title: The use of hyperbaric oxygen therapy for carbon monoxide poisoning in Europe.
abstract: BACKGROUND
  The aim of this survey was to identify practice differences in the treatment of carbon monoxide (CO) poisoning with hyperbaric oxygen (HBO₂) therapy among centers in Europe.
  
  
  METHODS
  Using a commercial online survey website (surveymonkey.com), we created a questionnaire and invited the medical directors of hyperbaric centers in Europe by email to complete the survey.
  
  
  RESULTS
  Sixty-eight centers from 23 countries participated in the survey. While transient or prolonged unconsciousness was unanimously recognized as an indication for HBO₂ therapy, positive neurological findings, ECG suggesting acute ischemia and pregnancy were considered important indications of HBO₂ therapy in more than 95% of the centers. Twenty-three (44%) centers reported that they used carboxyhemoglobin (COHb) levels as a criterion for patient selection. Among responders, 39% (18/46) reported delivering a single session within the first 24 hours of CO poisoning, and nine (19%) reported delivering three sessions in the first day. The majority of the centers (52%) replied that they initially gave a single session per patient, which was repeated if symptoms persisted. We identified a total of 21 different HBO₂ profiles used in European centers.
  
  
  CONCLUSIONS
  Our results showed that the indications of CO poisoning for HBO₂ therapy are still not universally recognized. Additionally, HBO₂ therapy protocols used at European hyperbaric centers varied significantly, suggesting a need for more education regarding the published guidelines.
authors.forename: Mesut
authors.initials: M
authors.lastname: Mutluoglu
authors.forename: Suleyman
authors.initials: S
authors.lastname: Metin
authors.lastname: Ibrahim Arziman
authors.forename: Günalp
authors.initials: G
authors.lastname: Uzun
authors.forename: Senol
authors.initials: S
authors.lastname: Yildiz
mesh_terms: D002545:Brain Ischemia / Q000628:therapy; D002249:Carbon Monoxide Poisoning / Q000628:therapy*; D005060:Europe; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000592:standards* / Q000706:statistics & numerical data; D008297:Male; D011247:Pregnancy; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D014474:Unconsciousness / Q000628:therapy