Optimization of Treatment Policy for Acute Carbon Monoxide Poisoning

Abstract

Objective: to evaluate the efficiency of combination use of hyperbaric oxygenation, succinate-containing solutions, and anti-edematous agents in patients with acute carbon monoxide poisoning. Subjects and methods. The results of treatment were analyzed in 32 patients admitted in 2009—2011 for severe acute carbon monoxide poisoning and a Glasgow coma score of 6—8. The patients were divided into 2 groups: 1) patients whose combination therapy involved hyperbaric oxygenation, Succinasol infusions, and L-lysine-aescinate injections; 2) those who received traditional therapy. All the patients underwent complex clinical, laboratory, and neurophysiologic examinations. Results. Just 24 hours after the combination use of Succinasol and L-lysine-aescinate, Group I patients were observed to have substantially reduced lactate, the content of the latter approached the normal value following 48 hours, which was much below the values in the control group. The similar pattern was observed when endogenous intoxication parameters were examined. During the performed therapy, the level of consciousness and that of intellect according to the MMSE and FAB scales were restored more rapidly in the study group patients than in Group 2. Conclusion. The combination use of hyperbaric oxygenation, the succinate-containing solution Succinasol, and the anti-edematous agent L-lysine-aescinate considerably enhances the efficiency of intensive therapy for acute carbon monoxide poisoning. Key words: carbon monoxide, toxic hypoxic encephalopathy, combination therapy, hyperbaric oxygenation, succinic acid, L-lysine-aescinate.