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Pediatric Carbon Monoxide Poisoning: Effects of Hyperbaric Oxygen Therapy on Thiol/Disulfide Balance
Zafer Bağci1, Abdullah Arslan2, Salim Neşelioğlu3
1From the Department of Pediatrics, Konya Education and Research Hospital, University of Health Sciences Turkey.
Insights
Hyperbaric oxygen therapy (HBOT) for carbon monoxide (CO) poisoning in children decreased antioxidant levels, unlike normobaric oxygen therapy (NBOT). While HBOT maintains thiol-disulfide balance, potential oxidative stress requires consideration.
Area of Science:
- Biochemistry
- Toxicology
- Pediatrics
Background:
- Carbon monoxide (CO) poisoning is a leading global cause of intoxication.
- Thiol-disulfide homeostasis plays a crucial role in cellular redox balance and antioxidant defense.
- Understanding the impact of oxygen therapies on this balance is vital for effective CO poisoning management.
Purpose of the Study:
- To compare the effects of hyperbaric oxygen therapy (HBOT) and normobaric oxygen therapy (NBOT) on thiol/disulfide homeostasis in pediatric CO intoxication.
- To evaluate changes in serum native thiol, disulfide, and total thiol levels and their ratios post-treatment.
Main Methods:
- A cross-sectional study involving 81 children (0-18 years) with CO intoxication.
- Patients were divided into two groups: 32 receiving HBOT and 49 receiving NBOT.
- Serum thiol/disulfide parameters were measured before and after treatment.
Main Results:
- Native thiol and total thiol levels significantly decreased with HBOT (P=0.02) but increased with NBOT (P=0.01).
- No significant differences were observed between groups in the change of native thiol/total thiol ratios (P=0.07).
- Changes in disulfide levels and related ratios showed no significant difference between treatments.
Conclusions:
- While HBOT maintains thiol-disulfide balance in CO poisoning, it leads to a significant decrease in antioxidant levels compared to NBOT.
- The efficiency of HBOT in treating CO intoxication is acknowledged, but potential oxidative stress and reperfusion injury from hyperoxygenation warrant careful consideration.
Objectives:
Carbon monoxide (CO) poisoning remains the foremost cause of poisoning worldwide. This study aimed to investigate the effects of hyperbaric oxygen therapy (HBOT) and normobaric oxygen therapy (NBOT) on thiol/disulfide homeostasis in children with CO intoxication.
Methods:
Eighty-one children aged 0 to 18 years with CO intoxication were included in this cross-sectional study. No changes were made in the routine clinical evaluation and treatment practices of the patients. Thirty-two children who received HBOT and 49 children who received NBOT were compared for serum native thiol, disulfide, and total thiol levels, as well as for the changes in disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol ratios before and after treatment.
Results:
Antioxidant levels, such as native thiol and total thiol, were significantly decreased in patients who received HBOT and increased in those who received NBOT (P = 0.02 and P = 0.01, respectively). There was no statistically significant difference between the 2 groups concerning the change of native thiol/total thiol ratios (P = 0.07). In addition, there was no significant difference regarding changes in disulfide, disulfide/native thiol, and disulfide/total thiol levels before and after treatment (P = 0.39, P = 0.07, and P = 0.07, respectively).
Conclusions:
Although thiol-disulfide balance is maintained in patients treated with HBOT, antioxidant levels decrease significantly compared with NBOT. Despite efficiency of HBOT in CO intoxication, oxidative stress and reperfusion injury due to hyperoxygenation should be considered in the treatment of HBOT.
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