Purpose: The purpose of this research was to explore the possible treatment effects of hyperbaric oxygen therapy (HBOT), combined with dexamethasone therapy, on patients with confirmed neurological toxicity caused by carbon monoxide and related brain lesions evident on magnetic resonance imaging (MRI).
Methods: A retrospective study was performed based on the medical records of patients with acute carbon monoxide (CO) poisoning who had visited the regional emergency center from January 2019 to November 2022. The incidence of neurological toxicity after combined HBOT and dexamethasone treatment were evaluated in 89 patients with brain MRI results who had risk factors of neurological toxicity such as loss of consciousness (LOC), mental alteration, elevation of CK, Troponin-I, and ischemic change on electrocardiography.
Results: Of the 89 patients with CO poisoning who exhibited features of possible neurological toxicity, 45 cases were conformed to have CO poisoning-related lesions on brain MRI and 44 cases were free of these effects. Among the 45 cases with CO poisoning-related lesions (+), three expired, one suffered hypoxic brain damage, and three were lost to follow-up. Therefore, the final studied group comprised 38 patients in total. The average admission period was 14 days, and the average dexamethasone dosage used was 80.00 mg. 12 patients (31.58%) with neurological toxicity and 26 patients (68.42%) without neurological toxicity were discharged. The final studied number of CO poisoning patients with brain MRI lesions (-) was 42 patients with 2 cases lost to follow-up. The average admission period was 8 days and average dexamethasone dosage used was 48.75 mg. 3 patients (7.14%) with neurological toxicity and 39 patients (92.86%) without neurological toxicity were discharged.
Conclusion: This retrospective review included 38 patients confirmed to have CO poisoning-related lesions on brain MRI who were treated with HBOT combined with dexamethasone therapy. It is, however, difficult to conclude whether these two factors (usage period and dosage of dexamethasone) are significantly related to the risk of acute lesion on brain MRI (+) (p-value>0.05).