• Sangsoo Han, Sangun Nah, Sungwoo Choi, Young Hwan Lee, Gi Woon Kim, and Young Soon Cho.
• Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
• J Emerg Med. 2021 Apr 1; 60 (4): 498-505.

BackgroundIt is important to prevent the development of delayed neuropsychiatric sequelae (DNS) in acute carbon monoxide (CO) intoxication, but no effective treatment has been clearly identified. Hyperbaric oxygen (HBO) therapy is one of the treatment options in acute CO poisoning; however, whether it can prevent the development of DNS is controversial.ObjectivesThe purpose of this study is to compare the effectiveness of normobaric oxygen (NBO) and HBO in preventing DNS.MethodsThis prospective observational study was conducted on all patients with CO poisoning admitted to the emergency department of a tertiary hospital from 2016 to 2019. We followed-up patients to determine whether symptoms of DNS occurred at ≤6 months. We matched the propensity score to an equivalent distribution of potential covariates.ResultsA total of 224 patients with CO poisoning were enrolled in this study. NBO was used for 26 patients and HBO for 198 patients. DNS occurred in 40 patients. There were significant differences between the NBO and HBO groups in terms of carboxyhemoglobin, loss of consciousness, dizziness, chest pain, hospitalization, and length of hospital stay. The incidence of DNS was 19.2% in the HBO group, which was higher than the 7.7% observed in the NBO group, but the difference was not significant (p = 0.18). After propensity score matching, the incidence of DNS did not differ between the NBO and HBO groups (8.3% vs. 10.4%, p > 0.99).ConclusionThere was no difference in the incidence of DNS between groups receiving HBO and NBO in acute CO intoxication.Copyright © 2020 Elsevier Inc. All rights reserved.

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