Real-world effectiveness of hyperbaric oxygen therapy for delayed neuropsychiatric sequelae after carbon monoxide poisoning

Objective To assess real-world effectiveness of hyperbaric oxygen therapy(HBOT)on delayed neuropsychiatric sequelae(DNS)after carbon monoxide(CO)poisoning we conducted a retrospective review of patients with CO poisoning admitted to Linkou Chang-Gung Memorial Hospital,Taiwan′s largest medical center,during 2009-2015.Methods We 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.We used receiver operating characteristic(ROC)curve analysis to assess the role of time elapsed between DNS diagnosis and HBOT initiation in predicting DNS improvement.Results A total of 62 patients developed DNS,of whom 11 recovered while the rest did not.Possible factors predicting DNS improvement included receiving HBOT post-DNS(72.7%vs 25.5%;P=0.006),and treatment with more than three HBOT sessions during acute stage CO poisoning(81.8%vs 27.5%;P=0.003).The relevant area under the ROC curve was 0.789(95%CI 0.603-0.974),and the best cut-off point was 3 days post-DNS diagnosis,with 87.5%sensitivity and 61.5%specificity.Conclusion 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.