Effectiveness of Hyperbaric Oxygen in Traumatic Brain Injury Patients: A Systematic Review and Meta-Analysis

Area of Science:

• Neurology
• Hyperbaric Medicine
• Trauma Care

Background:

• Traumatic brain injury (TBI) is a major global health concern, causing significant mortality and disability.
• Hyperbaric Oxygen Therapy (HBOT) is being explored for TBI treatment, but its effectiveness is debated.

Purpose of the Study:

• To systematically evaluate the efficacy of Hyperbaric Oxygen Therapy (HBOT) in patients with traumatic brain injury (TBI).
• To synthesize evidence from randomized controlled trials (RCTs) on HBOT for various TBI outcomes.

Main Methods:

• A comprehensive literature search was conducted across major databases (PubMed, Embase, Cochrane Library, Web of Science) up to March 2026.
• Included RCTs compared HBOT with sham, standard care, or no treatment in adult TBI patients.
• Data extraction and risk of bias assessment were performed by two independent reviewers, with meta-analysis using random/fixed-effects models.

Main Results:

• HBOT significantly improved cognitive functions including computerized cognitive performance, executive function, processing speed, and memory.
• Improvements were also noted in sleep quality.
• No significant benefits were found for Glasgow Outcome Scale, PTSD symptoms, neurobehavioral symptoms, or emotional distress. Most adverse events were mild and transient.

Conclusions:

• HBOT offers domain-specific benefits for cognitive function and sleep quality in TBI patients, particularly mild TBI.
• Evidence regarding HBOT's impact on PTSD, neurobehavioral symptoms, and emotional distress is inconclusive.
• The current evidence base has limited applicability to individuals with moderate-to-severe TBI.