[Hyperbaric oxygenation and adaptation to severe craniocerebral trauma]

Adaptation and disadaptation processes predetermining the outcome of treatment have been revealed upon the analysis of adaptation mechanisms formed in 49 patients with severe craniocerebral trauma in conditions of brain protection from hypoxia achieved by combined bolus injection of subnarcotic doses of sodium hydroxybutyrate and sodium thiopental and an early course of hyperbaric oxygenation (HBO). As the activation of biogenic amine systems responsible for stress promotes the enhancement of disadaptation processes, it is recommended to start a course of HBO upon their stabilization. The nature of lactate and pyruvate level changes in the in- and outflowing blood enabled the authors to identify the presence of negative arteriovenous difference in pyruvate upon the first attempt of HBO session as an adaptation marker and biochemical criterion showing the advisability of an HBO course.