Hyperbaric oxygen therapy and mortality from carbon monoxide poisoning: A nationwide observational study

Nakajima, Mikio; Aso, Shotaro; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo

doi:10.1016/j.ajem.2019.02.009

Cited by 11 publications

(11 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, the results were influenced by the use of high-oxygen therapy to reduce the half-life of CO, and use of HBOT to reduce ischemic damage. 22 These results support that hepatic injury after CO poisoning is benign, not permanent. However, the hepatic injury itself is a temporary result of benign, generally delayed neurologic sequelae generally causes problems rather than mortality in CO poisoning.…”

Section: Discussionsupporting

confidence: 58%

Evaluation of hepatic injury in acute carbon monoxide-poisoned patients in emergency department

et al. 2020

View full text Add to dashboard Cite

Introduction: The affinity of hemoglobin for carbon monoxide (CO) is 250 times higher than that for oxygen. Therefore, exposure to CO leads to a reduction in oxygen delivery to tissues, resulting in cellular hypoxia and affects whole body. Hepatic dysfunction in critically ill patients is related to poor outcome, but few studies have been conducted on this subject that occurs after CO poisoning. This study aims to conduct a study of hepatic injury in CO-poisoned patients in emergency department (ED). Methods: This retrospective observational study collected data from patients who were diagnosed with acute CO poisoning at the ED between June 2011 and May 2018 in local tertiary-care hospital (Wonju, Republic of Korea). The primary end point of this study was to describe the prevalence of hepatic injury in acute CO-poisoned patients. The secondary goals were to investigate the recovery trends of hepatic injury caused by acute CO poisoning and the relation to neurologic outcome and mortality. Results: Eight hundred ninety-four patients were enrolled in the final analysis, 128 cases (14.3%) had subclinical hepatic injury and 15 (1.6%) cases had hepatic injury. The relationship with mortality was not statistically significant. However, the hepatic injury group was higher incidence of intensive care unit admission and other complications. Patients in the hepatic injury group recovered through conservative management within 1 week of being admitted to the ED. Conclusions: While CO-induced hepatic injury is relatively uncommon, it can be associated with complications and poor neurologic outcome. However, CO-induced hepatic injury was not found to have a statistically significant effect on mortality rate.

show abstract

Section: Discussionsupporting

confidence: 58%

Evaluation of hepatic injury in acute carbon monoxide-poisoned patients in emergency department

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Regarding the effect of HBO 2 therapy on the survival rate after CO poisoning, our data did not reveal any evidence to support the previous reports [38,39] because the follow-up period was only 2 months and 41 patients were lost to follow-up. Nakajima et al reported that HBO 2 therapy was associated with a favorable consciousness level and ADL at discharge in patients with CO poisoning [40]. In the present study, cognitive dysfunction was only checked for 2 months after CO poisoning and there was no significant difference between the NBO 2 group and the HBO 2 group (Table 3).…”

Section: Plos Onementioning

confidence: 41%

“…Some retrospective studies have found that HBO 2 therapy has beneficial effects on the survival rate [38,39] or activities of daily living (ADL) in patients with CO poisoning [40]. Rose et al reported that HBO 2 therapy was associated with reduced in-hospital mortality and reduced 1-year mortality [38] and Huang et al reported a lower 4-year mortality rate after treatment for CO poisoning [39].…”

Section: Plos Onementioning

confidence: 99%

Use of hyperbaric oxygen therapy for preventing delayed neurological sequelae in patients with carbon monoxide poisoning: A multicenter, prospective, observational study in Japan

