Clinical observation of cognitive function training combined with hyperbaric oxygen treatment in delayed encephalopathy after carbon monoxide poisoning

Abstract

Objective To explore the curative effect of cognitive function training combined with hyperbaric oxygen treatment in delayed encephalopathy after carbon monoxide poisoning. Methods Eighty patients with delayed encephalopathy after carbon monoxide poisoning in the emergency department of our hospital between November 2009 and December 2014 were included in the study. The patients were randomly into the combination treatment group (n=20) , cognitive function training group (n=20) , hyperbaric oxygen group (n=20) and control group (n=20). Conventional therapy was given to the patients in the control group and other treatment groups; in addition, the cognitive function training group received cognitive function training, hyperbaric oxygen group was given hyperbaric oxygen, and the combination treatment group received cognitive function training plus hyperbaric oxygen therapy. The outcomes of different therapies were evaluated after 30-day treatment. The general characteristics of the patients, including age, gender, disease duration, underlying diseases and level of education were recorded. At baseline and after the treatment, the patients were evaluated for cognitive function with Mini-Mental State Examimation (MMSE) and Montreal Cognitive Assessment (MoCA) , and active ability of daily life (ADL) with modified Barthel index (MBI). Results The age, gender, diseases duration, underlying diseases and level of education did not differ across the 4 groups (all P>0.05). The rates of effectiveness were 100.0% (20/20) in the combination treatment group, 90.0% (18/20) in the cognitive function training group and 85.0% (17/20) in the hyperbaric oxygen group, which were higher than that in the control group (75.0%, 15/20) (all P 0.05) , but these values were remarkably increased from baseline in all groups after treatments (all P<0.05). After treatment, the combination treatment group and cognitive function training group showed significantly higher MMSE scores, and the combination treatment group, cognitive function training group and hyperbaric oxygen group showed significantly higher MoCA and MBI scores compared with the control group (all P<0.05). The post-treatment MMSE scores were significantly lower in the hyperbaric oxygen group and control group than those in the combination treatment group; the post -treatment MoCA and MBI scores were lower in the cognitive function training group, hyperbaric oxygen group and control group than those in the combination treatment group (all P<0.05). Conclusion Cognitive function training combined with hyperbaric oxygen therapy can significantly improve the therapeutic efficacy of delayed encephalopathy after carbon monoxide poisoning by offering better cognitive function and ADL. Key words: Hyperbaric oxygenation; Carbon monoxide poisoning; Treatment outcome; Cognitive function training