If required, HBOT should be initiated within 6 h.Īll patients with CO poisoning should be informed about the risk of delayed neurological sequelae (DNS). Especially in the absence of improvement despite treatment, a reevaluation for other possible differential diagnoses ought to be performed.Įvidence regarding the benefit of hyperbaric oxygen therapy (HBOT) is scant and the subject of controversy due to the heterogeneity of studies. If CO poisoning is suspected, 100% oxygen breathing should be immediately initiated in the prehospital setting.Ĭlinical symptoms do not correlate with COHb elimination from the blood therefore, COHb monitoring alone is unsuitable for treatment management. Reduced oxygen-carrying capacity, impairment of the cellular respiratory chain, and immunomodulatory processes may result in myocardial and central nervous tissue damage even after a reduction in COHb. Negative carboxyhemoglobin (COHb) levels should not rule out CO poisoning if the history and symptoms are consistent with this phenomenon. The diagnosis of CO poisoning is based on clinical symptoms and proven or probable exposure to CO. This guideline presents the current state of knowledge and national recommendations on the diagnosis and treatment of patients with CO poisoning. Symptoms of CO poisoning are nonspecific and can range from dizziness, headache, and angina pectoris to unconsciousness and death. Carbon monoxide (CO) can occur in numerous situations and ambient conditions, such as fire smoke, indoor fireplaces, silos containing large quantities of wood pellets, engine exhaust fumes, and when using hookahs.
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