Observation on the therapeutic effect of hyperbaric oxygen on acute encephalopathy and myocardial damage secondary to carbon monoxide poisoning in 105 cases
10.3760/cma.j.cn311847-20200722-00298
- VernacularTitle:高压氧治疗一氧化碳中毒继发急性脑病及心肌损害105例疗效观察
- Author:
Yanping ZHANG
1
;
Aihong LI
;
Wei XU
;
Junwei SONG
;
Changchun LYU
;
Shuxin ZONG
;
Pan ZHANG
Author Information
1. 255120 山东省淄博，淄博矿业集团中心医院高压氧科
- Publication Type:Journal Article
- Keywords:
Hyperbaric oxygen;
Carbon monoxide poisoning;
Acute encephalopathy;
Myocardial damage
- From:
Chinese journal of nautical medicine and hyperbaric medicine
2021;28(1):5-7,19
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe and study the therapeutic effect of hyperbaric oxygen (HBO) on acute encephalopathy and myocardial damage secondary to carbon monoxide (CO) poisoning.Methods:A total of 451 cases of CO poisoning admitted to the Department of Hyperbaric Oxygen of Central Hospital of Zibo Mining Group Co., Ltd. were retrospectively analyzed, including 105 cases of acute encephalopathy with secondary myocardial damage of different degrees. After dehydration, nerve nutrition, circulation improvement, waking up, organ protection, anti-infection, and other supportive symptomatic treatments, HBO was given for 2-3 courses. The myocardial enzyme levels of carboxyhemoglobin (COHb), cardiac troponin (cTnI), creatine kinase (CK), creatine kinase myocardial isoenzyme (CK-MB), and lactate dehydrogenase (LDH) were measured in all patients before and after treatment; the dynamic abnormal changes were monitored by 12-lead electrocardiograph (EKG); and the cerebrospinal fluid pressure was measured by lumbar puncture.Results:The blood biochemical test results after CO poisoning in 105 patients were as follows: the level of COHb was 40.3%~54.7%, with an average of (44.5±7.9)%; myocardial enzymes such as cTnI, CK, CK-MB, and LDH were significantly increased with 5-10 times of the normal values. The EKG of 105 patients showed significant abnormalities. The intracranial pressure was from 185 to 230 cmH 2O, with an average of (210.6±22.9) cmH 2O. After 2-3 courses of combined treatment, the level of COHb in 105 patients was 1.3%~4.7%, with an average of (3.2±0.6)%; the myocardial enzymes such as cTnI, CK, CK-MB and LDH returned to normal values. The intracranial pressure ranged from 160 to 178 cmH 2O, with an average of (166.4±11.9) cmH 2O. After treatment, 95 (90.5%) patients’ EKG gradually returned to normal; among the 10 patients (9.5%) with abnormal EKG, 5 patients had insufficient myocardial blood supply, 3 patients had atrial premature beat, and 2 patients had ventricular premature beat. There were significant differences in these indicators before and after treatment ( P<0.05, or P<0.01). Conclusion:CO poisoning is prone to secondary acute encephalopathy and myocardial damage. HBO combined therapy is highly effective for treating secondary acute encephalopathy and myocardial damage caused by CO poisoning, therefore it can provide a reference for clinical treatment.
