Order this document
MMWR Morb Mortal Wkly Rep 2002 Sep 20;51(37):829-30
Carbon monoxide (CO) is an odorless, colorless gas produced from the incomplete combustion of carbon-based fuels such as gasoline or wood. In the United States, CO poisoning causes approximately 500 unintentional deaths each year. Although CO poisonings often have been reported to occur in enclosed and semi-enclosed environments, they can also occur in open-air environments. This report describes two related cases of CO poisoning that occurred in children who were participating in recreational activities on a ski boat. Recreational boaters should be aware of the dangers of open-air CO poisoning, and engineering solutions are needed to reduce the amount of CO in boat exhaust.
PMID: 12353743, UI: 22240735
Other Formats: Links:
N Engl J Med 2002 Oct 3;347(14):1105-6
Publication Types:
PMID: 12362013, UI: 22249315
N Engl J Med 2002 Oct 3;347(14):1057-67
Department of Internal Medicine, Pulmonary and Critical Care Division, LDS Hospital, Salt Lake City, Utah 84143, USA. lweaver@ihc.com
BACKGROUND: Patients with acute carbon monoxide poisoning commonly have cognitive sequelae. We conducted a double-blind, randomized trial to evaluate the effect of hyperbaric-oxygen treatment on such cognitive sequelae. METHODS: We randomly assigned patients with symptomatic acute carbon monoxide poisoning in equal proportions to three chamber sessions within a 24-hour period, consisting of either three hyperbaric-oxygen treatments or one normobaric-oxygen treatment plus two sessions of exposure to normobaric room air. Oxygen treatments were administered from a high-flow reservoir through a face mask that prevented rebreathing or by endotracheal tube. Neuropsychological tests were administered immediately after chamber sessions 1 and 3, and 2 weeks, 6 weeks, 6 months, and 12 months after enrollment. The primary outcome was cognitive sequelae six weeks after carbon monoxide poisoning. RESULTS: The trial was stopped after the third of four scheduled interim analyses, at which point there were 76 patients in each group. Cognitive sequelae at six weeks were less frequent in the hyperbaric-oxygen group (19 of 76 [25.0 percent]) than in the normobaric-oxygen group (35 of 76 [46.1 percent], P=0.007), even after adjustment for cerebellar dysfunction and for stratification variables (adjusted odds ratio, 0.45 [95 percent confidence interval, 0.22 to 0.92]; P=0.03). The presence of cerebellar dysfunction before treatment was associated with the occurrence of cognitive sequelae (odds ratio, 5.71 [95 percent confidence interval, 1.69 to 19.31]; P=0.005) and was more frequent in the normobaric-oxygen group (15 percent vs. 4 percent, P=0.03). Cognitive sequelae were less frequent in the hyperbaric-oxygen group at 12 months, according to the intention-to-treat analysis (P=0.04). CONCLUSIONS: Three hyperbaric-oxygen treatments within a 24-hour period appeared to reduce the risk of cognitive sequelae 6 weeks and 12 months after acute carbon monoxide poisoning. Copyright 2002 Massachusetts Medical Society
PMID: 12362006, UI: 22249308
N Engl J Med 2002 Oct 3;347(14):1054-5
Duke University Medical Center, Durham, NC 27710, USA.
PMID: 12362005, UI: 22249307
the above reports in Macintosh PC UNIX Text HTML format documents on this page through Loansome Doc