Application of Mitochondrial and Oxidative Stress Biomarkers in the Evaluation of Neurocognitive Prognosis Following Acute Carbon Monoxide Poisoning

Associations between serum mitokine levels and outcomes in stable COPD: an observational prospective study

Mitokines (Humanin (HN), GDF15 and FGF21) are produced as a result of mitochondrial dysfunction and may have major roles in chronic inflammation, malnutrition and exercise capacity in people with COPD. Except for GDF15, studies on this subject are lacking. A total of 165 patients with stable COPD and 49 smokers without COPD were enrolled. We assessed their serum mitokine levels and clinical characteristics at baseline. We recorded moderate and severe exacerbation for the next 12 months. Baseline serum HN (p = 0.037) and GDF-15 (p = 0.013) levels were higher in the COPD group. High HN levels were independently associated with a high risk of exacerbation (HRE) (OR 2.798, 95% CI 1.266-6.187, p = 0.011), malnutrition (OR 6.645, 95% CI 1.859-23.749, p = 0.004), and 6MWD (OR 0.995, 95% CI 0.991-0.999, p = 0.008), and future moderate (HR 1.826, 95% CI 1.181-2.822, p = 0.007) and severe exacerbations (HR 3.445, 95% CI 1.357-8.740, p = 0.009). High GDF15 levels were associated with HRE (OR 3.028, 95% CI 1.134-8.083, p = 0.027), 6MWD (OR 0.995, 95% CI 0.990-0.999, p = 0.017) and predicted desaturation in 6MWT (OR 3.999, 95% CI 1.487-10.757, p = 0.006). High FGF21 levels were associated with HRE (OR 2.144, 95% CI 1.000-4.600, p = 0.05), and predicted future severe exacerbation (HR 4.217, 95% CI 1.459-12.193, p = 0.008). The mitokine levels were higher in patients with COPD than smokers without COPD, and were associated with important clinical outcomes such as exercise capacity and COPD exacerbation. Among the mitokines, HN showed the strongest association with COPD and may serve as a future risk biomarker in this disease.Trial registation NCT04449419.

Should We Use Hyperbaric Oxygen for Carbon Monoxide Poisoning Management? A Network Meta-Analysis of Randomized Controlled Trials

Carbon monoxide (CO) poisoning is a public health issue in numerous countries. Oxygen supplementation is the standard and initial management for acute CO poisoning. Normobaric oxygen (NBO) and hyperbaric oxygen (HBO) therapies for CO poisoning have been discussed for several decades. NBO, one-session HBO, two-session HBO, and three-session HBO have not been clearly compared, although there are some syntheses. Therefore, this study aimed to provide an overview of various HBO therapies for CO poisoning. We searched online databases for randomized controlled trials (RCTs) on this topic, and two authors individually extracted data on characteristics, mortality, headache recovery, general fatigue, memory impairment, and difficulty concentrating. Outcomes were pooled using network meta-analysis. We included eight RCTs (n = 1785) that met our eligibility criteria. Pooled estimates showed that HBO had no better outcomes than NBO. Moreover, two-session HBO seemed to have a higher general fatigue rate than NBO, and compared with one-session HBO therapy, it had a higher fatigue rate (risk ratio (RR): 1.29, 95% confidence interval (CI): 1.03-1.62), memory impairment rate (RR = 1.80, 95% CI: 1.01-3.19), and concentration impairment rate (RR = 1.85, 95% CI: 1.19-2.89). HBO may be ineffective for patients with CO poisoning. Therefore, clinicians should consider the available treatment options carefully before recommending HBO to patients.