Efficacy And Safety Of Hyperbaric Oxygen Therapy For Delayed Neuropsychiatric Sequelae Followed Carbon Monoxide Poisoning

Objective:To explore the effect of hyperbaric oxygen on delayed neuropsychiatric sequela followed carbon monoxide poisoning.Methods:Patients diagnosed acute carbon monoxide poisoning(ACOP)or DNS due to CO poisoning in the hospital from October 2015 to February 2017 were included.Patients who died of ACOP or in persisting unconsciousness condition were excluded.Information of the patients were retrospectively collected including personal data,clinical features and treatment course of hyperbaric oxygen(HBO).All subjects were divided into two groups,consisting of cases who developed into DNS and who fully recovered,according to clinical symptoms.The differences of personal data,clinical features and treatment course of HBO were compared between the two groups.After adjusting the confounding factors,hyperbaric oxygen treatment program of the two groups were analyzed.Results:1.There were 180 patients in the control group and a DNS group of 50 patients.The ratio of patients over 55 years old in the DNS group were higher than that in the control group(80%vs 60.8%).Patients who awoke from unconsciousness but left cognitive impairment were more likely to develop into DNS(P=0.003);2.Patients who treated with HBO within the first 24 hours,risk of developing into DNS were decreased(OR=0.10,P<0.05).At the same time,2 times a day and within the first 24 hours worked also as well.(OR=0.22,P=0.001).Even if patients who were given 2 times a day of HBO but not in the first 24 hours after poisoning,could not reduce the risk of evolving to DNS(P>0.05).The proportion of patients in the good outcome group accepted HBO for more than six days after poisoning was higher than that in the DNS group(68.5%vs46.0%);3.After adjusting confounding factors,patients who treated with HBO within the first 24 hours(OR:0.15,95%CI:0.07 ~ 0.34),2 times per day(OR:0.21,95%CI:0.07~0.62)or and lasted for more than 6 days(OR:0.27,95%CI:0.12 ~ 0.59)were in a lower risk of involving to DNS.Conclusions:1.For patients with ACOP in acute stage,HBO treatment began in the first 24 hours,1 or 2 times per day could reduce the risk of DNS.2.For patients with ACOP in acute stage,early sustaining to give HBO for more than 6 days could reduce the risk of DNS.Objective :To explore the effect of different treatment of hyperbaric oxygen(HBO)on long-term prognosis of delayed neuropsychiatric sequela followed carbon monoxide poisoning.Methods:Between October 2015~February 2017,fifty DNS patients in the hospital were followed up for 12 months.Data of the patients were retrospectively collected including personal data,clinical features and treatment course of hyperbaric oxygen.All the patients were divided into good prognosis group(m RS?2)and poor prognosis group(m RS?3).Different confounding factors and treatment course of hyperbaric oxygen were analyzed between two groups.Results :After correcting the confounding factors,such as over 55 years old,duration of exposed to CO,duration of losing consciousness after acute carbon monoxide poisoning and m RS evaluation at peak of the disease,compared with standard treatment course(<3months),prolonged treatment course of hyperbaric oxygen(>3months)was associated with lower risk of poor prognosis(m RS?3)(P<0.05).Conclusions:1.For DNS patients who had serious disease,hyperbaric oxygen therapy for more than 3 months could improve the long-term prognosis;2.Hyperbaric oxygen therapy for a longer time might be beneficial to the recovery of patients.