Glucocorticoids and high pressure oxygen in prevention and treatment of delayed encephalopathy after acute carbon monoxide poisoning: a meta-analysis for efficacy and safety
Tang Qing,Li Ying,Wang Yongyi,Ye Mengliang,Zhang Fan,Liu Qin,Wang Hong,Wang Yang.Glucocorticoids and high pressure oxygen in prevention and treatment of delayed encephalopathy after acute carbon monoxide poisoning: a meta-analysis for efficacy and safety[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(02):207-214.
Tang Qing,Li Ying,Wang Yongyi,Ye Mengliang,Zhang Fan,Liu Qin,Wang Hong,Wang Yang.Glucocorticoids and high pressure oxygen in prevention and treatment of delayed encephalopathy after acute carbon monoxide poisoning: a meta-analysis for efficacy and safety[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(02):207-214.DOI:
Objective To systematically review the efficacy and safety of glucocorticoids combined with conventional high pressure oxygen for delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Methods Databases including PubMed
EMbase
Web of Science
the Cochrane Library
CBM
CNKI
VIP and WanFang Data were searched to retireve the relevant references from the start to September 30 2015. Sensitivity analysis (RevMan 5.3) and Stata 14.0 were employed for meta-analysis. Results A total of 12 random controlled trials were included for final meta-analysis
involving 1 415 participants. Meta-analysis showed that the test group of corticosteroids and hyperbaric oxygen therapy had better outcomes in reducing the incidence DEACMP (RR=0.23
95%CI: 0.14~0.38
P0.001)
improving the cure rate (RR=1.52
95%CI: 1.17~1.98
P=0.002)
improving the overall efficiency (RR=1.36
95%CI: 1.22~1.51
P0.001)
and reducing the inefficiency (RR=0.24
95%CI: 0.15~0.40
P0.001) when compared with the control group receiving hyperbaric oxygen therapy. But there was no significant difference in the mortality between the 2 groups (P=0.38). The glucocorticoids group had a few adverse reactions (1.6%). Conclusion Although there are a small number of adverse reactions
the efficacy of corticosteroids combined with hyperbaric oxygen is superior to conventional high-pressure oxygen therapy in the prevention and treatment of DEACMP.