CARBON MONOXIDE (CO) POISONING - OXYMED HYPERBARIC OXYGEN THERAPY TIER 2
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Australia is not a leader in this field but lagging behind the rest of the world in relationship to the wider applications of modern Hyperbaric Oxygen Therapy using different 'pressure protocols for different conditions'.
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Carbon monoxide (CO) poisoning is the leading cause of poisoning mortality and morbidity in the USA
Alterations in mitochondrial respiration and reactive oxygen species in patients poisoned with carbon monoxide treated with hyperbaric oxygen.
Intensive Care Med Exp 2018 Jan 30;6(1). Epub 2018 Jan 30.
Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, 19104, PA, USA.
* Carbon monoxide (CO) poisoning is the leading cause of poisoning mortality and morbidity in the USA.
Carboxyhemoglobin (COHb) levels are not predictive of severity or prognosis. At this time, the measurement of mitochondrial respiration may serve as a biomarker in CO poisoning. The primary objective of this study was to assess changes in mitochondrial function consisting of respiration and generation of reactive oxygen species (ROS) in peripheral blood mononuclear cells (PBMCs) obtained from patients with CO poisoning.
Methods: PBMCs from patients having confirmed CO exposure treated with hyperbaric oxygen or HBO (CO group) and healthy controls (control group) were analyzed with high-resolution respirometry. PBMCs were placed in a 2-ml chamber at a final concentration of 3-4 × 10cells/ml to simultaneously obtain both respiration and hydrogen peroxide (HO) production. In the CO group, we performed measurements before and after patients underwent their first HBO treatment.
Results: We enrolled a total of 17 subjects, including 7 subjects with confirmed CO poisoning and 10 subjects in the control group. The CO group included five (71.4%) men and two (28.6%) women having a median COHb of 28%. There was a significant decrease in respiration as measured in pmol O × s × 10PBMCs in the CO group (pre-HBO) when compared to the control group: maximal respiration (18.4 ± 2.4 versus 35.4 ± 2.8, P < 0.001); uncoupled Complex I respiration (19.8 ± 1.8 versus 41.1 ± 3.8, P < 0.001); uncoupled Complex I + II respiration (32.3 ± 3.2 versus 58.3 ± 3.1, P < 0.001); Complex IV respiration (43.5 ± 2.9 versus 63.6 ± 6.31, P < 0.05). There were also similar differences measured in the CO group before and after HBO treatment with an overall increase in respiration present after treatment. We also determined the rate of HOproduction simultaneously with the measurement of respiration. There was an overall significant increase in the HOproduction in the CO group after HBO treatment when compared to prior HBO treatment and the control group.
Conclusions: In this study, PBMCs obtained from subjects with CO poisoning have an overall decrease in respiration (similar HOproduction) when compared to controls. The inhibition of Complex IV respiration is from CO binding leading to a downstream decrease in respiration at other complexes. PBMCs obtained from CO-poisoned individuals immediately following initial HBO therapy displayed an overall increase in both respiration and HOproduction. The study findings demonstrate that treatment with HBO resulted in improved cellular respiration but a higher HO production. It is unclear if the increased production of HO in HBO treatment is detrimental.
Efficacy of Combined XingZhi-YiNao Granules and Hyperbaric Oxygen Therapy for Cognition and Motor Dysfunction in Patients with Delayed Encephalopathy after Acute Carbon Monoxide Poisoning.
Evid Based Complement Alternat Med 2017 26;2017:1323297. Epub 2017 Nov 26.
Department of Integration of Chinese and Western Medicine, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 264000, China.
Purpose: To investigate the efficacy of XingZhi-YiNao (XZYN) granules and hyperbaric oxygenation (HBO) for cognition and motor dysfunction in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).
Methods: Eighty-nine patients with DEACMP were randomly divided into control group (= 19), HBO group (= 32), and XZYN group (= 38). All patients received conventional treatment. HBO group received HBO therapy once daily. XZYN group received extra XZYN granules plus HBO treatment. The related indexes including activity of daily living (ADL) scale, Montreal cognitive assessment (MoCA) scale, and mini mental state examination (MMSE) scale were measured. Cerebral white matter injury, age related white matter changes (ARWMC) scale, and the amplitude and latency of P300 were assessed.
Results: Compared with control group, the neurological function scores of ADL, MoCA, and MMSE in HBO and XZYN groups were significantly improved, the impairment degree of brain white matter and cognition function were obviously alleviated, the latencies of P300 were significantly shortened, and the amplitudes of P300 were evidently increased (< 0.05). Treatment efficacy of XZYN group was superior to that of HBO group (< 0.05).
Conclusion: Combined XZYN granules and HBO can significantly improve cognition and motor functions in patients with DEACMP.