We would like to thank the authors and the scientific societies for their constructive letters and the legitimate objection to an entry in Table 2 in our review (1). Our wording “NBOT or HBOT (no recommendation)“ should be replaced by the more precise statement “either NBOT or HBOT—no clear recommendation of the expert panel“ to prevent any misunderstanding.
In general, our article is meant to be a review of existing decisions of expert panels on the treatment of carbon monoxide poisoning. However, it also evaluates the current and partly not yet reviewed literature itself. Therefore, contrary to the opinion of the American College of Emergency Physicians, we regard the cheap indicative measurement of the carbon monoxide fraction using pulse oximetry as useful in the rescue service setting. Likewise, we think that HBOT is indicated in pregnant women. This view is based on the considerations regarding the oxygen binding curve and the case reports mentioned. Nevertheless, when we created this article, we considered it crucial to take an objective and individualized approach.
We would like to thank the authors and the scientific societies for their discussion of our article. We are also grateful for the supporting case report on the use of non-invasive mechanical ventilation. The case report mentioned also supports treatment with CPAP, which we recommended in the “Preclinical phase” section to effectively administer 100% oxygen after carbon monoxide poisoning.
Last but not least, we would like to thank Prof. Straube for her letter which highlights important and impressive clinical aspects.
Dr. med. Lars Eichhorn
Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin
Conflict of interest statement
Dr. Eichhorn is a member of the board of the German Society of Diving and Hyperbaric Medicine.
|1.||Eichhorn L, Thudium M, Jüttner B: The diagnosis and treatment of carbon monoxide poisoning. Dtsch Arztebl Int 2018; 115: 863–70 VOLLTEXT|