Letter to the Editor
I read with interest Dr. Leon Gussow's review of ACEP's session about hyperbaric oxygen (HBO) for treating carbon monoxide poisoning. (Toxicology Rounds: “Delving into the Evidence for HBO, Opioids, and Blockers,” EMN 2014;36:19; http://bit.ly/1cUZJT4.)
I am admittedly biased because I trained in HBO under Dr. Stephen Thom, but I would point out two things. First, I agree that all the clinical studies have major flaws, and I hope researchers can address this in the future, but it is difficult to blind a patient to this type of placebo treatment. Also, I'd mention that people like Dr. Thom have devoted a lifetime of research to proving that the biochemical mechanisms of hyperbaric oxygen deactivate perivascular inflammation associated not only with CO poisoning but also decompression sickness, necrotizing fasciitis, burns, and other conditions.
This may suggest to the uninitiated that Dr. Gussow doesn't support HBO for CO poisoning; it may be of use to bring up the enormous volume of data supporting biochemical mechanisms for hyperbaric oxygen therapy. I firmly believe that this will eventually be proven in clinical studies. It makes one sit up and take notice when someone's ST segments normalize from STEMI criteria to normal. Thanks as always for a great publication!
Matthew S. Partrick, MD
Key West, FL