Currently, there is no known optimal therapy for carbon monoxide （CO） poisoning and CO-associated delayed neu- rological sequelae. Hyperbaric oxygen therapy （HBOT） is a well-known treatment method, but its use for...Currently, there is no known optimal therapy for carbon monoxide （CO） poisoning and CO-associated delayed neu- rological sequelae. Hyperbaric oxygen therapy （HBOT） is a well-known treatment method, but its use for CO poison- ing patients is controversial to use due to lack of evidences regarding its efficacy. Thus, it is unlikely that HBOT alone will be accepted as the standard treatment method. In this article, current and potential treatment methods of CO poi- soning are presented as well as the tentative multi-factorial pathophysiology. A series of treatments are suggested for use as a bundle therapy, with targeted temperature management as the base treatment method. Such a therapy holds a great potential, especially for the cases where HBOT is not readily available. We suggest further investigations for elucidating the effects of these suggested treatments and their roles in terms of the complex pathophysiology of CO poisoning. Future ac- ceptance of this therapy based on the improved scientific and clinical knowledge may result in injury prevention and mini- mization of the signs and the symptoms in CO poisoning.展开更多
BACKGROUND Delayed neurological sequelae(DNS)caused by carbon monoxide(CO)intoxication poses considerable treatment challenges for clinical practitioners.In this report,we used nuclear medicine imaging and the Mini-Me...BACKGROUND Delayed neurological sequelae(DNS)caused by carbon monoxide(CO)intoxication poses considerable treatment challenges for clinical practitioners.In this report,we used nuclear medicine imaging and the Mini-Mental State Examination(MMSE)to evaluate the effectiveness of intravascular laser irradiation of blood(ILIB)therapy for the management of DNS.CASE SUMMARY A 51-year-old woman presented to our medical center experiencing progressive bradykinesia,rigidity of limbs,gait disturbance,and cognitive impairment.Based on her neurological deficits,laboratory tests and imaging findings,the patient was diagnosed with delayed neurological sequelae of CO intoxication.She received intensive rehabilitation and ILIB therapy during 30 sessions over 2 mo after diagnosis.Brain single-photon emission computed tomography was performed both prior to and after ILIB therapy.The original hypoperfusion area in bilateral striata,bilateral frontal lobe,right parietal lobe,and bilateral cerebellum showed considerable improvement after completion of therapy.The patient’s MMSE score also increased markedly from 6/30 to 25/30.Symptoms of DNS became barely detectable,and the woman was able to carry out her daily living activities independently.CONCLUSION ILIB therapy could facilitate recovery from delayed neurological sequelae in patients with CO intoxication,as demonstrated by improved cerebral blood flow and functional outcomes in our patient.展开更多
Background: Carbon monoxide (CO) poisoning remains a major cause of accidental injuries and multiple studies have indicated that CO is also associated with significantly severe or long-term toxicity to the central ner...Background: Carbon monoxide (CO) poisoning remains a major cause of accidental injuries and multiple studies have indicated that CO is also associated with significantly severe or long-term toxicity to the central nervous system. Given that CO poisoning causes serious morbidity and mortality, a better understanding of epidemiological features and clinical characteristics of acute CO poisoning in China is crucial.Methods: We collected the clinical data of acute CO poisoning in patients between November 2019 and April 2020 across Shandong province, China and analyzed its characteristics focusing on the weekly amount and the severity of the confirmed cases.Results: A total number of 21,088 acute CO poisoning cases were diagnosed. The overall incidence of acute CO poisoning was approximately 0.021%. On severity rankings, 63% of confirmed cases (n=13,378) were mild, 27%(n=5635) were moderate, and 10% (n=2075) were severe. Interestingly, the coastal cities had more confirmed cases than the inland/suburban areas in Shandong. Meanwhile, the number of confirmed cases was negatively correlated with the local mean daily temperature (P=0.0167).Conclusions: Mild acute CO poisoning cases accounted for the majority of all confirmed cases during the winter of 2019. In Shandong province, which is located in east China, residents of the coastal cities are more susceptible to CO poisoning than residents of inland cities.展开更多
文摘Currently, there is no known optimal therapy for carbon monoxide （CO） poisoning and CO-associated delayed neu- rological sequelae. Hyperbaric oxygen therapy （HBOT） is a well-known treatment method, but its use for CO poison- ing patients is controversial to use due to lack of evidences regarding its efficacy. Thus, it is unlikely that HBOT alone will be accepted as the standard treatment method. In this article, current and potential treatment methods of CO poi- soning are presented as well as the tentative multi-factorial pathophysiology. A series of treatments are suggested for use as a bundle therapy, with targeted temperature management as the base treatment method. Such a therapy holds a great potential, especially for the cases where HBOT is not readily available. We suggest further investigations for elucidating the effects of these suggested treatments and their roles in terms of the complex pathophysiology of CO poisoning. Future ac- ceptance of this therapy based on the improved scientific and clinical knowledge may result in injury prevention and mini- mization of the signs and the symptoms in CO poisoning.
文摘BACKGROUND Delayed neurological sequelae(DNS)caused by carbon monoxide(CO)intoxication poses considerable treatment challenges for clinical practitioners.In this report,we used nuclear medicine imaging and the Mini-Mental State Examination(MMSE)to evaluate the effectiveness of intravascular laser irradiation of blood(ILIB)therapy for the management of DNS.CASE SUMMARY A 51-year-old woman presented to our medical center experiencing progressive bradykinesia,rigidity of limbs,gait disturbance,and cognitive impairment.Based on her neurological deficits,laboratory tests and imaging findings,the patient was diagnosed with delayed neurological sequelae of CO intoxication.She received intensive rehabilitation and ILIB therapy during 30 sessions over 2 mo after diagnosis.Brain single-photon emission computed tomography was performed both prior to and after ILIB therapy.The original hypoperfusion area in bilateral striata,bilateral frontal lobe,right parietal lobe,and bilateral cerebellum showed considerable improvement after completion of therapy.The patient’s MMSE score also increased markedly from 6/30 to 25/30.Symptoms of DNS became barely detectable,and the woman was able to carry out her daily living activities independently.CONCLUSION ILIB therapy could facilitate recovery from delayed neurological sequelae in patients with CO intoxication,as demonstrated by improved cerebral blood flow and functional outcomes in our patient.
基金supported by a grant from the Shandong Medical and Health Science and Technology Development Project(No.2017WSG01004).
文摘Background: Carbon monoxide (CO) poisoning remains a major cause of accidental injuries and multiple studies have indicated that CO is also associated with significantly severe or long-term toxicity to the central nervous system. Given that CO poisoning causes serious morbidity and mortality, a better understanding of epidemiological features and clinical characteristics of acute CO poisoning in China is crucial.Methods: We collected the clinical data of acute CO poisoning in patients between November 2019 and April 2020 across Shandong province, China and analyzed its characteristics focusing on the weekly amount and the severity of the confirmed cases.Results: A total number of 21,088 acute CO poisoning cases were diagnosed. The overall incidence of acute CO poisoning was approximately 0.021%. On severity rankings, 63% of confirmed cases (n=13,378) were mild, 27%(n=5635) were moderate, and 10% (n=2075) were severe. Interestingly, the coastal cities had more confirmed cases than the inland/suburban areas in Shandong. Meanwhile, the number of confirmed cases was negatively correlated with the local mean daily temperature (P=0.0167).Conclusions: Mild acute CO poisoning cases accounted for the majority of all confirmed cases during the winter of 2019. In Shandong province, which is located in east China, residents of the coastal cities are more susceptible to CO poisoning than residents of inland cities.
