TREATMENT OF SMOKE INHALATION BY HYPERBARIC OXYGEN

Abstract-Five patients with smoke inhala tion from house fires presented to the hospital in a comatose state. Carboxyhemoglobin levels were elevated in all five patients, mean = 32% f 6. Arterial blood gases revealed the following means: pH 7.16 &O&i; PC& 35 mm HG f 10.5; HCOJ 12.6 mEq/L kO.07; base excess – 16 mEq/L f 1.58; PO, 353 mm Hg + 149; 0, sat uration 66% f 5.5. The patients were presumed to have both cyanide and carbon monoxide in toxication and were treated with the cyanide an tidote kit and hyperbaric oxygen (HBO). Four of five patients awoke within 15 minutes of reaching maximum pressure and remained neu rologically intact thereafter. The fifth patient died one week later. Cyanide blood levels drawn prior to treatment revealed a mean of 1.62 pg/ mL f 1.44. The highest cyanide level was 3.9 pg/ mL (the death) and the lowest 0.35 rg/mL. We conclude that smoke inhalation can result in acute cyanide poisoning and that hyperbaric ox ygen is a useful adjunct in the treatment of smoke inhalation.