S-100β in predicting the need of hyperbaric oxygen in CO-induced delayed neurological sequels

Abstract

Background: Delayed neurological sequels (DNS) have been described after carbon monoxide (CO) poisoning. There is a need to find a new prognostic marker to guide the use of hyperbaric oxygen (HBO) therapy. Aim: To evaluate serum S-100β level in patients presenting with acute CO poisoning as an indicator of poisoning severity and predictor of DNS occurrence and HBO need in those patients. Methods: This prospective cohort study included patients with acute CO poisoning. On admission, carboxyhemoglobin (COHb) and S-100β levels were measured. Patients were followed up for 6 months for signs of DNS. Results: Out of 50 patients, 6 only developed DNS. The mean of S-100β levels was significantly higher in patients with severe poisoning and those with DNS. Receiver operating characteristic curve analysis revealed that S-100β had an area under the curve 0. 871; at a cutoff value ≥ 0.67 µg/L, its sensitivity and specificity were 100% and 77.3%, respectively. The sensitivity of S-100β was significantly higher than that of COHb, while its specificity and overall accuracy were significantly higher than those of HBO criteria. Conclusion: Serum S-100β level on admission could be a marker of poisoning severity and a predictor of CO-induced DNS development that guides the use of HBO therapy.

Carbon monoxide poisoning: Recommendations for neuropsychological assessment

“…Serious neurological sequelae are strongly predicted by prolonged loss of consciousness and elevated S-100β [48,49]. S100β is a cytoplasmic calcium-binding protein mainly expressed by glia.…”

Hematological parameters as early predictors of delayed neurological sequelae in acute carbon monoxide poisoning.

“…Hyperbaric oxygen (HBO) therapy is the primary method of treatment for acute severe CO poisoning due to its beneficial effect in preventing inflammatory changes in the brain and lipid peroxidation, consequently decreasing DNS rates (Vezzani et al, 2016;Hafez and El-Sarnagawy, 2019).…”