背景:一氧化碳(CO)是碳基材料不完全燃烧的结果,引起头痛等症状,头晕,恶心,胸痛,混乱,and,在严重的情况下,无意识。常压氧疗(NBOT)是标准疗法,而高压氧治疗(HBOT)被推荐用于严重的器官损伤病例。这项研究检查了严重CO中毒患者的早期和晚期不良结局。
方法:本研究分析了2020年1月至2022年5月急诊收治的CO中毒严重病例。人口统计,临床,并检查了有症状个体和需要HBOT的个体的实验室数据。该研究记录了早期结果,如插管和住院死亡率,和后期结果,如延迟的神经系统后遗症和1年死亡率。卡方检验,斯皮尔曼的rho相关性测试,我们进行了logistic回归分析,以确定影响这些结局的因素.
结果:与接受NBOT的患者相比,接受HBOT的患者在延迟神经系统后遗症(DNS)方面存在显着差异(p=0.037)。观察到需要插管的显着差异,住院死亡率,和基于COHb水平的患者之间的1年死亡率,但在DNS中没有发现显著差异。1年死亡概率受COHb水平显著影响(比值比=1.159,95%CI[1.056-1.273])。接受NBOT的患者的DNS风险优势比高于接受HBOT的患者(优势比=8.464,95%[1.755-40.817],p=0.008)。
结论:研究显示插管没有差异,住院死亡率,HBOT组和NBOT组之间的1年死亡率。然而,DNS的显著差异表明治疗方式对神经系统结局有不同的影响.高COHb水平与插管风险增加有关,和死亡率强调了临床评估中监测COHb水平的重要性.
BACKGROUND: Carbon monoxide (CO) results from incomplete combustion of carbon-based materials, causing symptoms such as headaches, dizziness, nausea, chest pain, confusion, and, in severe cases, unconsciousness. Normobaric oxygen therapy (NBOT) is the standard therapy, whereas hyperbaric oxygen therapy (HBOT) is recommended in severe cases of organ damage. This study examined the early and late adverse outcomes in patients with severe CO poisoning.
METHODS: This study analyzed severe cases of CO poisoning among patients admitted to the emergency department between January 2020 and May 2022. The demographic, clinical, and laboratory data of symptomatic individuals and those requiring HBOT were examined. The study recorded early outcomes, such as intubation and in-hospital mortality, and late outcomes, such as delayed neurological sequelae and 1-year mortality. Chi-square tests, Spearman\'s rho correlation tests, and logistic regression analyses were performed to identify factors affecting these outcomes.
RESULTS: Patients who received HBOT showed a significant difference in delayed neurological sequelae (DNS) compared to those who received NBOT (p = 0.037). Significant differences were observed in the need for intubation, in-hospital mortality, and 1-year mortality between patients based on COHb levels, but no significant differences were found in DNS. The 1-year mortality probability was significantly influenced by COHb level (odds ratio = 1.159, 95% CI [1.056-1.273]). Patients receiving NBOT had a higher odds ratio for DNS risk than those receiving HBOT (odds ratio = 8.464, 95% [1.755-40.817], p = 0.008).
CONCLUSIONS: The study showed no differences in intubation, in-hospital mortality, and 1-year mortality rates between the HBOT and NBOT groups. However, significant differences in DNS suggest that treatment modalities have different effects on neurological outcomes. High COHb levels are associated with an increased risk of intubation, and mortality underscores the significance of monitoring COHb levels in clinical evaluations.