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Hyperbaric oxygen therapy and mortality from carbon monoxide poisoning: A nationwide observational study

Mikio Nakajima1, Shotaro Aso2, Hiroki Matsui2

  • 1Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan; Department of Trauma and Critical Care Medicine, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka-shi, Tokyo, Japan.

The American Journal of Emergency Medicine
|February 25, 2019
PubMed

Insights

Hyperbaric oxygen therapy (HBOT) did not reduce mortality in carbon monoxide (CO) poisoning patients. However, HBOT improved consciousness and daily living activities, even in non-severe CO poisoning cases.

Area of Science:

  • Emergency Medicine
  • Toxicology
  • Hyperbaric Medicine

Background:

  • The impact of hyperbaric oxygen therapy (HBOT) on carbon monoxide (CO) poisoning outcomes is not well-established.
  • Existing research lacks clarity on HBOT's effects on mortality and morbidity in CO poisoning patients.

Purpose of the Study:

  • To investigate the effects of HBOT on mortality and morbidity in adult patients with CO poisoning.
  • To analyze HBOT's impact on specific patient subgroups based on poisoning severity.

Main Methods:

  • Retrospective analysis of the Japanese Diagnosis Procedure Combination inpatient database (2010-2016).
  • Propensity score-matching to compare HBOT recipients with non-recipients.
  • Primary outcome: in-hospital mortality. Secondary outcomes: mental status and activities of daily living (ADL) at discharge.

Main Results:

  • No significant difference in in-hospital mortality between HBOT (0.8%) and control (1.2%) groups.
  • HBOT group showed significantly lower rates of depressed mental status and reduced ADL at discharge.
  • Benefits of HBOT on mental status and ADL were observed in the non-severe CO poisoning subgroup.

Conclusions:

  • HBOT is not significantly associated with reduced mortality in CO poisoning.
  • HBOT demonstrates significant benefits in improving consciousness level and ADL in CO poisoning patients.
  • HBOT may offer advantages for patients with non-severe CO poisoning.
Abstract

Keywords:
Carbon monoxideHyperbaric oxygenMatchingMortalityPoisoningPropensity score

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