| Hyperbaric or normobaric oxygen for acute carbon monoxide poisoning: a randomised controlled clinical trial. | |
| | |
MedLine Citation:
|
PMID: 10092916 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To assess neurological sequelae in patients with all grades of carbon monoxide (CO) poisoning after treatment with hyperbaric oxygen (HBO) and normobaric oxygen (NBO). DESIGN: Randomised controlled double-blind trial, including an extended series of neuropsychological tests and sham treatments in a multiplace hyperbaric chamber for patients treated with NBO. SETTING: The multiplace hyperbaric chamber at the Alfred Hospital, a university-attached quarternary referral centre in Melbourne providing the only hyperbaric service in the State of Victoria. PATIENTS: All patients referred with CO poisoning between 1 September 1993 and 30 December 1995, irrespective of severity of poisoning. Pregnant women, children, burns victims and those refusing consent were excluded. INTERVENTION: Daily 100-minute treatments with 100% oxygen in a hyperbaric chamber--60 minutes at 2.8 atmospheres absolute for the HBO group and at 1.0 atmosphere absolute for the NBO group--for three days (or for six days for patients who were clinically abnormal or had poor neuropsychological outcome after three treatments). Both groups received continuous high flow oxygen between treatments. MAIN OUTCOME MEASURES: Neuropsychological performance at completion of treatment, and at one month where possible. RESULTS: More patients in the HBO group required additional treatments (28% v. 15%, P = 0.01 for all patients; 35% v. 13%, P = 0.001 for severely poisoned patients). HBO patients had a worse outcome in the learning test at completion of treatment (P = 0.01 for all patients; P = 0.005 for severely poisoned patients) and a greater number of abnormal test results at completion of treatment (P = 0.02 for all patients; P = 0.008 for severely poisoned patients). A greater percentage of severely poisoned patients in the HBO group had a poor outcome at completion of treatment (P = 0.03). Delayed neurological sequelae were restricted to HBO patients (P = 0.03). No outcome measure was worse in the NBO group. CONCLUSION: In this trial, in which both groups received high doses of oxygen, HBO therapy did not benefit, and may have worsened, the outcome. We cannot recommend its use in CO poisoning. |
| | |
Authors:
|
C D Scheinkestel; M Bailey; P S Myles; K Jones; D J Cooper; I L Millar; D V Tuxen |
Related Documents
:
|
10886696 - Serum glutathione s-transferase alpha as a measure of hepatocellular function following... 21999716 - Assessment of the therapeutic alliance in physical rehabilitation: a rasch analysis. 22031346 - Responsiveness of four participation measures to changes during and after outpatient re... 16427526 - Anesthesia with 1.5 minimum alveolar concentration sevoflurane is not altered by physos... 11927146 - Beta-thromboglobulin and platelet factor 4 levels in post-myocardial infarction patient... 15200756 - Physicians' constructions of depression: inside/outside the boundaries of medicalization. |
Publication Detail:
|
Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Review |
Journal Detail:
|
Title: The Medical journal of Australia Volume: 170 ISSN: 0025-729X ISO Abbreviation: Med. J. Aust. Publication Date: 1999 Mar |
Date Detail:
|
Created Date: 1999-04-13 Completed Date: 1999-04-13 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0400714 Medline TA: Med J Aust Country: AUSTRALIA |
Other Details:
|
Languages: eng Pagination: 203-10 Citation Subset: IM |
Affiliation:
|
Alfred Hospital, Melbourne, VIC. cdsch@ozemail.com.au |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Animals Carbon Monoxide Poisoning / complications, physiopathology, therapy* Double-Blind Method Female Humans Hyperbaric Oxygenation / adverse effects, methods* Male Neuropsychological Tests Oxygen Inhalation Therapy* Severity of Illness Index Suicide, Attempted Treatment Outcome Victoria |
| Comments/Corrections | |
Comment In:
|
Med J Aust. 1999 Jun 7;170(11):563; author reply 564-5
[PMID:
10397051
]
Med J Aust. 1999 Jun 7;170(11):563; author reply 564-5 [PMID: 10397050 ] Med J Aust. 1999 Jun 7;170(11):563-4; author reply 564-5 [PMID: 10397052 ] ACP J Club. 1999 Jul-Aug;131(1):11 Med J Aust. 2000 Feb 7;172(3):141-2 [PMID: 10735028 ] Med J Aust. 1999 Jun 7;170(11):564-5 [PMID: 10397053 ] Med J Aust. 1999 Mar 1;170(5):197-9 [PMID: 10092913 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Management of coexisting coronary artery and asymptomatic carotid artery disease: report of a series...
Next Document: Antenatal hospitalisations in New South Wales, 1995-96.