The profile of cases at high risk of developing DNS is expected to include a clinical picture consisting of: the patient's selection of CO exposure as a means of suicide attempt in such serious mental condition as to affect his/her social and living functions; serious consciousness disturbance at admission due to acute CO poisoning, with a JCS score at or above 100; head CT findings indicating hypoxic encephalopathy; and abnormally high CK, CKMB and LDH levels detected by a blood test. In these cases, active consideration should be given to HBO therapy from an early stage after explaining to the patient's family members the risk of developing DNS, and at least five weeks' follow-up is believed necessary, during which due consideration should be given to the potential development of DNS.
The results of this study are tentative. Plans are to collect more substantiating data and conduct additional studies in the future.
The authors declare that they have no competing interests.
Conception and design: KK, KO and AS. Acquisition of Data: KK, KS, NK, AK, JY, MYU, YY, AM, TM, YS and FK. Analysis and Interpretation of Data: KK, HK and KO. Drafting the manuscript: KK. Final Approval of the Completed Manuscript: AS. All authors read and approved the final manuscript.
We like to express our gratitude to Professor Takaaki Beppu for his extremely useful instruction concerning hyperbaric medicine. We also appreciate Professor Shigeatsu Endo's suggestion concerning critical care medicine in emergency setting.
BMC Emerg Med. 2014;14(3) © 2014 BioMed Central, Ltd.