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Comparing high-flow nasal oxygen therapy and normobaric oxygen therapy on the treatment of carbon monoxide poisoning

Vergleich von nasaler High-Flow-Sauerstofftherapie und normobare Sauerstofftherapie zur Behandlung von Kohlenmonoxidvergiftung

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Abstract

Aim

We aimed to investigate whether there is a difference in the rate of decrease in carboxyhemoglobin (COHB) values between high-flow nasal oxygen (HFNO) and normobaric oxygen (NBO) therapy.

Material and method

This retrospective observational study included patients with carbon monoxide poisoning who were treated with HFNO or NBO (control group). All patients were started on NBO therapy with a non-rebreather face mask at a rate of 15 L/min. In the NBO group, NBO treatment was continued until the COHB value fell below 10%. In the HFNO group, as soon as the preparation of the HFNO device was completed, NBO treatment was terminated and HFNO treatment was started and continued until the COHB value fell below 10%. The primary outcome of the study was the difference between HFNO and NBO in terms of COHB half-life rates.

Results

A total of 81 patients were included in the study, 44 in the HFNO group and 37 in the NBO group. The median of COHB t1/2 values between HFNO and the NBO treatment groups were 47.3 (IQR: 25–75%: 31.5–65.4) and 46 (IQR: 25–75%: 32.3–56.2), respectively, but this difference was not statistically significant (p = 0.81).

Conclusion

The results of this study suggest that HFNO treatment does not have a significant advantage over NBO treatment in the carbon monoxide elimination rate within the first 60 min of treatment.

Zusammenfassung

Ziel

Ziel der vorliegenden Studie war es zu untersuchen, ob ein Unterschied der Abnahmerate von Werten für Carboxyhämoglobin (COHB) zwischen nasaler High-Flow- (HFNO) und normobarer Sauerstofftherapie (NBO) besteht.

Material und Methoden

In diese retrospektive Beobachtungsstudie wurden Patienten mit Kohlenmonoxidvergiftung eingeschlossen, die mit HFNO oder NBO (Kontrollgruppe) behandelt wurden. Alle Patienten begannen mit NBO-Therapie mit einer Nichtrückatmungsmaske bei einer Rate von 15 l/min. In der NBO-Gruppe wurde NBO-Therapie fortgeführt, bis der COHB-Wert unter 10% fiel. In der HFNO-Gruppe wurde die NBO-Therapie beendet, sobald die Vorbereitung des HFNO-Geräts abgeschlossen war, und mit der HFNO-Therapie begonnen, diese wurde fortgesetzt, bis der COHB-Wert unter 10% fiel. Der primäre Endpunkt der Studie bestand aus dem Unterschied zwischen HFNO und NBO in Bezug auf die Halbwertszeiten für COHB.

Ergebnisse

In die Studie wurden 81 Patienten eingeschlossen, 44 in der HFNO-Gruppe und 37 in der NBO-Gruppe. Der Mittelwert der Werte für COHB t1/2 betrug im Vergleich zwischen HFNO- und NBO-Therapie 47,3 (Interquartilsabstand, IQR, 25–75%: 31,5–65,4) bzw. 46 (IQR 25–75%: 32,3–56,2), aber dieser Unterschied war nicht statistisch signifikant (p = 0,81).

Schlussfolgerung

Den Ergebnissen der vorliegenden Studie zufolge weist die HFNO-Therapie keinen signifikanten Vorteil gegenüber der NBO-Therapie hinsichtlich der Kohlenmonoxideliminationsrate innerhalb der ersten 60 min der Behandlung auf.

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Authors and Affiliations

  1. Elbistan State Hospital, Department of Emergency Medicine, Kahramanmaraş, Turkey

    Sedat Akkan MD & Ömür Uyanik MD

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  1. Sedat Akkan MD
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  2. Ömür Uyanik MD
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Contributions

All authors: Conceived and designed the experiments, performed the experiments, analyzed and interpreted the data, contributed reagents, materials, analysis tools or data, wrote the paper.

Corresponding author

Correspondence to Sedat Akkan MD.

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Conflict of interest

S. Akkan and Ö. Uyanik declare that they have no competing interests.

All procedures performed in studies involving human participants or on human tissue were in accordance with the local ethical committee and ethic committee of Turkish Medicines and Medical Devices Agency (Kahramanmaras Sutcu Imam University, local ethical committee) and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Michael Buerke, Siegen

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The SPSS files can be made available.

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Akkan, S., Uyanik, Ö. Comparing high-flow nasal oxygen therapy and normobaric oxygen therapy on the treatment of carbon monoxide poisoning. Med Klin Intensivmed Notfmed 119, 214–219 (2024). https://doi.org/10.1007/s00063-023-01044-5

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  • DOI: https://doi.org/10.1007/s00063-023-01044-5

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