Document Type
Case Report
Disciplines
Higher Education | Medical Neurobiology | Medical Physiology | Medical Toxicology | Medicine and Health Sciences | Other Medical Specialties | Other Rehabilitation and Therapy | Physiological Processes
Abstract
Introduction: Carbon monoxide (CO) poisoning is caused when carbon monoxide builds up in the blood, most specifically due to its high binging affinity for the heme structure in hemoglobin.1 This can lead to serious tissue damage and even be fatal. CO poisoning is primarily the result of incomplete combustion of fuels, with common sources domestically and internationally including furnaces, gas heaters, generators, and motor vehicles.2 Symptoms tend to present as neuropsychiatric symptoms, such as dementia, psychosis, parkinsonism, and incontinence. There are few well-researched CO poisoning specific treatments, which suggest supplemental oxygen and hyperbaric oxygen being most effective. We present a case of CO poisoning in two individuals who were both treated with hyperbaric oxygen therapy,
Background: Two patients (83-year-old male, 74-year-old female) presented to the emergency department secondary to accidental carbon monoxide poisoning. On scene, emergency services confirmed high Carboxyhemoglobin (COHb) of 35%, and with a Glasgow Coma Scale (GCS) of 4/15 and 3/15 for the male and female respectively; they were subsequently intubated and transferred for emergent hyperbaric oxygen treatment. Due to the post CO non-traumatic brain injury sustained, they were eventually admitted to an inpatient rehabilitation (IPR). On admission, both were fully orientated with progressive improvement of cognition through the initial 2 weeks of their stay. Both patients experienced a drastic cognitive decline deemed to be a delayed post-CO exposure sequalae, which started week two of the female’s IPR stay and two months post-IPR for the male,
Results: Both patients suffered late onset neuropsychiatric encephalopathic effects secondary to carbon monoxide poisoning despite acute aggressive hyperbaric oxygen treatment right after initial injury.
Conclusion: Aggressive hyperbaric treatment has been shown to improve cognitive functioning. For these patients, the effects of hyperbaric treatment did not prevent the progression of delayed onset carbon monoxide induced encephalopathy.
DOI
https://doi.org/10.32873/unmc.dc.gmerj.7.1.002
Keywords
carbon monoxide, carbon monoxide poisoning, hyperbaric oxygen treatment, hypoxic brain injury, inpatient rehab
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Recommended Citation
Kasha, S., Naber, W. J., , Reimer, M. A Rare Delayed Neuropsychiatric Encephalopathy After Hyperbaric Oxygen Treatment for Carbon Monoxide Poisoning: A Couple’s Case Report. Graduate Medical Education Research Journal. 2025 Jun 27; 7(1).
https://digitalcommons.unmc.edu/gmerj/vol7/iss1/2
Included in
Higher Education Commons, Medical Neurobiology Commons, Medical Physiology Commons, Medical Toxicology Commons, Other Medical Specialties Commons, Other Rehabilitation and Therapy Commons, Physiological Processes Commons
