Hyperbaric oxygen therapy in patients with hypoxic ischemic encephalopathy

Abstract

Background and aim: To assess the efficacy of hyperbaric oxygen therapy (HBOT) in patients with hypoxic ischemic encephalopathy (HIE).

Design: Non-randomized case-control observational study.

Setting: Tertiary level neurorehabilitation unit.

Population: Twenty-five patients with HIE seen between 1 to 12 months after the injury and having a coma recovery scale-revised (CRS-R) score less than 7 at entry were recruited.

Methods: Out of the patients who received HBOT, 20 received 20 sessions of HBOT at two absolute atmosphere pressure (ATA), and two received 60 sessions at 2 ATA over three different treatment intervals. We compared the outcomes between cases (who received HBOT) and controls (who did not receive HBOT).Cases and controls were allocated to three groups based on the time interval after injury following which they were recruited to the study: 1-3 months (9 cases and 16 controls), 4-8 months (9 cases and 9 controls) and 9-12 months (8 cases and 3 controls).

Outcome measures: CRS-R, Karnofsky performance scale, and change in disorder of consciousness (DOC) at admission and discharge were assessed.

Results: We observed a significant difference in CRS-R favoring the HBOT group at time intervals of 1-3 and 4-8 months. More patients in the HBOT group improved in DOC than the control group.

Conclusions: HBOT given in the first nine months post-HIE can result in a better recovery and functional outcome.

Keywords: Disorders of consciousness; hyperbaric oxygen therapy; hypoxic ischemic encephalopathy.