Lee Y, Cha YS, Kim SH, Kim H, et al.
Critical care medicine. Date of publication 2021 Oct 1;volume 49(10):e910-e919.
1. Crit Care Med. 2021 Oct 1;49(10):e910-e919. doi: 10.1097/CCM.0000000000005112.
Effect of Hyperbaric Oxygen Therapy Initiation Time in Acute Carbon Monoxide
Poisoning.
Lee Y(1)(2), Cha YS(1)(2), Kim SH(3), Kim H(1)(2).
Author information:
(1)Department of Emergency Medicine, Yonsei University Wonju College of
Medicine, Wonju, Republic of Korea.
(2)Research Institute of Hyperbaric Medicine and Science, Yonsei University
Wonju College of Medicine, Wonju, Republic of Korea.
(3)Department of Biostatistics and Center of Biomedical Data Science, Yonsei
University Wonju College of Medicine, Wonju, Republic of Korea.
Comment in
Crit Care Med. 2022 Aug 1;50(8):e686-e687.
OBJECTIVES: Hyperbaric oxygen therapy (HBO2) is recommended for symptomatic
patients within 24-hour postcarbon monoxide poisoning. Previous studies have
reported significantly better outcomes with treatment administered within 6
hours after carbon monoxide poisoning. Thus, we aimed to compare the
neurocognitive outcomes according to HBO2 delay intervals.
DESIGN: Retrospective analysis of data from our prospectively collected carbon
monoxide poisoning registry.
SETTING: A single academic medical center in Wonju, Republic of Korea.
PATIENTS: We analyzed the data of 706 patients older than 16 years treated with
HBO2 with propensity score matching. Based on carbon monoxide exposure-to-HBO2
delay intervals, we classified patients into the early (control, less than or
equal to 6 hr) and late (case, 6-24 hr) groups. The late group was further
divided into Case-1 (6-12 hr) and Case-2 (12-24 hr) groups. We also compared
mild (nonintubated) and severe (intubated) groups.
INTERVENTIONS: HBO2.
MEASUREMENTS AND MAIN RESULTS: After propensity score matching, Global
Deterioration Scale scores at 6 months postcarbon monoxide exposure showed
significantly fewer poor outcome patients in the early than in the late group (p
= 0.027). The early group had significantly fewer patients with poor outcomes
than the Case-2 group (p = 0.035) at 1 month and than the Case-1 (p = 0.033) and
Case-2 (p = 0.004) groups at 6 months. There were significantly more patients
with poor prognoses at 6 months as treatment interval increased (p = 0.008). In
the mild cohort, the early group had significantly fewer patients with poor
6-month outcomes than the late group (p = 0.033).
CONCLUSIONS: Patients who received HBO2 within 6 hours of carbon monoxide
exposure had a better 6-month neurocognitive prognosis than those treated within
6-24 hours. An increase in the interval to treatment led to an increase in poor
outcomes.
Copyright © 2021 by the Society of Critical Care Medicine and Wolters Kluwer
Health, Inc. All Rights Reserved.
DOI: 10.1097/CCM.0000000000005112
PMID: 34074856 [Indexed for MEDLINE]
Conflict of interest statement: Dr. H. Kim received support for article research
from the Korea Ministry of Health. The remaining authors have disclosed that
they do not have any potential conflicts of interest.
