Dr. Cheung Wai Man, Intensive Care Unit, Department of Medicine and Geriatrics, Caritas Medical Centre.
Abstract
Carbon monoxide poisoning is a common problem encountered in our clinical practice. The mainstay of management is supplemental oxygen and other supportive therapy. There was much debate over the use of hyperbaric oxygen in acute carbon monoxide poisoning. In this dissertation, various aspects of carbon monoxide poisoning such as epidemiology, pathophysiology, clinical features, diagnosis and management pitfalls are reviewed. An overview of hyperbaric oxygen therapy, its potential complications and precautions are discussed. Current evidence, area of controversy and unresolved issues about this therapy as compared with normobaric oxygen are addressed. Statistics concerning hospital admissions due to acute carbon monoxide poisoning, mortality statistics from Coroner’s court and statistics on the use of hyperbaric oxygen therapy in Hong Kong is presented in the second part of this dissertation. A sharp increase in incidence and mortality rate was noted since 1999. The use of hyperbaric oxygen therapy is about 10% for those who were admitted. A retrospective case review on carbon monoxide poisoned patients admitted to Caritas Medical Centre in past 5 years will be presented in the third part of this dissertation. Lastly, use of hyperbaric oxygen therapy in Hong Kong will be discussed.