Thiol/disulfide homeostasis in patients treated with normobaric or hyperbaric oxygen for carbon monoxide poisoning

We aimed to determine the value of thiol/disulfide homeostasis (TDH) as an oxidative stress marker in hyperbaric oxygen therapy (HBOT) and normobaric oxygen therapy (NBOT) patients presenting with carbon monoxide poisoning. In addition, we compared the effect of HBOT and NBOT on thiol/disulfide parameters.

This prospective study included 66 patients and 67 healthy individuals who presented to the emergency department. We evaluated serum native thiol, disulfide, and total thiol levels in 8 patients who received HBOT and 58 who received NBOT. We also compared pre- and post-treatment levels of disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol.

There was a statistically significant difference between the case and control groups in native thiol and total thiol before NBOT (p < 0.006, p < 0.006). We also found a statistically significant difference between the groups in pre- and post-NBOT levels of native thiol and total thiol (p < 0.002, p < 0.003). However, our comparison of HBOT and NBOT showed no significant difference in the levels of native thiol, total thiol, disulfide, disulfide/native thiol, disulfide/total thiol, or native thiol/total thiol (p < 0.544, p < 0.860, p < 0.644, p < 0.409, p < 0.409, p < 0.409, respectively).

Although thiol/disulfide parameters increased in patients receiving HBOT or NBOT, changes in antioxidant levels did not differ significantly between NBOT and HBOT patients. This suggests that NBOT and HBOT have similar effects on thiol/disulfide parameters. NBOT alone may be effective in centers that do not have HBOT facilities.