Différences entre versions de « Intoxication au monoxyde de carbone »
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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.<ref>https://mksap18.acponline.org/app/topics/pm/mk18_b_pm_s13/mk18_b_pm_s13_7_2</ref> | 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.<ref>https://mksap18.acponline.org/app/topics/pm/mk18_b_pm_s13/mk18_b_pm_s13_7_2</ref> | ||
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| + | == Définition == | ||
| + | * Carboxyhémoglobinémie normale: '''<3%''' | ||
| + | * Carboxyhémoglobinémie chez les fumeurs: '''10%-15%''' | ||
== Traitement == | == Traitement == | ||
| − | Methylene blue would be recommended for toxic levels of methemoglobin, usually 20% to 30% or higher | + | * 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 == | == Références == | ||
Version actuelle datée du 11 février 2020 à 14:33
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%
Traitement
- 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.
