Qin
Hyperbaric oxygen therapy improved cognitive and motor function in patients with delayed encephalopathy after acute carbon monoxide poisoning
Clinical bottom line
1.HBOT resulted in a clinically importnat improvement in ADL
2. HBOT made a small improvement in cognitive function measures
Citation: Qin L, Meihua C, Dadong G, Li W, Jinglin W, Xiaoyu D, Mingjun B, Yong Z. Efficacy of Combined Xing Zhi-Yi Nao granules and Hyperbaric Oxygen Therapy for Cognition and Motor Dysfunction in Patients with Delayed Encephalopathy after Acute Carbon Monoxide Poisoning. Evidence-based Complementary and Alternative Medicine 2017; Article ID 1323297:1-6.
Lead author’s name and Email: L. Qin : liqin701015@163.com
Three-part clinical question (patients, intervention, outcome): In patients with delayed encephalopathy after acute COP, does the addition of hyperbaric oxygen therapy, compared to standard treatment alone, result in improved cognition and motor function?
Search terms: Delayed encephalopathy, carbon monoxide, Chinese medicine
The study: Non-blinded non-concealed randomised controlled trial with intention-to-treat.
The study patients: Patients between 18-75 years old, diagnosed with symptoms of DEACMP, 2-60 days from carbon monoxide exposure and presenting bilateral demyelination lesions on brain MRI. Those with significant co-morbidities or failed completion of follow-up plans were excluded.
Control group: (N = 19; 19 analysed): Nasal oxygen inhalation, injections of cytidine diphosphate choline and vitamin B, and management of fluids, blood glucose and blood pressure.
Experimental group: (N = 24; 24 analysed): As above, but also receiving HBOT daily for two months.
The evidence
Measure |
Control Group |
HBOT Group |
Difference |
95% CI | ||
Mean |
SD |
Mean |
SD | |||
Activities of daily living scale at 2 months (0 worst to 100 best) |
23.0 |
6.1 |
60.5 |
8.1 |
37.5 |
33.0 to 42.0 |
'Montreal cognitive assessment scale'at 2 months (0 worst to 30 best) |
18.2 |
3.6 |
22.2 |
2.7 |
4.0 |
2.1 to 5.9 |
Mini mental state examination at 2 months (0 worst to 30 best) |
18.1 |
4.5 |
22.4 |
3.5 |
4.3 |
1.8 to 6.8 |
Comments
- Details regarding HBOT dose not given in the paper.
- No blinding or allocation concealment and no indication of how the participants were randomised. Significant risk of bias.
- MoCA and MMSE scores in the treatment arms overall modestly improved but remain indicative of problematic cognitive dysfunction. ADL improvement clinically significant.
- Follow-up period was limited to two months. No long-term conclusions can be drawn.
- The authors included a third treatment arm which assessed HBOT with daily traditional Chinese medicine XingZhi-YiNao granules that were uniquely formulated for this study. This performed better than both the control and HBOT groups.
Appraised by: Bosco Tran bosco.tran@student.unsw.edu.au
Kill or update by: February 2025