CHEST Guidelines-Justifying-Hyperbaric-Oxygen-Delivery-for-Carbon-M (1)

Justifying-Hyperbaric-Oxygen-Delivery-for-Carbon-M (1)

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The article discusses the contentious use of Hyperbaric Oxygen Therapy (HBOT) for treating carbon monoxide (CO) poisoning, a significant global health issue. CO binds with hemoglobin to form carboxyhemoglobin, causing tissue hypoxia even at low concentrations. While administration of 100% normobaric oxygen is standard for CO exposure, HBOT’s effectiveness compared to standard oxygen delivery remains debated.<br /><br />Historically, the effectiveness of HBOT has been questioned due to its promotion without robust scientific backing, often bundled with pseudo-scientific medical practices. This skepticism dates back to the 17th century with Nathaniel Henshaw and further displayed through the unvalidated large-scale initiatives in the 1920s by Orval J. Cunningham. These early setbacks hindered HBOT’s credibility despite its demonstrated efficacy in treating decompression sickness and emerging research supporting its broader therapeutic potential.<br /><br />Recent studies have tried to establish HBOT’s efficacy for CO poisoning, primarily focusing on its ability to expedite carboxyhemoglobin dissociation and provide neurological benefits at the cellular level. However, previous research faced criticism for soft endpoints, lack of clear population definitions, and limited cohort sizes.<br /><br />A study by Huang et al., utilizing a substantial Taiwanese database, suggests a reduction in mortality rates for CO poisoning victims treated with HBOT. This study adjusted for variables like age and comorbidities, highlighting its potential benefits over normobaric oxygen treatments. Yet, the absence of precise data on CO exposure levels and carboxyhemoglobin concentrations remains a limitation.<br /><br />While the findings provide encouraging support for HBOT, they underline the necessity of a large-scale, randomized controlled trial to definitively compare HBOT with standard oxygen therapies, addressing costs, accessibility, and treatment protocol standardization. Such a trial is essential for validating HBOT’s role in managing CO poisoning and guiding future clinical practices.

Keywords

Hyperbaric Oxygen Therapy

carbon monoxide poisoning

carboxyhemoglobin

tissue hypoxia

normobaric oxygen

therapeutic potential

neurological benefits

mortality rates

randomized controlled trial

treatment protocol standardization