Bidstrup Daniel, Jansen Erik Christian, Hyldegaard Ole
Hyperbaric Unit, Department of Anesthesia, Centre of Head and Orthopedics, Rigshospitalet, University of Copenhagen, Denmark.
Undersea Hyperb Med. 2017 Nov-Dec;44(6):559-567. doi: 10.22462/11.12.2017.7.
The aim of this study was to evaluate whether monitoring of acute carbon monoxide-poisoned (COP) patients by means of quantitative Romberg's test (QR-test) during a hyperbaric oxygen (HBO₂) therapy regimen could be a useful supplement in the evaluation of neurological status.
We conducted a retrospective study (2000-2014) in which we evaluated data containing quantitative sway measurements of acute COP patients (n = 58) treated in an HBO₂ regimen. Each patient was tested using QR-test before and after each HBO₂ treatment. Data were analyzed using linear mixed models (LMM). In each LMM, sway prior to HBO₂ therapy was set as the fixed effect and change in sway after HBO₂ therapy was set as the response variable. Patient, treatment number, weight and age were set as random effects for all LMMs.
From the LMMs we found that larger values of sway prior to HBO₂ produced a negative change in sway. We found no correlation between CO level and sway (P=0.1028; P=0.8764; P=0.4749; P=0.5883). Results showed that loss of visual input caused a significant increase in mean sway (P=0.028) and sway velocity (P⟨0.0001).
The Quantitative Romberg's test is a fast, useful supplement to neurological evaluation and a potential valuable tool for monitoring postural stability during the course of treatment in acute COP patients.
本研究旨在评估在高压氧(HBO₂)治疗方案期间,通过定量罗姆伯格试验(QR试验)监测急性一氧化碳中毒(COP)患者是否可作为神经状态评估的有益补充。
我们进行了一项回顾性研究(2000 - 2014年),评估了接受HBO₂治疗方案的急性COP患者(n = 58)的定量摇摆测量数据。每位患者在每次HBO₂治疗前后均使用QR试验进行测试。数据采用线性混合模型(LMM)进行分析。在每个LMM中,将HBO₂治疗前的摇摆设定为固定效应,将HBO₂治疗后的摇摆变化设定为反应变量。将患者、治疗次数、体重和年龄设定为所有LMM的随机效应。
从LMM中我们发现,HBO₂治疗前较大的摇摆值会导致摇摆出现负向变化。我们发现一氧化碳水平与摇摆之间无相关性(P = 0.1028;P = 0.8764;P = 0.4749;P = 0.5883)。结果显示,视觉输入丧失会导致平均摇摆(P = 0.028)和摇摆速度(P⟨0.0001)显著增加。
定量罗姆伯格试验是神经评估的一种快速、有用的补充方法,也是监测急性COP患者治疗过程中姿势稳定性的潜在有价值工具。