Carbon monoxide (CO) is odorless, colorless, tasteless, and nonirritating gas. Hence, mild CO poisoning often remains unrecognized and appears lethally. Carbon and gas systems, unfavorable architectural designs and machines may also cause intoxications. The prevalence rates in Hungary ranged from 2.37 to 3.80 cases per 100,000 people per year between 2013 and 2015; fatality rates have been decreased from 5.96 in 2013 to 3.38 in 2015. Given the vagueness and the broad spectrum of complaints, misdiagnosis of CO toxicity is common. The gold standard diagnosis is detecting the level of circulating carboxyhemoglobin (CO-Hgb). The measurement of CO-Hgb can be performed via blood-gas analyses or by spectrophotometry. Treatment protocol should follow the ACBDE rule. Administration of 100% oxygen should be performed as soon as possible. Later in-hospital management includes evaluation, treatment and prevention of further peripheral organ damage and long-term neurological complications. Fetuses and children are prone to suffer more severe intoxication due to higher oxygen demand. Though hyperbaric oxygen is the mainstay therapy, a prompt cesarean section is effective in preventing further intoxication. In conclusion, fatal CO intoxication can occur due to plain early signs and symptoms. Hyperbaric oxygen therapy should be considered in severe intoxication, in fetal and children.
Part of the book: Poisoning
Hyperbaric oxygen therapy (HBOT) is a state-of-the-art medical treatment, which is proved to be beneficial in a number of diseases and promising in new fields as well. HBOT is evidence-based treatment for, among others, severe CO intoxication, decompression disease and chronic wound healing. Recent studies promise beneficial effects of HBOT in multiple sclerosis. In vitro, cellular models of these complex pathological conditions are limited. In this chapter, we aim to mirror in vitro effects of HBOT and other altered oxygen levels on endothelial cells, fibroblast, mesenchymal and pluripotent stem cells. Through these in vitro models, the role of HBOT in angiogenesis, blot clotting, wound healing, cell therapy and tissue engineering will be discussed. To summarize in vitro effects of HBOT, it has beneficial role on proliferation and viability of most cell types. Furthermore, functional characteristics of the investigated cell types, for example, angiogenesis by endothelial cells, are improved in response to HBOT. Standardized preclinical protocols with HBOT help to translate the benefits to clinical trials and clinical use.
Part of the book: Hyperbaric Oxygen Treatment in Research and Clinical Practice