In carbon monoxide poisoning, when should hyperbaric oxygen therapy be considered?

• A. Only after symptom resolution.
• B. Criteria are met for hyperbaric oxygen therapy.
• C. In all CO poisoning cases.
• D. Hyperbaric therapy is never indicated.

Answer: (B)

Hyperbaric oxygen therapy is not used in every carbon monoxide poisoning case; it’s considered only when specific high‑risk criteria are met. This approach is based on identifying patients who are at greater risk for serious or permanent harm, such as those with brain involvement (confusion, loss of consciousness, neurologic deficits, seizures) or severe metabolic acidosis, cardiac involvement, or pregnancy with exposure. When these criteria are present, HBOT can offer added benefit by reducing the half-life of carboxyhemoglobin and improving tissue oxygen delivery, which is why the best course is to consider HBOT only when those criteria are met. In patients without these indicators, standard high‑flow oxygen is typically sufficient. Options suggesting HBOT for all cases or never being indicated aren’t aligned with how treatment is tailored to risk.