BACKGROUND: The aim of this survey was to identify practice differences in the treatment of carbon monoxide (CO) poisoning with hyperbaric oxygen (HBO₂) therapy among centers in Europe. MATERIALS AND METHODS: Using a commercial online survey website (surveymonkey.com), we created a questionnaire and invited the medical directors of hyperbaric centers in Europe by email to complete the survey. RESULTS: Sixty-eight centers from 23 countries participated in the survey. While transient or prolonged unconsciousness was unanimously recognized as an indication for HBO₂ therapy, positive neurological findings, ECG suggesting acute ischemia and pregnancy were considered important indications of HBO₂ therapy in more than 95% of the centers. Twenty-three (44%) centers reported that they used carboxyhemoglobin (COHb) levels as a criterion for patient selection. Among responders, 39% (18/46) reported delivering a single session within the first 24 hours of CO poisoning, and nine (19%) reported delivering three sessions in the first day. The majority of the centers (52%) replied that they initially gave a single session per patient, which was repeated if symptoms persisted. We identified a total of 21 different HBO₂ profiles used in European centers. CONCLUSION: Our results showed that the indications of CO poisoning for HBO₂ therapy are still not universally recognized. Additionally, HBO₂ therapy protocols used at European hyperbaric centers varied significantly, suggesting a need for more education regarding the published guidelines.
BACKGROUND: The aim of this survey was to identify practice differences in the treatment of carbon monoxide (CO) poisoning with hyperbaric oxygen (HBO₂) therapy among centers in Europe. MATERIALS AND METHODS: Using a commercial online survey website (surveymonkey.com), we created a questionnaire and invited the medical directors of hyperbaric centers in Europe by email to complete the survey. RESULTS: Sixty-eight centers from 23 countries participated in the survey. While transient or prolonged unconsciousness was unanimously recognized as an indication for HBO₂ therapy, positive neurological findings, ECG suggesting acute ischemia and pregnancy were considered important indications of HBO₂ therapy in more than 95% of the centers. Twenty-three (44%) centers reported that they used carboxyhemoglobin (COHb) levels as a criterion for patient selection. Among responders, 39% (18/46) reported delivering a single session within the first 24 hours of CO poisoning, and nine (19%) reported delivering three sessions in the first day. The majority of the centers (52%) replied that they initially gave a single session per patient, which was repeated if symptoms persisted. We identified a total of 21 different HBO₂ profiles used in European centers. CONCLUSION: Our results showed that the indications of CO poisoning for HBO₂ therapy are still not universally recognized. Additionally, HBO₂ therapy protocols used at European hyperbaric centers varied significantly, suggesting a need for more education regarding the published guidelines.
Authors: Derek M Culnan; Beretta Craft-Coffman; Genevieve H Bitz; Karel D Capek; Yiji Tu; William C Lineaweaver; Maggie J Kuhlmann-Capek Journal: Ann Plast Surg Date: 2018-03 Impact factor: 1.539