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Carbon monoxide poisoning - Management
Basis for recommendation
These recommendations are based on expert opinion [Varon and Marik, 1997; HPA, 2007a; CMO, 2008; NPIS, 2008].
Admission
- Admission is recommended by experts for:
- Treatment with 100% oxygen.
- Assessment and management of metabolic acidosis.
- Assessment and management of hypoxic injury, especially to the heart and central nervous system.
Treatment with oxygen
- Treatment with oxygen is recommended because breathing 100% oxygen is known to reduce the half-life of carboxyhaemoglobin, and is considered to be effective by experts [NPIS, 2008; Smollin and Olson, 2008].
- CKS found no studies proving the benefit of 100% oxygen compared with air or lower concentrations of oxygen, but such studies are unlikely to be undertaken on ethical grounds.
- Treatment with hyperbaric oxygen is not currently recommended, because there is insufficient evidence that hyperbaric oxygen therapy improves long-term outcomes of people with severe carbon monoxide poisoning, compared with standard oxygen therapy [NPIS, 2008].
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