Association Between Near Infrared Spectroscopy (NIRS) and Normobaric and Hyperbaric Oxygen Treatment in Acute Carbon Monoxide Poisoning

Objective: Carbon monoxide (CO) is the main cause of death and morbidity associated with poisoning in developed countries. The most important mortality and morbidity cause of CO poisoning is cerebral hypoxia. Near infrared spectroscopy (NIRS) is a useful method for assessing brain oxygenation. In this study, we aimed to evaluate the brain oxygenation of CO poisoning patients with NIRS and to investigate its benefits in patients follow up and treatment. Methods: The study was conducted as a single-center, prospective clinical trial with 33 patients who were diagnosed by measuring blood carboxyhemoglobin (CO-Hb) level or referred from other hospitals diagnosed with CO poisoning. Patients were divided into two groups as normobaric oxygen therapy (NBOT) group and hyperbaric oxygen therapy (HBOT) group according to the treatment method applied. Results: Although average cerebral saturation (ScO2) levels after treatment were higher in the NBOT group than before treatment, no statistically significant difference was found except the left frontal ScO2 values. In HBOT group, there was no difference between ScO2 values before and after treatment sessions. Conclusions: Our study concluded that NIRS may be useful in assessing brain oxygenation in CO poisoned patients, but not in determining the HBOT start-up, and not in monitoring the effectiveness of HBOT.

Akut Karbonmonoksit Zehirlenmesinde Near Infrared Spectroskopy (NIRS) ile Normobarik ve Hiperbarik Oksijen Tedavisi Arasındaki İlişki

Amaç: Karbonmonoksit (CO) gelişmiş ülkelerde zehirlenme ile ilişkili ölüm ve morbiditenin ana nedenidir. CO zehirlenmesinin en önemli mortalite ve morbidite nedeni serebral hipoksidir. Near infrared spectroscopy (NIRS) beyin oksijenizasyonunu değerlendirmede kullanışlı bir yöntemdir. Bu çalışma ile CO zehirlenmelerinde hastaların beyin oksijenizasyonunu NIRS ile değerlendirerek, hastaların takip ve tedavisindeki faydalarını araştırmayı amaçladık. Gereç ve Yöntem: Araştırma tek merkezli, prospektif klinik çalışma olarak, Ekim 2013 - Nisan 2014 tarihleri arasında, tanısı kan karboksihemoglobin (CO-Hb) düzeyi bakılarak veya CO zehirlenmesi tanısı ile diğer hastanelerden sevkli gelen 33 hasta ile yapıldı. Hastalar uygulanan tedavi yöntemine göre normobarik oksijen tedavisi (NBOT) grubu ve hiperbarik oksijen tedavisi (HBOT) grubu olarak 2 gruba ayrıldı. Bulgular: NBOT grubunda tedavi sonrası ortalama serebral satürasyonu (ScO2) düzeyleri tedavi öncesine göre daha yüksek tespit edilmesine rağmen, sol frontal ScO2 değerleri dışında istatistiki olarak anlamlılık tespit edilmedi. HBOT grubunda ise tedavi öncesi ve tedavi seansları sonrası ScO2 değerleri arasında farklılık tespit edilmedi. Sonuç: Çalışmamızda CO zehirlenmeli hastalarda NIRS'ın beyin oksijenizasyonunu değerlendirmede faydalı olabileceği fakat HBOT başlama kararı vermede ve HBOT’nin etkinliğini izlemede faydalı olmadığı sonucuna varılmıştır.

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ISSN: 1309-3878
Yayın Aralığı: 3
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez