Lin CH, Su WH, Chen YC, Feng PH, Shen WC, Ong JR, Wu MY, Wong CS, et al.
Medicine. Date of publication 2018 Sep 1;volume 97(39):e12456.
1. Medicine (Baltimore). 2018 Sep;97(39):e12456. doi: 10.1097/MD.0000000000012456.
Treatment with normobaric or hyperbaric oxygen and its effect on
neuropsychometric dysfunction after carbon monoxide poisoning: A systematic
review and meta-analysis of randomized controlled trials.
Lin CH(1), Su WH(2), Chen YC(3), Feng PH(4)(5), Shen WC(3), Ong JR(6)(7), Wu
MY(5)(8)(9), Wong CS(6)(7)(10).
Author information:
(1)School of Medicine, College of Medicine, Taipei Medical University.
(2)Department of Otolaryngology, Head and Neck Surgery, Chimei Medical Center.
(3)Department of Pharmacy.
(4)Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho
Hospital.
(5)Department of Internal Medicine, School of Medicine, College of Medicine.
(6)Emergency Department, Shuang Ho Hospital.
(7)Department of Emergency, School of Medicine.
(8)Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital,
Taipei Medical University.
(9)Graduate Institute of Epidemiology and Preventive Medicine, College of Public
Health, National Taiwan University.
(10)Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical
University, Taipei, Taiwan.
BACKGROUND: Carbon monoxide (CO) poisoning may result in acute neurological
sequelae, cognitive sequelae, and delay neurological sequelae. The administration
of hyperbaric oxygen (HBO) to prevent the development of delayed neurological
sequelae in CO poisoning have extensively investigated but conflicting results
have been reported. We performed a systematic literature review and meta-analysis
of randomized controlled trials (RCTs) evaluating HBO treatment and its effect on
neuropsychometric dysfunction after CO poisoning.
METHODS: We searched Medline, Embase, Pubmed, and the Cochrane Register of
Controlled Trials from inception to December 2017. Eligible studies compared HBO
therapy with normobaric oxygen (NBO) in patients with CO poisoning.
RESULTS: Six studies compared HBO with NBO in CO poisoning patients. Compared
with patients treated with NBO, a lower percentage of patients treated with HBO
reported headache (16.2% vs 16.5%, relative risk [RR] = 0.83, 95%
CI = 0.38-1.80), memory impairment (18.2% vs 23.8%, RR = 0.80, 95%
CI = 0.43-1.49), difficulty concentrating (15.0% vs 18.4%, RR = 0.86, 95%
CI = 0.55-1.34), and disturbed sleep (14.7% vs 16.2%, RR = 0.91, 95%
CI = 0.59-1.39). Two sessions of HBO treatment exhibited no advantage over one
session.
CONCLUSIONS: The meta-analysis indicated that compared with CO poisoning patients
treated with NBO, HBO treated patients have a lower incidence of
neuropsychological sequelae, including headache, memory impairment, difficulty
concentrating, disturbed sleep, and delayed neurological sequelae. Taking into
consideration the cost-effectiveness of one session of HBO, one session of HBO
treatment could be an economical option for patients with CO poisoning with high
severity.
DOI: 10.1097/MD.0000000000012456
PMCID: PMC6181555
PMID: 30278526 [Indexed for MEDLINE]
