Two Patients With Delayed Neuropsychiatric Sequelae Caused by Exposure to Carbon Monoxide Under the Same Conditions

Kudo, Kaoru; Sanjo, Katsumi; Koizumi, N; Koeda, Atsuhiko; Otsuka, Kotaro; Beppu, Teruhiko; Endo, Shunsuke; Sakai, Akio

doi:10.4088/pcc.11l01316

Cited by 2 publications

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“…However, since head MRI depicts all the various histological changes, it may not be possible to accurately tell the progress of the condition in the cerebral white matter [ 16 ]. In addition, there have been cases who developed DNS despite having subnormal MBP levels in the CSF two weeks immediately following injury [ 17 ]. A recent study examined development of cognitive sequelae and genetic factors 6 weeks after CO poisoning.…”

Section: Introductionmentioning

confidence: 99%

Predictors for delayed encephalopathy following acute carbon monoxide poisoning

et al. 2014

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BackgroundIn Japan, many carbon monoxide (CO) poisoning cases are transported to emergency settings, making treatment and prognostic assessment an urgent task. However, there is currently no reliable means to predict whether “delayed neuropsychiatric sequelae (DNS)” will develop after acute CO poisoning. This study is intended to find out risk factors for the development of DNS and to characterize the clinical course following the development of DNS in acute CO poisoning cases.MethodsThis is a retrospective cohort study of 79 consecutive patients treated at a single institution for CO poisoning. This study included 79 cases of acute CO poisoning admitted to our emergency department after attempted suicide, who were divided into two groups consisting of 13 cases who developed DNS and 66 cases who did not. The two groups were compared and analyzed in terms of clinical symptoms, laboratory findings, etc.ResultsPredictors for the development of DNS following acute CO poisoning included: serious consciousness disturbance at emergency admission; head CT findings indicating hypoxic encephalopathy; hematology findings including high creatine kinase, creatine kinase-MB and lactate dehydrogenase levels; and low Global Assessment Scale scores. The clinical course of the DNS-developing cases was characterized by prolonged hospital stay and a larger number of hyperbaric oxygen (HBO) therapy sessions.ConclusionIn patients with the characteristics identified in this study, administration of HBO therapy should be proactively considered after informing their family, at initial stage, of the risk of developing DNS, and at least 5 weeks’ follow-up to watch for the development of DNS is considered necessary.

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Section: Introductionmentioning

confidence: 99%