Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Research Institute of Hyperbaric Medicine and Science, Yonsei University Wonju College of Medicine, Wonju, Korea.
Undersea Hyperb Med. 2021 First Quarter;48(1):43-51. doi: 10.22462/01.03.2021.5.
Hyperbaric oxygen (HBO2) therapy is a safe and well-tolerated treatment modality. Seizures, one of the most severe central nervous system side effects of HBO2 therapy, can occur. Episodes of seizures during HBO2 therapy have not yet been reported in countries such as Korea, where hyperbaric medicine is still in the developmental stage.
The registry data of all patients treated with HBO2 therapy in a tertiary academic hospital in Korea were prospectively collected, and patients who developed seizures during HBO2 therapy between October 2016 and December 2019 were evaluated. In addition, we reviewed previous studies on occurrence of seizures during HBO2 therapy.
During the study period, a total of 10,425 treatments were provided to 1,308 patients. The most frequently treated indication was carbon monoxide (CO) poisoning ABSTRACT (n=547, 41.8%). During the HBO2 therapy sessions (total: 10,425), five seizure episodes occurred (patients with CO poisoning: n=4; patients with arterial gas embolism [AGE]: n=1). The frequency of seizures in patients with CO poisoning (0.148%) and AGE (3.448%) was significantly higher than that in patients with all indications (0.048%) (p=0.001). None of the patients had lasting effects due to the seizures.
Our study revealed a similar frequency rate in terms of all indications and CO poisoning, and a slightly higher rate in AGE. Seizures were observed in patients with CO poisoning and AGE. Therefore, if clinicians plan to operate a hyperbaric center in a country like Korea, where there are several patients with acute CO poisoning, they should be prepared to handle seizures that may occur during HBO2 therapy.
高压氧（HBO2）治疗是一种安全且耐受良好的治疗方式。其最严重的中枢神经系统副作用之一——癫痫发作，也可能发生。在高压医学仍处于发展阶段的韩国等国家，尚未有报道在 HBO2 治疗期间出现癫痫发作的情况。
前瞻性收集韩国一家三级学术医院接受 HBO2 治疗的所有患者的登记数据，并评估在 2016 年 10 月至 2019 年 12 月期间 HBO2 治疗期间出现癫痫发作的患者。此外，我们还回顾了之前关于 HBO2 治疗期间癫痫发作的研究。
在研究期间，共为 1308 名患者提供了 10425 次治疗。最常治疗的适应症是一氧化碳（CO）中毒（n=547，41.8%）。在 HBO2 治疗过程中（总计：10425 次），共发生了 5 次癫痫发作（CO 中毒患者：n=4；动脉气体栓塞[AGE]患者：n=1）。CO 中毒患者（0.148%）和 AGE 患者（3.448%）的癫痫发作频率明显高于所有适应症患者（0.048%）（p=0.001）。由于癫痫发作，没有患者出现持续影响。
我们的研究显示，所有适应症和 CO 中毒的频率相似，而 AGE 略高。在 CO 中毒和 AGE 患者中观察到了癫痫发作。因此，如果临床医生计划在像韩国这样有许多急性 CO 中毒患者的国家开设高压中心，他们应该准备好处理 HBO2 治疗期间可能发生的癫痫发作。
