Lindell K. Weaver, M.D., New England Journal of Medicine, Volume 360: 1217-1225, 19 March, 2009
A 39-year-old female executive has a several-month history of fatigue, headache, and memory lapse. Multiple specialists have performed evaluations, but no diagnosis has been established. During a period of feeling worse than usual, she called a friend, who arrived at the residence to find the woman semicomatose and called 911. The patient was given supplemental oxygen and transported to the emergency department, where she is alert and has nonfocal findings on examination. Her carboxyhemoglobin level is 18%. How should she be
treated? What is the expected outcome?
Editor’s note: Dr Weaver is the author of the following paper – Lindell K. Weaver, M.D., Ramona O. Hopkins, Ph.D., Karen J. Chan, B.S., Susan Churchill, N.P., C. Gregory Elliott, M.D., Terry P. Clemmer, M.D., James F. Orme, Jr., M.D., Frank O. Thomas, M.D., and Alan H. Morris, M.D. Hyperbaric Oxygen for Acute Carbon Monoxide Poisoning. Volume 347:1057-1067 October 3, 2002 Number 14 (free full text at the NEJM website here ). According to Dr Weaver, among the published randomized clinical trials of hyperbaric oxygen so far, only the above one satisfied all Consolidated Standards for the Reporting of Trials (CONSORT) guidelines, including double-blinding, enrollment of all eligible patients, a priori definitions of outcomes, and high rates of follow-up.
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