급성일산화탄소 중독환자에서 고압산소치료의 압력에 따른 예후 비교
Comparison of hyperbaric oxygen therapy pressures for acute carbon monoxide poisoning
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Purpose: No consensus currently exists regarding the maximal pressure of hyperbaric oxygen (HBO2)therapy performed within 24 hours of acute carbon monoxide (CO) poisoning. This study aimed to evalu ate the difference in therapeutic effects according to the first HBO2 pressure (3.0 atmospheres absolute[ATA] vs. 2.8 ATA). Methods: We used prospectively collected registry data on CO poisoning at a tertiary academic hospitalin the Republic of Korea. Adult patients with acute CO poisoning treated with HBO2 within 24 hours afterarrival at the emergency department and without the use of additional HBO2 after 24 hours betweenJanuary 2007 and February 2022 were included. Data from 595 patients were analyzed using propensityscore matching (PSM). Patients with mild (non-intubated) and severe (intubated) poisoning were alsocompared. Neurocognitive outcomes at 1 month after CO poisoning were evaluated using the Global De terioration Scale combined with neurological impairment. Results: After PSM, the neurocognitive outcomes at 1-month post-CO exposure were not significantlydifferent between the 2.8 ATA (110 patients) and 3.0 ATA (55 patients) groups (p=1.000). Similarly, therewas also no significant difference in outcomes in a subgroup analysis according to poisoning severity inmatched patients (165 patients) (mild [non-intubated]: p=0.053; severe [intubated]: p=1.000). Conclusion: Neurocognitive sequelae at 1 month were not significantly different between HBO2 therapypressures of 2.8 ATA and 3.0 ATA in patients with acute CO poisoning. In addition, the 1-month neuro cognitive sequelae did not differ significantly between intubated and non-intubated patients.
Abstract
Purpose: No consensus currently exists regarding the maximal pressure of hyperbaric oxygen (HBO2)therapy performed within 24 hours of acute carbon monoxide (CO) poisoning. This study aimed to evalu ate the difference in therapeutic effects according to the first HBO2 pressure (3.0 atmospheres absolute[ATA] vs. 2.8 ATA). Methods: We used prospectively collected registry data on CO poisoning at a tertiary academic hospitalin the Republic of Korea. Adult patients with acute CO poisoning treated with HBO2 within 24 hours afterarrival at the emergency department and without the use of additional HBO2 after 24 hours betweenJanuary 2007 and February 2022 were included. Data from 595 patients were analyzed using propensityscore matching (PSM). Patients with mild (non-intubated) and severe (intubated) poisoning were alsocompared. Neurocognitive outcomes at 1 month after CO poisoning were evaluated using the Global De terioration Scale combined with neurological impairment. Results: After PSM, the neurocognitive outcomes at 1-month post-CO exposure were not significantlydifferent between the 2.8 ATA (110 patients) and 3.0 ATA (55 patients) groups (p=1.000). Similarly, therewas also no significant difference in outcomes in a subgroup analysis according to poisoning severity inmatched patients (165 patients) (mild [non-intubated]: p=0.053; severe [intubated]: p=1.000). Conclusion: Neurocognitive sequelae at 1 month were not significantly different between HBO2 therapypressures of 2.8 ATA and 3.0 ATA in patients with acute CO poisoning. In addition, the 1-month neuro cognitive sequelae did not differ significantly between intubated and non-intubated patients.
참고문헌 (25)
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