The neurological effects of carbon monoxide (CO) poisoning can be severe. For a study, researchers sought to evaluate the prognosis of patients with CO poisoning. There were neither accurate prognostic markers nor an efficient treatment plan. In order to understand the clinical significance of these potential indicators and the neuroprotective effect of mild hypothermia on brain injury in patients with severe acute CO poisoning, they looked at changes in neurological function score, disease severity score, cerebral oxygen utilization score (O2UCc), bispectral index (BIS) score, and neuron-specific enolase (NSE) concentration.
From 2013 to 2018, the hospital treated 277 individuals who had acute, severe CO poisoning. According to their body temperatures on the day of admission and their willingness to receive treatment, patients were separated into 3 groups: a fever group (n=78), a normal temperature group (NT group, n=113), and a mild hypothermia group (MH group, n=86). All patients underwent hyperbaric oxygen therapy, and those who were part of the MH group also got moderate hypothermia therapy. All patients were further assessed at the specified time periods for illness severity, neurobehavioral state, the incidence of delayed encephalopathy after acute carbon monoxide poisoning (DEACMP), and other markers, including BIS, O2UCc, and NSE.
The prognosis of CO poisoning patients was improved by mild hypothermia treatment, which also considerably reduced O2UCc and NSE values and increased BIS. At 6 months, there were 27% cases of DEACMP in the fever group, 23% cases in the NT group, and 8% cases in the MH group. The cutoff values for the Glasgow-Pittsburgh coma scale (G-P score), BIS index, and NSE were 12.41, 52.17, and 35.20 ng/mL, respectively. According to the receiver operating characteristic curve (ROC), the sensitivity and specificity were 79.3%, 77.6%, 79.3% and 67.6%, 89.5%, 88.6%, respectively.
Early moderate hypothermia therapy may become more common in clinics and might greatly lessen the degree of brain damage following CO poisoning. G-P scores, NSE, and BIS index can be viewed as the indications that can help anticipate when and how DEACMP would occur.
Reference: sciencedirect.com/science/article/abs/pii/S0735675722005186
