Targeting optimal time for hyperbaric oxygen therapy following carbon monoxide poisoning for prevention of delayed neuropsychiatric sequelae: A retrospective study

Liao, Shih‐Chieh; Mao, Yan; Yang, Kun Ju; Wang, Kuo Cheng; Wu, Li; Yang, Chen Chang

doi:10.1016/j.jns.2018.11.025

Cited by 32 publications

(25 citation statements)

References 28 publications

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“…suggested a "golden time" of 6 h [14], while Liao and coll. concluded that HBOT should preferably be performed within 22.5 h after CO poisoning [15]. Nevertheless, this retrospective analysis highlighted a mean transfer time of 3 h and 40 min (Table 3), which is well below the thresholds mentioned above.…”

Section: Discussionmentioning

confidence: 64%

Hyperbaric Oxygen Treatment for Carbon Monoxide Poisoning in Italy: Retrospective Validation of a Data Collection Tool for the Italian Registry of Carbon Monoxide Poisonings (IRCOP)

Maffi

Paganini

Vezzani

et al. 2020

IJERPH

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Background: Carbon Monoxide (CO) poisoning is a frequent cause of intoxication. However, CO poisoning incidence is globally underreported, as well as its features, especially in Italy. The aim of this study was to investigate such characteristics of CO intoxication and foster the creation of the Italian Registry of Carbon Monoxide Poisonings. Methods: A data collection tool was developed and organized in five sections: Patient’s characteristics; CO intoxication modality; emergency medical service and emergency department; hyperbaric facility; outcomes. The tool was validated through a retrospective analysis, including CO intoxicated patients treated in 14 Italian hyperbaric facilities between 2015 and 2016. Results: A total of 1383 patients were included. The high completion ratio (85%) of the collection tool suggests its feasibility in practical terms. CO intoxications were mostly accidental (93.64%) and caused by solid fuel (48.59%). There was not a uniform application of hyperbaric oxygen treatment protocols, but most of the patients were adequately treated at least at 2.5 ATA for more than 60 min (44.97%). Conclusion: This analysis provided new information that was previously unavailable in this country. Furthermore, this tool proved to be a valid base for future registry aiming to consolidate the body of knowledge about CO intoxications in Italy.

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Section: Discussionmentioning

confidence: 64%

Hyperbaric Oxygen Treatment for Carbon Monoxide Poisoning in Italy: Retrospective Validation of a Data Collection Tool for the Italian Registry of Carbon Monoxide Poisonings (IRCOP)

Maffi

Paganini

Vezzani

et al. 2020

IJERPH

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“…The MRI lesions of the patients in the DNS group were as follows; 25 patients for periventricular white matter abnormalities, 22 patients for corpus callosum, 14 patients for subcortical U Fibers, 17 patients for external capsule, and 16 patients for internal capsule. Also, the median MMSE score of DNS group was 20 (18)(19)(20)(21)(22).…”

Section: Resultsmentioning

confidence: 99%

“…Discharged patients who agreed to undergo follow-up were checked by telephone interview to determine whether DNS had occurred within 2 weeks, 1 month, and 3 months from the time of CO exposure, by two emergency physicians who were blinded to the study objective [9,18,19]. If the patient reported the symptoms of DNS during the telephone interview, he or she was asked to come to the hospital to be further evaluated for the diagnosis of DNS.…”

