▲Figure 1 CT of chest on Day 1: patchy and clouded high-density
shadows were observed in both lungs with unclear boundaries. Gas shadows
can be seen in bilateral chest wall, subcutaneous soft tissue in axilla
and mediastinum.
Given the hyperbaric oxygen treatment guidelines for emergency carbon
monoxide poisoning, the patient was put into a hyperbaric oxygen chamber
for emergency oxygen therapy in the hope of relieving lung inflammation
and repairing nerve damage as much as possible, and began to take
methylprednisolone, cefoperazone, citiciline sodium, omeprazole and
other drugs, inhaled budesonide suspension and ambroxol hydrochloride
solution for phlegm treatment, and injected compound brain peptide
glycoside and niacinamide to promote nerve repair. No invasive
ventilation was used. For the first hyperbaric oxygen treatment, the
pressure was set to 1.3ATA(1ATA=760mmhg(101.32Kpa)) for 100 minutes
using compressed air pressurization. The lethargy of the patient
improved on the second day, and CT revealed that the double pneumonia
and pneumomediastinum had been reduced compared with the previous day.
After that, he continued to receive hyperbaric oxygen therapy at 1.3 ATA
for one week. No other treatment options were changed, and after one
week his CT showed that the lung inflammation and pneumomediastinum had
completely subsided. After CT showed complete resolution of lung
symptoms, he received consolidation oxygen at 1.6ATA for 5 days, during
which time he did not develop symptoms of physical discomfort. Through
follow-up, we learned that he had no symptoms of delayed encephalopathy
or other complications. We will continue to follow up.