Carstairs Shaun D, Miller Alexander D, Minns Alicia B, Duchnick Jay, Riffenburgh Robert H, Clark Richard F, Tomaszewski Christian A
Division of Medical Toxicology, Department of Emergency Medicine, University of California, San Diego, CA, USA.
Department of Emergency Medicine, Naval Medical Center, San Diego, CA, USA.
J Med Toxicol. 2016 Dec;12(4):386-390. doi: 10.1007/s13181-016-0573-5. Epub 2016 Jul 25.
Hyperbaric oxygen (HBO) has been advocated for treatment of acute carbon monoxide (CO) poisoning. There exists considerable debate as to whether HBO prevents delayed neurologic sequelae (DNS) due to CO poisoning. Additionally, existing data in the literature supporting HBO efficacy do not identify an optimal number of HBO treatments. We sought to determine in a mouse model whether there is a difference between one versus multiple HBO sessions for the prevention of DNS. Fifty mice were randomized into five groups of ten mice each: (1) control, receiving no CO exposure or treatment; (2) CO poisoned, receiving no treatment (CO group); (3) CO poisoned, receiving normobaric oxygen for 58 min following the end of exposure (CO + NBO group); (4) CO poisoned, followed by one session of HBO(CO + HBO1); and (5) CO poisoned, followed by three HBO treatment sessions, one every 6 h (CO + HBO3). Prior to poisoning, all animals were trained in step-down latency (SDL) and step-up latency (SUL) tasks. One week after exposure and treatment, all five groups were retested to evaluate the retention of this training. There was no difference detected among groups in SDL (p = 0.67 among all groups) when evaluated using a Kruskal-Wallis test. There was a significant difference among groups in SUL (p = 0.027 among all groups) when evaluated using a Kruskal-Wallis test. When individual groups were compared using a Wilcoxon signed-rank test with Bonferroni correction, there were no statistically significant differences in either SDL or SUL. There was no difference between groups treated with either one or three HBO sessions. One possibility to explain this might be that HBO sessions administered some time after a CO exposure may enhance the lipid peroxidation cascade and worsen neurologic outcomes; alternatively, HBO may simply impart no benefit when compared to NBO.
高压氧（HBO）已被提倡用于治疗急性一氧化碳（CO）中毒。关于HBO是否能预防CO中毒所致的迟发性神经后遗症（DNS），存在相当大的争议。此外，文献中支持HBO疗效的现有数据并未确定HBO治疗的最佳次数。我们试图在小鼠模型中确定单次与多次HBO治疗在预防DNS方面是否存在差异。五十只小鼠被随机分为五组，每组十只：（1）对照组，未接触CO也未接受治疗；（2）CO中毒组，未接受治疗（CO组）；（3）CO中毒组，暴露结束后接受常压氧治疗58分钟（CO + NBO组）；（4）CO中毒组，随后接受一次HBO治疗（CO + HBO1）；（5）CO中毒组，随后接受三次HBO治疗，每6小时一次（CO + HBO3）。在中毒前，所有动物都接受了逐步降低潜伏期（SDL）和逐步升高潜伏期（SUL）任务的训练。暴露和治疗一周后，对所有五组进行重新测试，以评估该训练的保留情况。使用Kruskal-Wallis检验评估时，各组在SDL方面未检测到差异（所有组之间p = 0.67）。使用Kruskal-Wallis检验评估时，各组在SUL方面存在显著差异（所有组之间p = 0.027）。当使用带有Bonferroni校正的Wilcoxon符号秩检验对各个组进行比较时，SDL或SUL均无统计学显著差异。接受一次或三次HBO治疗的组之间没有差异。对此的一种解释可能是，在CO暴露一段时间后进行的HBO治疗可能会增强脂质过氧化级联反应并使神经学结果恶化；或者，与NBO相比，HBO可能根本没有益处。
