Hyperbaric oxygen therapy is indicated for carbon monoxide poisoning in which scenario?

• A. Hyperbaric oxygen therapy in selected cases with severe poisoning or neurologic symptoms
• B. Standard care with room air
• C. Immediate dialysis
• D. No therapy

Answer: (A)

In carbon monoxide poisoning, the goal is to rapidly reverse tissue hypoxia by displacing CO from hemoglobin and improving oxygen delivery to tissues. While giving 100% oxygen promptly is standard care, hyperbaric oxygen therapy is reserved for selected patients with severe poisoning or neurologic symptoms because it clears CO from the body more quickly and enhances brain oxygenation. Under high-pressure hyperbaric conditions, the dissolved oxygen in plasma increases dramatically, which accelerates CO elimination and lowers the carboxyhemoglobin half-life, reducing the risk of delayed neurologic injury. This is why hyperbaric oxygen therapy is indicated in those more serious presentations rather than as routine treatment for every CO exposure. Standard room-air care would be insufficient for these high-risk cases, while dialysis isn’t a treatment for CO poisoning, and doing nothing would leave patients at ongoing risk.