HBOT-induced noncardiogenic pulmonary edema in acute carbon monoxide poisoning: A case report and mechanistic insights

Rationale: Acute carbon monoxide poisoning is a common medical emergency, and hyperbaric oxygen therapy (HBOT) serves as the cornerstone of treatment. Although rare, serious complications such as acute pulmonary edema (APE) can be life-threatening. Most reported cases involve patients with preexisting cardiac conditions, making this case of APE in a patient without cardiac comorbidities particularly noteworthy. Patient concerns: A 35-year-old male patient developed dyspnea accompanied by severe coughing during the decompression phase of HBOT for acute carbon monoxide poisoning. Diagnoses: Emergency chest computed tomography showed APE. Interventions: Immediate endotracheal intubation and mechanical ventilation were initiated, along with a combination of diuretics, glucocorticoids, and bronchodilators. Outcomes: During the 3-month follow-up period, the patient remained asymptomatic with complete resolution of clinical manifestations. Lessons: Although HBOT-induced APE is a rare complication, its critical clinical implications necessitate rigorous monitoring of respiratory dynamics and oxygenation status during treatment sessions.