Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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Associations between Early Hyperoxia and Long Term Neurologic Outcome in Acute Carbon Monoxide Poisoning

급성 일산화탄소 중독환자에서 병원 전 고산소혈증이 장기 신경학적 예후에 미치는 영향

  • Kim, Ju Chan (Department of Emergency Medicine, Chonnam National University Medical School) ;
  • Chun, Byeong Jo (Department of Emergency Medicine, Chonnam National University Medical School) ;
  • Moon, Jeong Mi (Department of Emergency Medicine, Chonnam National University Medical School) ;
  • Cho, Young Soo (Department of Emergency Medicine, Chonnam National University Medical School)
  • 김주찬 (전남대학교 의과대학 응급의학교실) ;
  • 전병조 (전남대학교 의과대학 응급의학교실) ;
  • 문정미 (전남대학교 의과대학 응급의학교실) ;
  • 조용수 (전남대학교 의과대학 응급의학교실)
  • Received : 2019.12.03
  • Accepted : 2020.01.06
  • Published : 2020.06.30
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Abstract

Purpose: We studied the impact of arterial oxygen tension (PaO2) on the long term neurologic outcome in patients with acute carbon monoxide poisoning. Methods: The study population included 311 patients who presented to emergency department with acute CO poisoning from January 2015 to January 2018. These patients underwent arterial blood gas testing at the time of presentation. The baseline demographic, clinical, laboratory, and clinical outcome data were recorded. The primary outcome of interest was the long term neurologic status. Results: The normoxia group was significantly older and it had a higher incidence of diffusion weighted MRI abnormality, and this group needed multiple HBO sessions compared to the group with moderate or severe hyperoxia. Also, the incidence of altered mentality at discharge was higher in the normoxia group than that of the moderate hyperoxia group. The incidence of a poor long term neurologic outcome was 11.3%. The incidence of a poor long term neurologic outcome decreased as the PaO2 increased. The PaO2 was significantly lower in patients with a poor long term neurologic outcome than that of the patients with a good outcome 198 (165.2 to 231.1) mmHg in the good outcome group vs. 154 (119-162) mmHg in poor outcome, p<0.001). In multivariate logistic regression analysis, PaO2 was selected as an independent factor of the poor long-term neurologic outcome (OR 0.981 (95% CI: 0.968 to 0.995)) Conclusion: Higher PaO2 was independently associated with a lower incidence of a poor long-term neurologic outcome.

Keywords

References

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