Department of Emergency Medicine, Sivas Cumhuriyet University, Sivas, Turkey.
Clin Toxicol (Phila). 2024 Feb;62(2):88-93. doi: 10.1080/15563650.2024.2323092. Epub 2024 Mar 11.
Delayed neurological sequelae are a major complication of carbon monoxide poisoning. However, today there is still no objective screening tool for predicting delayed neurological sequelae in patients with carbon monoxide poisoning. The present study aimed to assess the usefulness of optic nerve sheath diameter measurements in predicting delayed neurological sequelae after carbon monoxide poisoning.
In this retrospective study, patients with a diagnosis of carbon monoxide poisoning in the emergency department from 2010 to 2021 were included in the study. Right and left optic nerve sheath diameters were calculated based on cranial computed tomography scans, and the presence of delayed neurological sequelae was evaluated.
The mean (± standard deviation) optic nerve sheath diameter in patients who developed delayed neurological sequelae was statistically significantly greater on both the right and left compared to patients who did not develop delayed neurological sequelae (right; 5.02 ± 0.06 mm versus 4.89 ± 0.07 mm, < 0.001; left; 5.03 ± 0.09 mm versus 4.85 ± 0.10 mm, < 0.001). A multivariate linear regression analysis revealed that carboxyhemoglobin and both right and left optic nerve sheath diameter were the factors associated with the delayed neurological sequelae.
The present study revealed that optic nerve sheath diameter measurements may be a useful screening tool to predict delayed neurological sequelae after carbon monoxide poisoning. The ability to predict a poor neurological prognosis in carbon monoxide poisoning is important for initiating early rehabilitation interventions and make help future trials. Limitations of this study include that normal optic nerve sheath diameters are not well established, and that not every patient underwent computed tomography.
Optic nerve sheath diameters measurements may be a helpful screening tool for predicting delayed neurological sequelae after carbon monoxide poisoning.
迟发性神经后遗症是一氧化碳中毒的主要并发症。然而，目前仍然没有客观的筛选工具来预测一氧化碳中毒患者的迟发性神经后遗症。本研究旨在评估视神经鞘直径测量在预测一氧化碳中毒后迟发性神经后遗症中的作用。
在这项回顾性研究中，纳入了 2010 年至 2021 年在急诊科诊断为一氧化碳中毒的患者。根据头颅 CT 扫描计算右侧和左侧视神经鞘直径，并评估是否存在迟发性神经后遗症。
发生迟发性神经后遗症的患者的右侧和左侧视神经鞘直径均明显大于未发生迟发性神经后遗症的患者（右侧：5.02±0.06mm 与 4.89±0.07mm，<0.001；左侧：5.03±0.09mm 与 4.85±0.10mm，<0.001）。多变量线性回归分析显示，碳氧血红蛋白和右侧及左侧视神经鞘直径是与迟发性神经后遗症相关的因素。
本研究表明，视神经鞘直径测量可能是预测一氧化碳中毒后迟发性神经后遗症的有用筛选工具。预测一氧化碳中毒后不良神经预后的能力对于启动早期康复干预措施和指导未来的临床试验非常重要。本研究的局限性包括正常视神经鞘直径尚未得到充分确立，并且并非所有患者都进行了 CT 检查。
视神经鞘直径测量可能是预测一氧化碳中毒后迟发性神经后遗症的有用筛选工具。
