Taiwan: Retrospective Review Study on HBOT

A retrospective review study by Shu-Chen Liao and team revealed that early hyperbaric oxygen therapy (HBOT) significantly improved delayed neuropsychiatric sequelae (DNS) symptoms in those who developed DNS after carbon monoxide (CO) poisoning. Also, treatment effects sustained for 1 year after DNS diagnosis. The findings of the study are published in the journal Scientific Reports.

Hyperbaric oxygen therapy (HBOT) is a well-established treatment for decompression sickness, a potential risk of scuba diving. Evidence from clinical studies in recent years suggests that hyperbaric oxygen therapy may be a treatment for repairing nerves after brain injury and neuropsychiatric diseases.

The objective of the study was to assess the real-world effectiveness of hyperbaric oxygen therapy (HBOT) on delayed neuropsychiatric sequelae (DNS) after CO poisoning.

The study was a retrospective review of patients with CO poisoning admitted to Linkou Chang-Gung Memorial Hospital, Taiwan's largest medical center, during 2009–2015. It included patients developing DNS after CO poisoning and compared improvements in neuropsychiatric function, with and without HBOT, after 12 months post-DNS to understand differences in recovery rates. DNS improvement-associated factors were also evaluated. They used receiver operating characteristic (ROC) curve analysis to assess the role of time elapsed between DNS diagnosis and HBOT initiation in predicting DNS improvement.

A total of 62 patients developed DNS, of whom 11 recovered while the rest did not.

Results of the Study

• Possible factors predicting DNS improvement included receiving HBOT post-DNS (72.7% vs 25.5%).
• Treatment with more than three HBOT sessions during acute stage CO poisoning (81.8% vs 27.5%).
• The relevant area under the ROC curve was 0.789, and the best cut-off point was 3 days post-DNS diagnosis, with 87.5% sensitivity and 61.5% specificity.

Liao and the team concluded that "Early HBOT in patients who developed DNS after CO poisoning significantly improved their DNS symptoms, with treatment effects sustained for 1 year after DNS diagnosis."

Reference

Liao, SC., Shao, SC., Yang, KJ. et al. Real-world effectiveness of hyperbaric oxygen therapy for delayed neuropsychiatric sequelae after carbon monoxide poisoning. Sci Rep 11, 19212 (2021). https://doi.org/10.1038/s41598-021-98539-y