Différences entre versions de « Intoxication au monoxyde de carbone »
| Ligne 4 : | Ligne 4 : | ||
* Carboxyhémoglobinémie normale: '''<3%''' | * Carboxyhémoglobinémie normale: '''<3%''' | ||
* Carboxyhémoglobinémie chez les fumeurs: '''10%-15%''' | * Carboxyhémoglobinémie chez les fumeurs: '''10%-15%''' | ||
| + | |||
| + | == Physiopathologie == | ||
| + | * Demi-vie approximative d'élimination du CO<ref>ATLS 11e éd</ref>: | ||
| + | ** à l'air ambiant '''4 heures''' | ||
| + | ** sous masque à réserve 100%: '''40-50 minutes''' | ||
== Traitement == | == Traitement == | ||
| + | === Carboxyhémoglobinémie inconnue === | ||
| + | * Traitement présomptif par O2 100% durant '''4-6 heures'''<ref>ATLS 11e éd</ref> | ||
| + | === Carboxyhémoglobinémie | ||
* Patients with high levels of carboxyhemoglobin (25% and greater) and evidence of organ ischemia should be treated with hyperbaric oxygen if possible. | * Patients with high levels of carboxyhemoglobin (25% and greater) and evidence of organ ischemia should be treated with hyperbaric oxygen if possible. | ||
* Methylene blue would be recommended for toxic levels of methemoglobin, usually 20% to 30% or higher. | * Methylene blue would be recommended for toxic levels of methemoglobin, usually 20% to 30% or higher. | ||
Version du 13 août 2026 à 22:32
Cited indications for hyperbaric oxygen therapy include loss of consciousness, ischemic cardiac changes, neurological deficits, significant metabolic acidosis, or carboxyhemoglobin level greater than 25%. A carboxyhemoglobin level of 50% is critical and needs to be reduced as quickly as possible. Breathing 100% oxygen at normal atmospheric pressure, this patient will clear the carboxyhemoglobin with a half-life of 90 minutes, but hyperbaric oxygen therapy will lower the half-life to 30 minutes. Also, there is considerable risk of delayed neurocognitive impairment following a severe exposure such as this, and hyperbaric oxygen is believed to lower the risk of this long-term complication, although the strength of this evidence is disputed.[1]
Définition
- Carboxyhémoglobinémie normale: <3%
- Carboxyhémoglobinémie chez les fumeurs: 10%-15%
Physiopathologie
- Demi-vie approximative d'élimination du CO[2]:
- à l'air ambiant 4 heures
- sous masque à réserve 100%: 40-50 minutes
Traitement
Carboxyhémoglobinémie inconnue
- Traitement présomptif par O2 100% durant 4-6 heures[3]
=== Carboxyhémoglobinémie
- Patients with high levels of carboxyhemoglobin (25% and greater) and evidence of organ ischemia should be treated with hyperbaric oxygen if possible.
- Methylene blue would be recommended for toxic levels of methemoglobin, usually 20% to 30% or higher.
Références
- ↑ https://mksap18.acponline.org/app/topics/pm/mk18_b_pm_s13/mk18_b_pm_s13_7_2
- ↑ ATLS 11e éd
- ↑ ATLS 11e éd
