In carbon monoxide poisoning, what therapy may be used beyond high-flow oxygen?

• A. Hyperbaric oxygen therapy
• B. Dialysis
• C. Platelet transfusion
• D. Antivenom

Answer: (A)

Hyperbaric oxygen therapy is added beyond high-flow oxygen in carbon monoxide poisoning because it more rapidly eliminates the toxin and improves oxygen delivery to tissues.

CO binds hemoglobin with high affinity, forming carboxyhemoglobin and reducing oxygen delivery to tissues. While 100% oxygen speeds dissociation compared with room air, hyperbaric oxygen at high pressure dramatically increases dissolved oxygen in plasma and accelerates the return of hemoglobin to its normal state much faster. This helps prevent or lessen neurologic injury and other serious effects, especially in patients with neurological symptoms, loss of consciousness, or pregnancy.

Other options don’t address the underlying problem. Dialysis isn’t effective for removing CO from hemoglobin. Platelet transfusion and antivenom have no role in CO poisoning, since the issue is CO bound to hemoglobin rather than a toxin that dialysis or antivenoms can remove.