Hyperbaric Oxygen Missing in Treatment of Airplane Passengers

Yesterday we blogged about the carbon monoxide poisoning on a plane to Denver that was diverted to Tulsa. We are unhappy with the outcome of the poisoning. More people should have been taken to the hospital. The best known treatment for carbon monoxide poisoning is hyperbaric oxygen in a hospital setting.

The patient is delivered 100 percent oxygen in a total body chamber, where pressure is increased and controlled. Since only one person was taken to the hospital, it is unlikely that the patients received the treatment they needed and deserved.

Hyperbaric oxygen treatment is shown to decrease the delayed neurological sequelae (DNS) that can occur after a poisoning. DNS might include problems with memory, attention, concentration, or affect. It can occur immediately after the poisoning or in the following days and weeks. DNS typically occurs within the 20 days after the carbon monoxide poisoning.

The benefits of hyperbaric oxygen treatment are increasing dissolved oxygen in the blood and accelerated elimination of carbon monoxide, according to a 2002 study in The New England Journal of Medicine. The study was led by Dr. Lindell Weaver.

Another benefit includes preventing lipid peroxidation in the brain. Lipid peroxidation means that there is a degradation of lipids, resulting in cell damage. Also hyperbaric oxygen treatment involves preservation of ATP levels in tissue exposed to carbon monoxide. ATP is the source of energy that keeps everything going in one’s body.

However, the procedure of hyperbaric oxygen is not totally risk free. The transport of the patient to the hospital can be risky. Also the patient may have hyperoxic seizures, where there is too much oxygen. Damage to the ears or the lungs may also be involved due to the change in air pressure.

In Weaver’s study, 152 patients had been enrolled split up into hyperbaric oxygen group and normobaric oxygen group. At six weeks, DNS were less frequent in the hyperbaric oxygen group at 25 percent than in the normobaric oxygen group at 46.1 percent. Normobaric oxygen is operated at one atmosphere, while hyperbaric oxygen is operated at a higher pressure.

The response to the carbon monoxide poisoning on the Delta flight was disappointing. With this research out there, the responders should have been more aware of what kind of treatment that this kind of poisoning needs. The risk of not treating the carbon monoxide poisoning unfortunately involves brain damage.