Quantitative Romberg's test in acute carbon monoxide poisoning treated by hyperbaric oxygen

Abstract

Objective: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

Keywords: carbon monoxide intoxication; hyperbaric oxygen therapy; neurologic dysfunction; postural stability; proprioception; dizziness.