan lain, seperti mual, pusing, dan lemas, tidak dijumpai perbedaan bermakna. 24 Ventilasi non-invasif metode CPAP dengan sungkup ketat dapat menjadi alternatif terapi keracunan CO karena tersedia cukup luas dibandingkan dengan ketersediaan fasilitas terapi HBO. Proses eliminasi CO dari tubuh bergantung pada fraksi oksigen yang dihirup dan kecepatan difusi CO melalui membran alveoli-kapiler dan kecepatan ekspirasi.…”

Karbonmonoksit Zehirlenmesinde Hiperbarik Oksijen Tedavisinin Acil Servis İşleyişindeki Yeri

“…Son yıllarda yapılan çalışmalarda sürekli pozitif basınçlı ventilasyon (CPAP) kullanımının, yüksek akışlı oksijen tedavisine kıyasla COHb düzeyini daha hızlı azalttığı gösterildi. Bu sayede CPAP tedavisi alan hastaların semptomlarında hızlı düzelme ve acil takip süresini kısalma sağladığı gösterilmiştir (9,10). HBO tedavisi hastaların 1,4 atmosfer ve üzeri basınçlarda hiperbarik bölmelerde %100 oksijen solutulması olarak tanımlanabilir.…”