page_title: Carbon monoxide poisoning
section_title: Hyperbaric oxygen
hierarchical_section_title: Carbon monoxide poisoning / Treatment / Hyperbaric oxygen
caption_attribution_description: English: Picture taken by myself of our Sechrist hyperbaric chamber at the Moose Jaw Union Hospital, Saskatchewan, Canada. Permission to photograph the subject for Wikipedia granted. Picture taken July 11, 2008.
context_page_description: Carbon monoxide poisoning typically occurs from breathing in carbon monoxide at excessive levels. Symptoms are often described as "flu-like" and commonly include headache, dizziness, weakness, vomiting, chest pain, and confusion. Large exposures can result in loss of consciousness, arrhythmias, seizures, or death. The classically described "cherry red skin" rarely occurs. Long term complications may include feeling tired, trouble with memory, and movement problems. In those exposed to smoke, cyanide toxicity should also be considered.
  Carbon monoxide poisoning can occur accidentally, as an attempt to end one's own life, or as an attempt to end another's life. CO is a colorless and odorless gas which is initially non-irritating. It is produced during incomplete burning of organic matter. This can occur from motor vehicles, heaters, or cooking equipment that run on carbon-based fuels. It can also occur from exposure to methylene chloride. Carbon monoxide primarily causes adverse effects by combining with hemoglobin to form carboxyhemoglobin preventing the blood from carrying oxygen. Additionally, myoglobin and mitochondrial cytochrome oxidase are affected.
context_section_description: Hyperbaric oxygen is also used in the treatment of carbon monoxide poisoning, as it may hasten dissociation of CO from carboxyhemoglobin and cytochrome oxidase to a greater extent than normal oxygen. Hyperbaric oxygen at three times atmospheric pressure reduces the half life of carbon monoxide to 23 (~80/3 minutes) minutes, compared to 80 minutes for oxygen at regular atmospheric pressure. It may also enhance oxygen transport to the tissues by plasma, partially bypassing the normal transfer through hemoglobin. However, it is controversial whether hyperbaric oxygen actually offers any extra benefits over normal high flow oxygen, in terms of increased survival or improved long-term outcomes. There have been randomized controlled trials in which the two treatment options have been compared; of the six performed, four found hyperbaric oxygen improved outcome and two found no benefit for hyperbaric oxygen. Some of these trials have been criticized for apparent flaws in their implementation. A review of all the literature concluded that the role of hyperbaric oxygen is unclear and the available evidence neither confirms nor denies a medically meaningful benefit. The authors suggested a large, well designed, externally audited, multicentre trial to compare normal oxygen with hyperbaric oxygen.
caption: A person within a hyperbaric oxygen chamber
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