Qin

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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

  1. Details regarding HBOT dose not given in the paper.
  2. No blinding or allocation concealment and no indication of how the participants were randomised. Significant risk of bias.
  3. MoCA and MMSE scores in the treatment arms overall modestly improved but remain indicative of problematic cognitive dysfunction. ADL improvement clinically significant.
  4. Follow-up period was limited to two months. No long-term conclusions can be drawn.
  5. 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