Inflammatory mediators and other biomarkers in co-intoxicated patients after hyperbaric oxygen therapy (HBO2)

Objective: The present study was conducted in attempt to identify reliable biomarkers in predicting the severity of neurological injury. Materials and methods: A number of 30 patients with confirmed CO poisoning and a number of 7 healthy control volunteers were involved into the study. All participants received at least 60 minutes of hyperbaric oxygen therapy (HBO2) at 2.5 atmospheres absolute (ATA). Standard blood gas analysis was performed on 10 mL venous blood samples obtained immediately before and after HBO2. Seven biomarkers and carboxyhemoglobin (COHb) levels were measured. Results: Following HBO2, all patients recovered fully and were discharged in stable condition. Significant differences between pre and post HBO2 values were found in three of the seven biomarkers analyzed: TNF-alpha, IL-10, and S100B. Additionally, S100B and NSE levels were significantly different from controls for the 10 patients who experienced temporary loss of consciousness (LOC), and IL-6 levels were significantly different from controls for all CO-intoxicated patients. Conclusion: Conclusive evidence of a correlation between a single biomarker and LOC patients was not found. However, the data suggests that the significance of the fall between pre and post HBO2 values for TNF-alpha and IL-10, along with the resolution of IL-6 levels, may herald the severity of the patient's neurological condition.