Department of Hyperbaric Oxygen Medicine, 74639Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Department of Radiology, 74639Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Hum Exp Toxicol. 2021 Aug;40(8):1355-1361. doi: 10.1177/0960327121997992. Epub 2021 Mar 1.
Late recovery in patients following prolonged coma from carbon monoxide poisoning have been reported, but the probability is unclear. The purpose of this research was to assess the prognosis of patients in prolonged coma after severe carbon monoxide poisoning and related clinical and imaging features.
There were 13 patients who had been in a state of coma for >7 days after acute carbon monoxide poisoning in the retrospective observational study, and demographic data, clinical data, laboratory data, complications, and image data were collected. Outcome was assessed by means of the Glasgow outcome scale after 1 year. The relationship between complications and imaging manifestations and prognosis was also analyzed.
One year after severe carbon monoxide poisoning, two patients (15.4%) had died (GOS 1), nine (69.2%) were in a persistent vegetative state (GOS 2), one (7.7%) was moderately disabled (GOS 4), and one (7.7%) achieved a good recovery (GOS 5) with minimal disability.
Most patients with prolonged coma after severe carbon monoxide poisoning had a poor prognosis, although the younger patients had a better prognosis. Respiratory failure, hypotension and renal failure during the course of the disease were associated with a poor prognosis. The prognosis of patients with injuries in two sites in early CT was poor. Multiple lesions (≥3) and extensive white matter damage (Fazekas grade (PVH or DWMH) = 3) on MRI of chronic phase were also associated with a poor prognosis.
有报道称，一氧化碳中毒后长时间昏迷的患者会出现迟发性恢复，但具体概率尚不清楚。本研究旨在评估重度一氧化碳中毒后长时间昏迷患者的预后及相关临床和影像学特征。
回顾性观察研究中纳入了 13 例急性一氧化碳中毒后昏迷超过 7 天的患者，收集了人口统计学数据、临床数据、实验室数据、并发症和影像学数据。1 年后采用格拉斯哥预后量表评估预后。还分析了并发症和影像学表现与预后的关系。
重度一氧化碳中毒 1 年后，2 例患者（15.4%）死亡（GOS 1），9 例（69.2%）持续植物状态（GOS 2），1 例（7.7%）中度残疾（GOS 4），1 例（7.7%）轻度残疾（GOS 5）恢复良好。
尽管年轻患者的预后较好，但大多数重度一氧化碳中毒后长时间昏迷的患者预后较差。疾病过程中出现呼吸衰竭、低血压和肾衰竭与预后不良相关。早期 CT 显示两处损伤的患者预后较差。慢性期 MRI 上的多发病灶（≥3 个）和广泛的白质损伤（Fazekas 分级（PVH 或 DWMH）=3）也与预后不良相关。
