EFFECTIVENESS OF HYPERBARIC OXYGEN COMBINED WITH MANNITOL IN THE TREATMENT OF ACUTE CARBON MONOXIDE POISONING AND ITS EFFECT ON THE INCIDENCE OF ADVERSE EFFECTS IN PATIENTS

Yuming Gao¹, Wei Ren², Haitao Cui³, Bing Han¹, Lili Bai^{4, *}

¹Department of Emergency, Jiaozhou Central Hospital of Qingdao, Jiaozhou 266300, Shandong, China - ²Department of Intensive Care Unit, Jiaozhou Central Hospital of Qingdao, Jiaozhou 266300, Shandong, China - ³Department of Clinical Laboratory, Jiaozhou Central Hospital of Qingdao, Jiaozhou 266300, Shandong, China - ⁴Department of Poisoning Treatment, The Fifth Medical Center of PLA General Hospital, Beijing 266300,Shandong, China

Objective: To investigate the efficacy of hyperbaric oxygen (HBO) combined with mannitol (MT) in the treatment of acute carbon monoxide poisoning (ACOP) and its effect on the incidence of adverse reactions. 

Methods: The clinical data of 103 ACOP patients in the emergency department of our hospital from March 2019 to March 2020 were retrospectively analyzed. The ACOP patients meeting the inclusion criteria were split into the conventional group (n=52) and the combination group (n=51) according to the order of admission. The conventional group received HBO treatment only after admission, while the combination group received MT combined with HBO to analyze the efficacy and incidence of adverse reactions in both groups by evaluating the neurological function and myocardial injury indexes at different times. 

Results: A total of 103 subjects meeting the criteria were included in this study. In the conventional group, 52 cases were collected, 2 cases were suspended, and 50 cases were finally completed. In the combination group, 51 cases were collected, 1 case was suspended, and 50 cases were finally completed. No remarkable differences in the baseline data were observed between the two groups before treatment (P<0.05). Compared with the conventional group, the combination group achieved obviously shorter hospitalization time and awakening time (P<0.001), lower ARWMC scores at 10 days, 1 month and 3 months after treatment (P<0.00), higher MoCA scores at 1 month and 3 months after treatment (P<0.001), lower myocardial injury indexes after treatment (P<0.001), higher number of cases with complete recovery after treatment (P<0.05), lower number of cases with no recovery (P<0.05), and lower total incidence of adverse reactions (P<0.05). 

Conclusion: The above results show that HBO combined with MT is superior to HBO alone in reducing the incidence of myocardial injury and adverse reactions in patients. Therefore, this treatment method is recommended for emergency treatment of ACOP.