Sung HK, et al. J Korean Med Sci. 2021 Apr;36(16):e111. https://doi.org/10.3346/jkms.2021.36.e111

Background: Hyperbaric oxygen therapy (HBOT) involves inhaling nearly 100% oxygen in a pressurized environment and is commonly used to treat various diseases and injuries. Despite its well-known safety, HBOT is associated with side effects, with frequent middle ear barotrauma (MEB) and oxygen toxicity. Understanding the characteristics and risk factors associated with these side effects is critical for improving patient compliance and treatment outcomes. Methods: This retrospective multicenter study aimed to analyze the characteristics and factors associated with side effects during HBOT using a computer-controlled pressurized monoplace hyperbaric chamber. We conducted a retrospective observational study across the two tertiary hospitals in Korea, involving patients who received HBOT from October 2016 for one hospital and October 2017 for another hospital to June 2020. Data were extracted from electronic medical records and hyperbaric chamber logs, including patient demographics, medical history, HBOT indications, and details of side effects. Statistical analyses, including chi-square and t-tests, were used to compare variables. Results: A total of 247 patients (mean age: 59.35 ± 15.05 years, 63.56% male) were included. The most common indications for HBOT were sudden sensorineural hearing loss (27.94%) and post-graft/flap (24.29%). Hypertension (46.15%) and diabetes mellitus (39.27%) were the most frequent comorbidities. Otalgia was the most prevalent side effect (33.20%), followed by chest discomfort (2.02%) and headache (1.62%). A significant proportion of patients (11.74%) terminated HBOT due to side effects, with most pauses occurring at pressures between 1.2 and 1.4 ATA (26.67%). Side effects, particularly otalgia, significantly impact patient compliance with HBOT. Conclusions: The incidence of side effects varies by pressure level during treatment, suggesting the need for tailored strategies to minimize side effects. This study highlights the importance of patient monitoring and education to improve the safety and efficacy of HBOT in monoplace chambers.

Purpose: This study aimed to compare the clinical features of methanol and ethylene glycol poisoning.Methods: This single-center retrospective observational study included patients with toxic alcohol poisoning who visited a regional emergency medical center. Patients with methanol and ethylene glycol poisoning from January 2004 to June 2023 were selected for the study using diagnostic codes.Results: Twenty-two patients with toxic alcohol poisoning visited during the study period, with 11 patients for each category. Compared to methanol poisoning, ethylene glycol poisoning patients were more likely to have consumed alcohol for suicidal purposes (n=4 [36.36%] vs. n=8 [72.73%]) and were more likely to be drowsy (n=0 vs. n=6 [54.55%], p=0.016). The anion gap (25.43±8.35 mmol/L vs. 13.22±6.23 mmol/L, p=0.001) and lactic acid levels (1.785 [1.3–2.785] mmol/L vs. 9.90 [4.20–11.81] mmol/L, p=0.007) were higher in ethylene glycol poisoning patients than in methanol poisoning patients. Among alcohol dehydrogenase blockers, oral ethanol was administered to 10 patients (45.45%) (n=4 [36.36%] vs. n=6 [54.55%]), and intravenous ethanol was administered to six patients (n=4 [36.36%] vs. n=2 [18.18%]). Fomepizole was administered to two patients (9.09%) each, and renal replacement therapy was non-significantly more common in patients with ethylene glycol poisoning (n=8 [72.73%] vs. n=3 [27.27%], p=0.128). Three patients had delays in diagnosis and treatment, and while there were no fatalities, one patient was left with permanent vision damage.Conclusion: Because these are uncommon types of poisoning and the clinical presentation is difficult to recognize early, healthcare providers should be familiar with toxic alcohol types and screen for them to ensure proper diagnosis and treatment.

Objective This study examined the characteristics of patients who attempted suicide in the emergency department before and during the COVID-19 pandemic.Methods We compared data from patients in the emergency department following suicide attempts between January 2018 and December 2021. The patients were categorized into two groups: “pre–COVID-19” and “during COVID-19” pandemic.Results The findings revealed an increasing trend of suicide attempts during the study period. Suicide attempts were reported at 1,107 before the COVID-19 pandemic and 1,356 during the COVID-19 pandemic. Patients who attempted suicide during the COVID-19 pandemic were younger (38.0±18.5 years vs. 40.7±18.4 years, P<0.01), had a smaller proportion of men (36% vs. 44%, P<0.01), and had fewer medical comorbidities (20.2% vs. 23.6%, P<0.05). The group during the COVID-19 pandemic reported better hygiene conditions (50.5% vs. 40.8%, P<0.01) and lower alcohol consumption (27.7% vs. 37.6%, P<0.01). Patients who attempted suicide during the COVID-19 pandemic had higher rates of use of psychiatric medications and previous suicide attempts. The most common reasons for the suicide attempt were unstable psychiatric disorders (38.8%), poor interpersonal relationships (20.5%), and economic difficulties (14.0%). Drug poisoning (44.1%) was the most common method of suicide attempts. Subgroup analysis with patients who attributed their suicide attempts to COVID-19 revealed a higher level of education (30.8%) and employment status (69.2%), with economic difficulties (61.6%) being the primary cause of suicide attempts.Conclusion These findings suggest that the prolonged duration of the COVID-19 pandemic and its effects on social and economic factors have influenced suicide attempts.