et al. 2021

View full text Add to dashboard Cite

Background The purpose of this study was to clarify the practical clinical treatment for acute carbon monoxide (CO) poisoning in Japan and to investigate the efficacy of hyperbaric oxygen (HBO2) therapy in preventing delayed neurological sequelae (DNS) in the acute phase of CO poisoning. Methods We conducted a multicenter, prospective, observational study of acute CO poisoning in Japan. Patients with acute CO poisoning were enrolled and their treatment details were recorded. The primary endpoint was the onset of DNS within 2 months of CO exposure. Factors associated with DNS were assessed with logistic regression analysis. Results A total of 311 patients from 57 institutions were registered and 255 were analyzed: 171 received HBO2 therapy (HBO2 group) and 84 did not (normobaric oxygen [NBO2] group). HBO2 therapy was performed zero, once, twice, or three times within the first 24 h in 1.8%, 55.9%, 30.9%, and 11.3% of the HBO2 group, respectively. The treatment pressure in the first HBO2 session was 2.8 ATA (47.9% of the HBO2 group), 2.0 ATA (41.8%), 2.5 ATA (7.9%), or another pressure (2.4%). The incidence of DNS was 13/171 (7.6%) in the HBO2 group and 3/84 (3.6%) in the NBO2 group (P = 0.212). The number of HBO2 sessions in the first 24 h was one of the factors associated with the incidence of DNS (odds ratio, 2.082; 95% confidence interval, 1.101–3.937; P = 0.024). Conclusions The practical clinical treatment for acute CO poisoning, including HBO2 therapy, varied among the institutions participating in Japan. HBO2 therapy with inconsistent protocols showed no advantage over NBO2 therapy in preventing DNS. Multiple HBO2 sessions was associated with the incidence of DNS.

show abstract

“…Hyperbaric oxygen is an effective treatment method of ACOP, which can quickly correct anoxia. Although hyperbaric oxygen treatment is related to the good consciousness level of CO poisoning patients, its impact on their mortality or morbidity rate is still unknown, and is not directly tied to their reduction of mortality rate (18). However, in ACOP multiple organ failure of adults and children, there have been cases showing success of extracorporeal membrane oxygenation (ECMO) treatment (19).…”

Section: Discussionmentioning

confidence: 99%

Cardiac injury after acute carbon monoxide poisoning and its clinical treatment scheme

Geng

Hao

et al. 2020

Exp Ther Med

View full text Add to dashboard Cite

This study was designed to investigate cardiac injury after acute carbon monoxide poisoning and its clinical treatment scheme. Seventy patients with moderate and severe acute carbon monoxide poisoning (ACOP) admitted from January 2017 to December 2018 into The Affiliated Hospital of Qingdao University were regarded as a research group (RG), and another 30 healthy adults undergoing physical examination in the hospital during the same period were selected as a control group (CG). Thirty-five patients in the RG who received hyperbaric oxygen therapy were considered as group A, and 35 patients who received extracorporeal membrane oxygenation therapy were considered as group B. The effective rates and complications of the two groups after treatment were compared. The concentrations of creatine kinase isoenzyme (CK-MB) and lactate dehydrogenase (LDH) of myocardial enzymes at different time points before and after treatment were detected. Expression of miR-30a in the blood of experimental subjects was detected by time-fluorescence quantitative PCR, and the relationship between miR-30a expression and ACOP patients was analyzed. Patients in groups A and B achieved obvious efficacy, but the effective rate and incidence rate of complications in the extracorporeal membrane oxygenation (ECMO) group were better than those in the hyperbaric oxygen group. The concentrations of CK-MB and LDH in group A and group B were significantly higher than those in control group (P<0.01). The expression level of miR-30a in the RG was significantly higher than that in the control group (P<0.05). Both hyperbaric oxygen therapy and ECMO therapy have obvious efficacy on ACOP patients, but the latter is better than the former. The expression level of miR-30a in blood of ACOP patients increased significantly, which is positively correlated with myocardial injury, and it decreased after treatment. It is believed that miR-30a can provide a reference index for early diagnosis and prediction of disease progression and prognosis in cardiac injury of ACOP.

show abstract

Hyperbaric oxygen therapy and mortality from carbon monoxide poisoning: A nationwide observational study

Cited by 11 publications

References 28 publications

Evaluation of hepatic injury in acute carbon monoxide-poisoned patients in emergency department

Evaluation of hepatic injury in acute carbon monoxide-poisoned patients in emergency department

Use of hyperbaric oxygen therapy for preventing delayed neurological sequelae in patients with carbon monoxide poisoning: A multicenter, prospective, observational study in Japan

Cardiac injury after acute carbon monoxide poisoning and its clinical treatment scheme

Contact Info

Product

Resources

About