Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Sci Rep. 2021 Sep 28;11(1):19212. doi: 10.1038/s41598-021-98539-y.
To assess real-world effectiveness of hyperbaric oxygen therapy (HBOT) on delayed neuropsychiatric sequelae (DNS) after carbon monoxide (CO) poisoning we conducted a retrospective review of patients with CO poisoning admitted to Linkou Chang-Gung Memorial Hospital, Taiwan's largest medical center, during 2009-2015. We included patients developing DNS after CO poisoning and compared improvements in neuropsychiatric function, with and without HBOT, after 12 months post-DNS to understand differences in recovery rates. DNS improvement-associated factors were also evaluated. We used receiver operating characteristic (ROC) curve analysis to assess the role of time elapsed between DNS diagnosis and HBOT initiation in predicting DNS improvement. A total of 62 patients developed DNS, of whom 11 recovered while the rest did not. Possible factors predicting DNS improvement included receiving HBOT post-DNS (72.7% vs 25.5%; P = 0.006), and treatment with more than three HBOT sessions during acute stage CO poisoning (81.8% vs 27.5%; P = 0.003). The relevant area under the ROC curve was 0.789 (95% CI 0.603-0.974), and the best cut-off point was 3 days post-DNS diagnosis, with 87.5% sensitivity and 61.5% specificity. Early HBOT in patients who developed DNS after CO poisoning significantly improved their DNS symptoms, with treatment effects sustained for 1 year after DNS diagnosis.
为了评估高压氧治疗（HBOT）对一氧化碳（CO）中毒后迟发性神经精神后遗症（DNS）的实际效果，我们对 2009 年至 2015 年期间在台湾最大的医疗中心林口长庚纪念医院因 CO 中毒住院的患者进行了回顾性研究。我们纳入了 CO 中毒后发生 DNS 的患者，并比较了接受和未接受 HBOT 治疗的患者在 DNS 后 12 个月的神经精神功能改善情况，以了解恢复率的差异。还评估了与 DNS 改善相关的因素。我们使用接受者操作特征（ROC）曲线分析来评估 DNS 诊断后与 HBOT 开始之间的时间间隔在预测 DNS 改善中的作用。共有 62 例患者发生 DNS，其中 11 例恢复，其余未恢复。可能预测 DNS 改善的因素包括 DNS 后接受 HBOT（72.7%比 25.5%；P=0.006），以及在急性 CO 中毒期间接受超过 3 次 HBOT 治疗（81.8%比 27.5%；P=0.003）。ROC 曲线下的相关面积为 0.789（95%CI 0.603-0.974），最佳截断点为 DNS 诊断后 3 天，灵敏度为 87.5%，特异性为 61.5%。在发生 CO 中毒后发生 DNS 的患者中早期进行 HBOT 治疗可显著改善他们的 DNS 症状，治疗效果在 DNS 诊断后持续 1 年。
