Hyperbaric oxygenation for severe head injuries. Preliminary results of a controlled study

Area of Science:

• Neurology
• Hyperbaric Medicine
• Trauma Surgery

Background:

• Head injury coma presents significant mortality and morbidity.
• Hyperbaric oxygenation (OHP) is explored for its potential therapeutic effects on brain injuries.
• Standard therapies for head injury coma have limitations.

Purpose of the Study:

• To evaluate the effectiveness of hyperbaric oxygenation (OHP) in treating patients with head injury coma.
• To identify subgroups of patients who might benefit from OHP therapy.
• To assess the impact of OHP on mortality and recovery of consciousness.

Main Methods:

• A prospective study involving 60 patients with head injury coma.
• Random assignment to either hyperbaric oxygenation (OHP) or standard therapy.
• OHP administered at 2.5 ATA, with subgroup analysis based on patient characteristics and injury type.

Main Results:

• No significant difference in overall mortality or mean coma duration between OHP and standard therapy groups.
• A significant increase in consciousness recovery at 1 month was observed in a subgroup of 18 patients under 30 with brain stem contusion and no supratentorial mass lesion.
• Complications led to interruption of OHP protocol in 11 cases.

Conclusions:

• Overall, hyperbaric oxygenation (OHP) demonstrated limited efficacy in treating head injury coma, possibly due to intermittent application or complications.
• OHP may offer therapeutic benefits for specific patient subgroups, particularly younger individuals with localized brain stem injuries.
• Further research is warranted to optimize OHP protocols and understand its mechanisms in mitigating cerebral edema and ischemia.