Adjunctive hyperbaric oxygen therapy for spinal cord ischemia after complex aortic repair

Area of Science:

• Neurosurgery
• Cardiovascular Surgery
• Hyperbaric Medicine

Background:

• Spinal cord ischemia (SCI) is a severe complication after complex aortic repair (CAR).
• Standard SCI treatment includes cerebrospinal fluid drainage, hemoglobin maintenance, and blood pressure management.
• Hyperbaric oxygen therapy (HBOT) has shown promise in improving SCI outcomes in prior studies.

Purpose of the Study:

• To evaluate the effectiveness of HBOT as a rescue treatment for SCI following CAR.
• To assess motor function recovery in patients receiving HBOT in addition to standard care.

Main Methods:

• Retrospective review of HBOT treatments for SCI post-CAR from January 2013 to June 2021.
• Analysis of motor function scores using linear mixed models at various timepoints (pre-HBOT, post-HBOT, final assessment).
• Subgroup analysis comparing motor function improvement between patients who improved and those who did not.

Main Results:

• Thirty patients with SCI post-CAR received HBOT.
• Fourteen patients showed motor function improvement, with eight achieving full recovery.
• Seven of ten patients with paraplegia did not improve significantly with HBOT.
• Overall muscle function scores showed a mean increase from pre-HBOT to final assessment (6.7 points).

Conclusions:

• HBOT, as an adjunct to standard treatment, may offer potential benefits for spinal cord function recovery post-CAR.
• The efficacy of HBOT in improving motor function after SCI is not uniform across all patient subgroups.
• Further research is needed to identify patient characteristics that predict response to HBOT.