Section: Data Collectionmentioning

confidence: 99%

Effect of ethanol in carbon monoxide poisoning and delayed neurologic sequelae: A prospective observational study

et al. 2021

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Objectives Carbon monoxide (CO) is one of the most common poisoning substances, which causes mortality and morbidity worldwide. Delayed neurologic sequelae (DNS) have been reported to occur from several days to months after exposure to CO. Thus, there is a need for prevention, recognition, and treatment of DNS. Patients with CO poisoning as a component of intentional suicide often also consume ethanol, but there is debate regarding its role in DNS. We explored whether ethanol has a neuroprotective effect in CO poisoning. Methods This prospective observational study included patients who visited the emergency department from August 2016 to August 2019 due to CO poisoning. After treatment of acute CO poisoning, patients were interviewed by telephone to ascertain whether DNS had occurred within 2 weeks, 1 month, and 3 months from the time of CO exposure. Results During the study period, 171 patients were enrolled. 28 patients (16.37%) developed DNS. The initial Glasgow Coma Scale (GCS) scores were 15 (10.5–15) for the non-DNS group and 10 (7–15) for the DNS group (p = 0.002). The ethanol levels were 11.01 ± 17.58 mg/dL and 1.49 ± 2.63 mg/dL for each group (p < 0.001). In multivariate logistic regression analysis, the GCS score had an odds ratio of 0.770 (p < 0.001) and the ethanol level had 0.882 (p < 0.030) for onset of DNS. Conclusions Higher ethanol level and higher initial GCS score were associated with lower incidence of DNS. Ethanol could have a neuroprotective effect on the occurrence of DNS in CO poisoning patients.

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“…All patients were treated by administering 100% normobaric oxygen by a non-rebreather mask upon arrival at hospital. The decision to refer patients to HBO therapy unit at Tanta University Educational Hospital was made by the treating physicians at TUPCC following the guidelines of HBO therapy for CO poisoning that were loss of consciousness on admission, neurological deficits, ischemic cardiac changes, significant metabolic acidosis and elevated COHb level ≥ 25% (Liao et al, 2019a). Number of needed HBO sessions and duration of hospital stay were registered.…”

Section: Data Collection and Definition Of Variablesmentioning

confidence: 99%

Hematological parameters as early predictors of delayed neurological sequelae in acute carbon monoxide poisoning.

Shahin

Allam

Elkholy

et al. 2020

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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Introduction: Delayed neurological sequelae (DNS) are the most frequent morbidity after acute carbon monoxide (CO) poisoning. Therefore, their prevention and early prediction are the main goal of treatment. Aim of the work: This study aimed to investigate parameters based on peripheral complete blood cell count (CBC) as predictors of DNS in acute CO poisoning. Methodology: It included 67 acutely CO poisoned patients and 38 healthy volunteers. On admission, history, clinical examination and routine laboratory investigations were done. Ratios based on CBC counts were measured. Patients were followed up along 6 months for DNS signs. Results: The results revealed that total white blood cells (WBC) count, absolute neutrophil count & percentage and median values of neutrophil-lymphocyte ratio (NLR) & systemic immune inflammation index (SII) were significantly higher while lymphocytes percentage, absolute monocytic count and percentage were significantly lower in CO poisoned patients compared to control group. DNS-complicated patients had significantly lower total WBC count, absolute neutrophil count & percentage and significantly higher median values of NLR and SII than non-complicated. Based on receiver operating characteristic analysis (ROC), NLR and SII were significant predictors of DNS. Conclusion: It was concluded that, NLR and SII ratios may be helpful predictors of DNS after acute CO poisoning.

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Targeting optimal time for hyperbaric oxygen therapy following carbon monoxide poisoning for prevention of delayed neuropsychiatric sequelae: A retrospective study

Cited by 32 publications

References 28 publications

Hyperbaric Oxygen Treatment for Carbon Monoxide Poisoning in Italy: Retrospective Validation of a Data Collection Tool for the Italian Registry of Carbon Monoxide Poisonings (IRCOP)

Hyperbaric Oxygen Treatment for Carbon Monoxide Poisoning in Italy: Retrospective Validation of a Data Collection Tool for the Italian Registry of Carbon Monoxide Poisonings (IRCOP)

Effect of ethanol in carbon monoxide poisoning and delayed neurologic sequelae: A prospective observational study

Hematological parameters as early predictors of delayed neurological sequelae in acute carbon monoxide poisoning.

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