一氧化碳中毒 (从2023年高压指示手册第15版重印)
Lindell K Weaver1,2,3
1Hyperbaric Medicine Division, Intermountain LDS Hospital, Salt Lake City, Utah.
概括
一氧化碳 (CO) 中毒是一种严重的健康风险,导致大量的急诊室访问和长期的神经问题. 高压氧气疗法 (HBOT) 通过减少炎症和改善CO中毒的结果提供了一个有前途的治疗方法.
科学领域:
- 毒理学 毒理学 毒理学
- 紧急医疗 紧急医疗
- 神经学 神经学
背景情况:
- 一氧化碳 (CO) 中毒在美国每年影响5万人,导致紧急访问.
- 暴露可能是急性和致命的或慢性和次致命的,导致包括神经缺陷在内的各种症状.
- 碳化合物中毒经常导致大脑损伤,影响认知,情感,神经和体力功能.
研究的目的:
- 审查高压氧气疗法 (HBOT) 在治疗一氧化碳中毒方面的疗效.
- 要突出HBOT减轻CO引起的损害的机制.
- 在有症状的CO中毒病例中推HBOT.
主要方法:
- 审查现有的随机临床试验在人类和动物研究的HBOT对CO中毒.
- 对HBOT对碳氧血球蛋白消除和炎症过程的生理影响的分析.
- 对HBOT对线粒体功能和神经炎症的影响的评估.
主要成果:
- 高压氧 (HBO2) 比正常氧更有效地加快碳氧血球蛋白 (COHb) 的排泄.
- HBO2调节炎症过程,改善线粒体功能,减少大脑炎症.
- 证据支持HBOT在CO中毒病例中的好处,特别是当化物中毒或吸入烟雾复杂时.
结论:
- 在所有急性症状性CO中毒病例中,应考虑高压氧疗法.
- 在减轻CO引起的神经损伤方面,HBOT比标准氧气疗法具有显著的优势.
- HBOT的治疗益处得到了强有力的临床和临床前证据的支持.
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