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Medizinische Klinik - Intensivmedizin und Notfallmedizin

Erschienen in:

02.08.2023 | Originalien

Comparing high-flow nasal oxygen therapy and normobaric oxygen therapy on the treatment of carbon monoxide poisoning

verfasst von: Sedat Akkan, MD, Ömür Uyanik, MD

Erschienen in: Medizinische Klinik - Intensivmedizin und Notfallmedizin | Ausgabe 3/2024

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Abstract

Aim

We aimed to investigate whether there is a difference in the rate of decrease in carboxyhemoglobin (COHB) values between high-flow nasal oxygen (HFNO) and normobaric oxygen (NBO) therapy.

Material and method

This retrospective observational study included patients with carbon monoxide poisoning who were treated with HFNO or NBO (control group). All patients were started on NBO therapy with a non-rebreather face mask at a rate of 15 L/min. In the NBO group, NBO treatment was continued until the COHB value fell below 10%. In the HFNO group, as soon as the preparation of the HFNO device was completed, NBO treatment was terminated and HFNO treatment was started and continued until the COHB value fell below 10%. The primary outcome of the study was the difference between HFNO and NBO in terms of COHB half-life rates.

Results

A total of 81 patients were included in the study, 44 in the HFNO group and 37 in the NBO group. The median of COHB t_1/2 values between HFNO and the NBO treatment groups were 47.3 (IQR: 25–75%: 31.5–65.4) and 46 (IQR: 25–75%: 32.3–56.2), respectively, but this difference was not statistically significant (p = 0.81).

Conclusion

The results of this study suggest that HFNO treatment does not have a significant advantage over NBO treatment in the carbon monoxide elimination rate within the first 60 min of treatment.

Rose JJ, Wang L, Xu Q et al (2017) Carbon monoxide poisoning: pathogenesis, management, and future directions of therapy. Am J Respir Crit Care Med 195:596–606CrossRefPubMedPubMedCentral

Roth D, Schreiber W, Herkner H, Havel C (2014) Prevalence of carbon monoxide poisoning in patients presenting to a large emergency department. Int J Clin Pract 68:1239–1245CrossRefPubMed

Kim YM, Shin HJ, Choi DW et al (2020) Comparison of high-flow nasal cannula oxygen therapy and conventional reserve-bag oxygen therapy in carbon monoxide intoxication: A pilot study. Am J Emerg Med 38(8):1621–1626. https://doi.org/10.1016/j.ajem.2019.158451CrossRefPubMed

Gedikli U, Emektar E, Corbacioglu SK et al (2019) Determination of netrin‑1 levels and its relationship with neurotoxicity in carbon monoxide poisoning. Hum Exp Toxicol 38(5):561–566. https://doi.org/10.1177/0960327119828124CrossRefPubMed

Roderique JD, Josef CS, Feldman MJ, Spiess BD (2015) A modern literature review of carbon monoxide poisoning theories, therapies, and potential targets for therapy advancement. Toxicology 334:45–58CrossRefPubMed

Dagar S, Emektar E, Uzunosmanoglu H et al (2019) Clinical uses of lactate and lactate clearance in carbon monoxide poisoning. Istanbul Med J 20(6):519-23. https://doi.org/10.4274/imj.galenos.2019.10170

Kao LW, Nañagas KA (2004) Carbon monoxide poisoning. Emerg Med Clin North Am 22:985–1018CrossRefPubMed

Weaver LK, Howe S, Hopkins R et al (2000) Carboxyhemoglobin half-life in carbon monoxide-poisoned patients treated with 100 % oxygen at atmospheric pressure. Chest 117:801–808CrossRefPubMed

Pace N, Strajman E, Walker EL (1950) Acceleration of carbon monoxide elimination in man by high pressure oxygen. Science 111:652–654CrossRefPubMed

10.

Wolf SJ, Maloney GE, Shih RD et al (2017) Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with acute carbon monoxide poisoning. Ann Emerg Med 69:98–107.e6CrossRefPubMed

11.

Weaver LK, Deru K (2017) Carboxyhemoglobin half-life during hyperbaric oxygen in a patient with lung dysfunction: a case report. Undersea Hyperb Med 44:173–177CrossRefPubMed

12.

Turgut K, Yavuz E (2020) Comparison of non-invasive CPAP with mask use in carbon monoxide poisoning. Am J Emerg Med 38(7):1454–1457. https://doi.org/10.1016/j.ajem.2020.04.050CrossRefPubMed

13.

Nishimura M (2016) High-flow nasal cannula oxygen therapy in adults: physiological benefits, indication, clinical benefits, and adverse effects. Respir Care 61(4):529–541CrossRefPubMed

14.

Gulen M, Satar S, Yesiloglu O, Avci A, Acehan S (2020) High-flow nasal cannula oxygen therapy in the management of acute respiratory distress syndrome secondary to opioid overdose. Turk J Emerg Med 21(1):30–33CrossRefPubMedPubMedCentral

15.

Yesiloglu O, Gulen M, Satar S, Avci A, Acehan S, Akoglu H (2021) Treatment of carbon monoxide poisoning: high-flow nasal cannula versus non-rebreather face mask. Clin Toxicol 59(5):386–391CrossRef

16.

Tomruk O, Karaman K, Erdur B et al (2019) A new promising treatment strategy for carbon monoxide poisoning: high flow nasal cannula oxygen therapy. Med Sci Monit 25:605–609CrossRefPubMedPubMedCentral

17.

Ozturan IU, Yaka E, Suner S et al (2019) Determination of carboxyhemoglobin half-life in patients with carbon monoxide toxicity treated with high flow nasal cannula oxygen therapy. Clin Toxicol 57(7):617–623. https://doi.org/10.1080/15563650.2018.1540046CrossRef

Titel: Comparing high-flow nasal oxygen therapy and normobaric oxygen therapy on the treatment of carbon monoxide poisoning
verfasst von: Sedat Akkan, MD
Ömür Uyanik, MD
Publikationsdatum: 02.08.2023
Verlag: Springer Medizin
Erschienen in: Medizinische Klinik - Intensivmedizin und Notfallmedizin / Ausgabe 3/2024
Print ISSN: 2193-6218
Elektronische ISSN: 2193-6226
DOI: https://doi.org/10.1007/s00063-023-01044-5

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Comparing high-flow nasal oxygen therapy and normobaric oxygen therapy on the treatment of carbon monoxide poisoning

Abstract