Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 14:10:1127978.
doi: 10.3389/fmed.2023.1127978. eCollection 2023.

Association between number of hyperbaric oxygen therapy sessions and neurocognitive outcomes of acute carbon monoxide poisoning

Je Seop Lee  1   2 , Yong Sung Cha  1   2 , Jihye Lim  3
Affiliations

Association between number of hyperbaric oxygen therapy sessions and neurocognitive outcomes of acute carbon monoxide poisoning

Je Seop Lee et al. Front Med (Lausanne). .

Abstract

Background: Hyperbaric oxygen therapy (HBO2) is recommended for symptomatic patients within 24 h of carbon monoxide (CO) poisoning. Currently, there is no consensus on the number of HBO2 sessions within 24 h after arrival at the hospital. Therefore, we evaluated differences in the therapeutic effects according to the number of HBO2 sessions in acute CO poisoning.

Methods: This cohort study included data collected from our CO poisoning registry and prospective cohorts between January 2006 and August 2021 in a single academic medical center in South Korea. Based on the number of HBO2 sessions performed within 24 h, we classified patients into one- and multiple- (two or three) session groups. We also compared mild (non-invasive mechanical ventilation) and severe (invasive mechanical ventilation) groups. CO-related neurocognitive outcomes were measured using the Global Deterioration Scale (GDS; stages: 1-7) combined with neurological impairment at 1 month after poisoning. We classified GDS stages as favorable (1-3 stages) and poor (4-7 stages) neurocognitive outcomes. Patients belonging to a favorable group based on GDS assessment, but with observable neurological impairment, were assigned to the poor outcome group. Propensity score matching (PSM) was performed to adjust for age, sex, and related variables to identify statistical differences between groups.

Results: We analyzed the data of 537 patients between ages 16 and 70 years treated with HBO2. After PSM, there was no significant difference in neurocognitive outcomes at 1 month among the two groups of patients (p = 0.869). Furthermore, there were no significant differences in neurocognitive outcomes between invasive mechanical ventilation and non-invasive mechanical ventilation patients in the three groups (p = 0.389 and p = 0.295).

Conclusion: There were no significant differences in the reduction of poor neurocognitive outcomes according to the number of HBO2 sessions implemented within 24 h of CO exposure.

Keywords: carbon monoxide poisoning; cognitive dysfunction; hyperbaric oxygen therapy; prognosis; session.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study flow-chart. CO, carbon monoxide; HBO2, hyperbaric oxygen therapy.
Figure 2
Figure 2
Forest plot of standardized mean difference based on before and after matching. PSM, propensity score matching; GCS, Glasgow coma scale; CO, carbon monoxide; HBO2, hyperbaric oxygen therapy; CO-Hb, carboxyhemoglobin.
Figure 3
Figure 3
Neurocognitive outcome according to the number of hyperbaric oxygen therapy sessions in the total cohort. GDS, Global deterioration scale.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Weaver LK. Carbon monoxide poisoning In: Moon RE, editor. Hyperbaric oxygen therapy indications. 14th ed. North Palm Beach, FL: Best Publishing Company; (2019). 81–104.
    1. Hampson NB. U.S. mortality due to carbon monoxide poisoning, 1999–2014. Accidental and intentional deaths. Ann Am Thorac Soc. (2016) 13:1768–74. doi: 10.1513/AnnalsATS.201604-318OC - DOI - PubMed
    1. Hampson NB, Weaver LK. Carbon monoxide poisoning: a new incidence for an old disease. Undersea Hyperb Med. (2007) 34:163–8. - PubMed
    1. Weaver LK, Hopkins RO, Chan KJ, Churchill S, Elliott CG, Clemmer TP, et al. . Hyperbaric oxygen for acute carbon monoxide poisoning. N Engl J Med. (2002) 347:1057–67. doi: 10.1056/NEJMoa013121 - DOI - PubMed
    1. Choi IS. Delayed neurologic sequelae in carbon monoxide intoxication. Arch Neurol. (1983) 40:433–5. doi: 10.1001/archneur.1983.04050070063016 - DOI - PubMed