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

Published online by Cambridge University Press:  22 October 2019

Bahadır Caglar Open the ORCID record for Bahadır Caglar [Opens in a new window] ,
Suha Serin ,
Gokhan Yilmaz Open the ORCID record for Gokhan Yilmaz [Opens in a new window] ,
Alper Torun  and
Ismet Parlak
Bahadır Caglar*
Affiliation:
Emergency Medicine Clinic, Elazig Training and Research Hospital, Elazig, Turkey
Suha Serin
Affiliation:
Emergency Medicine Clinic, Behcet Uz Training and Research Hospital, Izmir, Turkey
Gokhan Yilmaz
Affiliation:
Emergency Medicine Clinic, Kayseri City Hospital, Kayseri, Turkey
Alper Torun
Affiliation:
Emergency Medicine Clinic, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
Ismet Parlak
Affiliation:
Emergency Medicine Clinic, Aksaray University, Aksaray, Turkey
*
Correspondence: Bahadir Caglar, MD Emergency Medicine Clinic Elazig Training and Research Hospital Elazig, Turkey E-mail: mail@bahadircaglar.com
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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.

Keywords

carbon monoxide poisoningnon-invasive ventilationtoxicology
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 34 , Issue 6 , December 2019 , pp. 588 - 591
Copyright
© World Association for Disaster and Emergency Medicine 2019 

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