Utility of High Flow Nasal Cannula in CO Toxicity

Determination of Half-life of the Carboxyhemoglobin Level and Utility of High Flow Nasal Cannula in Carbon Monoxide Toxicity in the Emergency Department

determination of the half-life of COHb in CO-poisoned patients with high flow nasal oxygen therapy in the ED.

Carbon monoxide (CO) poisoning is common and potentially fatal environmental emergency which requires immediate attention. It is responsible for up to 40,000 emergency department (ED) visits and 5000 to 6000 deaths per year, making it one of the leading causes of poisoning death in the United States. The management options for CO poisoning are limited to high flow oxygen by face mask or hyperbaric oxygen treatment. While half-life of carboxyhemoglobin (COHb) in a patient treating with high flow oxygen via a nonbreathing face mask is 90 minutes, it becomes 30 minutes with hyperbaric oxygen treatment (HBO).

The hypothesis of this study is using high flow nasal oxygen therapy in the CO poisoning may be more effective and safer treatment method comparing to standard oxygen therapy in the ED. Also, it may be a safe promising alternative of hyperbaric oxygen therapy.

The aim of the study is to determine the half-life of COHb in CO-poisoned patients with high flow nasal oxygen therapy in the ED.

Inclusion Criteria:

• The patients who are admitted to the emergency department with CO poisoning with a CoHB level of >10%.
• The patients who accept to participate in the study.

Exclusion Criteria:

• The patients who are <18 years old.
• The patients who need mechanical ventilation
• The patients who are implemented oxygen more than 30 minutes before the ED admission
• The patients who will be transferred to the hyperbaric oxygen center before the CoHB levels are decreased to the half.