Use of hyperbaric oxygen therapy for preventing delayed neurological sequelae in patients with carbon monoxide poisoning: A multicenter, prospective, observational study in Japan.

<h4>Background</h4>The purpose of this study was to clarify the practical clinical treatment for acute carbon monoxide (CO) poisoning in Japan and to investigate the efficacy of hyperbaric oxygen (HBO2) therapy in preventing delayed neurological sequelae (DNS) in the acute phase of CO po...

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Autores principales:	Motoki Fujita, Masaki Todani, Kotaro Kaneda, Shinya Suzuki, Shinjiro Wakai, Shota Kikuta, Satomi Sasaki, Noriyuki Hattori, Kazuyoshi Yagishita, Koji Kuwata, Ryosuke Tsuruta, COP-J Study Investigators
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1dd4358dc29849e084c11d54baa204f5
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spelling	oai:doaj.org-article:1dd4358dc29849e084c11d54baa204f52021-12-02T20:10:20ZUse of hyperbaric oxygen therapy for preventing delayed neurological sequelae in patients with carbon monoxide poisoning: A multicenter, prospective, observational study in Japan.1932-620310.1371/journal.pone.0253602https://doaj.org/article/1dd4358dc29849e084c11d54baa204f52021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253602https://doaj.org/toc/1932-6203<h4>Background</h4>The purpose of this study was to clarify the practical clinical treatment for acute carbon monoxide (CO) poisoning in Japan and to investigate the efficacy of hyperbaric oxygen (HBO2) therapy in preventing delayed neurological sequelae (DNS) in the acute phase of CO poisoning.<h4>Methods</h4>We conducted a multicenter, prospective, observational study of acute CO poisoning in Japan. Patients with acute CO poisoning were enrolled and their treatment details were recorded. The primary endpoint was the onset of DNS within 2 months of CO exposure. Factors associated with DNS were assessed with logistic regression analysis.<h4>Results</h4>A total of 311 patients from 57 institutions were registered and 255 were analyzed: 171 received HBO2 therapy (HBO2 group) and 84 did not (normobaric oxygen [NBO2] group). HBO2 therapy was performed zero, once, twice, or three times within the first 24 h in 1.8%, 55.9%, 30.9%, and 11.3% of the HBO2 group, respectively. The treatment pressure in the first HBO2 session was 2.8 ATA (47.9% of the HBO2 group), 2.0 ATA (41.8%), 2.5 ATA (7.9%), or another pressure (2.4%). The incidence of DNS was 13/171 (7.6%) in the HBO2 group and 3/84 (3.6%) in the NBO2 group (P = 0.212). The number of HBO2 sessions in the first 24 h was one of the factors associated with the incidence of DNS (odds ratio, 2.082; 95% confidence interval, 1.101-3.937; P = 0.024).<h4>Conclusions</h4>The practical clinical treatment for acute CO poisoning, including HBO2 therapy, varied among the institutions participating in Japan. HBO2 therapy with inconsistent protocols showed no advantage over NBO2 therapy in preventing DNS. Multiple HBO2 sessions was associated with the incidence of DNS.Motoki FujitaMasaki TodaniKotaro KanedaShinya SuzukiShinjiro WakaiShota KikutaSatomi SasakiNoriyuki HattoriKazuyoshi YagishitaKoji KuwataRyosuke TsurutaCOP-J Study InvestigatorsPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0253602 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Motoki Fujita Masaki Todani Kotaro Kaneda Shinya Suzuki Shinjiro Wakai Shota Kikuta Satomi Sasaki Noriyuki Hattori Kazuyoshi Yagishita Koji Kuwata Ryosuke Tsuruta COP-J Study Investigators Use of hyperbaric oxygen therapy for preventing delayed neurological sequelae in patients with carbon monoxide poisoning: A multicenter, prospective, observational study in Japan.
description	<h4>Background</h4>The purpose of this study was to clarify the practical clinical treatment for acute carbon monoxide (CO) poisoning in Japan and to investigate the efficacy of hyperbaric oxygen (HBO2) therapy in preventing delayed neurological sequelae (DNS) in the acute phase of CO poisoning.<h4>Methods</h4>We conducted a multicenter, prospective, observational study of acute CO poisoning in Japan. Patients with acute CO poisoning were enrolled and their treatment details were recorded. The primary endpoint was the onset of DNS within 2 months of CO exposure. Factors associated with DNS were assessed with logistic regression analysis.<h4>Results</h4>A total of 311 patients from 57 institutions were registered and 255 were analyzed: 171 received HBO2 therapy (HBO2 group) and 84 did not (normobaric oxygen [NBO2] group). HBO2 therapy was performed zero, once, twice, or three times within the first 24 h in 1.8%, 55.9%, 30.9%, and 11.3% of the HBO2 group, respectively. The treatment pressure in the first HBO2 session was 2.8 ATA (47.9% of the HBO2 group), 2.0 ATA (41.8%), 2.5 ATA (7.9%), or another pressure (2.4%). The incidence of DNS was 13/171 (7.6%) in the HBO2 group and 3/84 (3.6%) in the NBO2 group (P = 0.212). The number of HBO2 sessions in the first 24 h was one of the factors associated with the incidence of DNS (odds ratio, 2.082; 95% confidence interval, 1.101-3.937; P = 0.024).<h4>Conclusions</h4>The practical clinical treatment for acute CO poisoning, including HBO2 therapy, varied among the institutions participating in Japan. HBO2 therapy with inconsistent protocols showed no advantage over NBO2 therapy in preventing DNS. Multiple HBO2 sessions was associated with the incidence of DNS.
format	article
author	Motoki Fujita Masaki Todani Kotaro Kaneda Shinya Suzuki Shinjiro Wakai Shota Kikuta Satomi Sasaki Noriyuki Hattori Kazuyoshi Yagishita Koji Kuwata Ryosuke Tsuruta COP-J Study Investigators
author_facet	Motoki Fujita Masaki Todani Kotaro Kaneda Shinya Suzuki Shinjiro Wakai Shota Kikuta Satomi Sasaki Noriyuki Hattori Kazuyoshi Yagishita Koji Kuwata Ryosuke Tsuruta COP-J Study Investigators
author_sort	Motoki Fujita
title	Use of hyperbaric oxygen therapy for preventing delayed neurological sequelae in patients with carbon monoxide poisoning: A multicenter, prospective, observational study in Japan.
title_short	Use of hyperbaric oxygen therapy for preventing delayed neurological sequelae in patients with carbon monoxide poisoning: A multicenter, prospective, observational study in Japan.
title_full	Use of hyperbaric oxygen therapy for preventing delayed neurological sequelae in patients with carbon monoxide poisoning: A multicenter, prospective, observational study in Japan.
title_fullStr	Use of hyperbaric oxygen therapy for preventing delayed neurological sequelae in patients with carbon monoxide poisoning: A multicenter, prospective, observational study in Japan.
title_full_unstemmed	Use of hyperbaric oxygen therapy for preventing delayed neurological sequelae in patients with carbon monoxide poisoning: A multicenter, prospective, observational study in Japan.
title_sort	use of hyperbaric oxygen therapy for preventing delayed neurological sequelae in patients with carbon monoxide poisoning: a multicenter, prospective, observational study in japan.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/1dd4358dc29849e084c11d54baa204f5
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Use of hyperbaric oxygen therapy for preventing delayed neurological sequelae in patients with carbon monoxide poisoning: A multicenter, prospective, observational study in Japan.

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