![]() ![]() reported that three-fourths of patients with DNS recovered within 1 year 9. The outcome of DNS is relatively good in certain CO poisoned patients in a study from Seoul, Korea, Choi et al. Since there are no strict diagnostic criteria, most reported DNS cover a broad spectrum of neurological deficits, including cognitive impairments, and behavioral and psychological disorders 8. In addition to causing acute morbidity and mortality, CO poisoning can cause delayed neuropsychiatric sequelae (DNS), with the lag time ranging from 2 days to 6 weeks 7. Long periods or high atmospheric concentrations of CO exposure however can cause damage to vital organs, which have high oxygen demand and consumption, such as the heart and the brain 6. Most patients with CO poisoning present to the emergency department (ED) with nonspecific symptoms and fully recover after oxygen therapy. CO often originates from the incomplete combustion of hydrocarbon fuels in fires, stoves, charcoal briquette burners, boilers, chimneys, internal combustion engines, gas-fuelled water heaters, and so on 2, 5. ![]() Early HBOT in patients who developed DNS after CO poisoning significantly improved their DNS symptoms, with treatment effects sustained for 1 year after DNS diagnosis.Ĭarbon monoxide (CO) is one of the main environmental causes of acute poisoning worldwide, and is associated with a high mortality rate and specific complications 1, 2, 3, 4, 5. ![]() The relevant area under the ROC curve was 0.789 (95% CI 0.603–0.974), and the best cut-off point was 3 days post-DNS diagnosis, with 87.5% sensitivity and 61.5% specificity. Possible factors predicting DNS improvement included receiving HBOT post-DNS (72.7% vs 25.5% P = 0.006), and treatment with more than three HBOT sessions during acute stage CO poisoning (81.8% vs 27.5% P = 0.003). A total of 62 patients developed DNS, of whom 11 recovered while the rest did not. We used receiver operating characteristic (ROC) curve analysis to assess the role of time elapsed between DNS diagnosis and HBOT initiation in predicting DNS improvement. DNS improvement-associated factors were also evaluated. We included patients developing DNS after CO poisoning and compared improvements in neuropsychiatric function, with and without HBOT, after 12 months post-DNS to understand differences in recovery rates. To assess real-world effectiveness of hyperbaric oxygen therapy (HBOT) on delayed neuropsychiatric sequelae (DNS) after carbon monoxide (CO) poisoning we conducted a retrospective review of patients with CO poisoning admitted to Linkou Chang-Gung Memorial Hospital, Taiwan’s largest medical center, during 2009–2015. ![]()
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