Comparison of hyperbaric oxygen therapy pressures for acute carbon monoxide poisoning

ABSTRACT

Purpose@#No consensus currently exists regarding the maximal pressure of hyperbaric oxygen (HBO2) therapy performed within 24 hours of acute carbon monoxide (CO) poisoning. This study aimed to evaluate the difference in therapeutic effects according to the first HBO2 pressure (3.0 atmospheres absolute [ATA] vs. 2.8 ATA). @*Methods@#We used prospectively collected registry data on CO poisoning at a tertiary academic hospital in the Republic of Korea. Adult patients with acute CO poisoning treated with HBO2 within 24 hours after arrival at the emergency department and without the use of additional HBO2 after 24 hours between January 2007 and February 2022 were included. Data from 595 patients were analyzed using propensity score matching (PSM). Patients with mild (non-intubated) and severe (intubated) poisoning were also compared. Neurocognitive outcomes at 1 month after CO poisoning were evaluated using the Global Deterioration Scale combined with neurological impairment. @*Results@#After PSM, the neurocognitive outcomes at 1-month post-CO exposure were not significantly different between the 2.8 ATA (110 patients) and 3.0 ATA (55 patients) groups (p=1.000). Similarly, there was also no significant difference in outcomes in a subgroup analysis according to poisoning severity in matched patients (165 patients) (mild [non-intubated]: p=0.053; severe [intubated]: p=1.000). @*Conclusion@#Neurocognitive sequelae at 1 month were not significantly different between HBO2 therapy pressures of 2.8 ATA and 3.0 ATA in patients with acute CO poisoning. In addition, the 1-month neurocognitive sequelae did not differ significantly between intubated and non-intubated patients.