Hyperbaric oxygen for severe traumatic brain injury: a randomized trial

Abstract

Objective: The present study aimed to explore the effects of hyperbaric oxygen therapy on the prognosis and neurological function of patients with severe traumatic brain injury.

Methods: A prospective study was carried out in 88 patients diagnosed with severe brain injury at our hospital and they were enrolled as research participants and randomly assigned to control and experimental groups (n = 44 per group) using a random number table method. Both groups underwent routine treatment. Patients in the experimental group were administered hyperbaric oxygen therapy approximately 1 week after admission when their vital signs had stabilized.

Results: No significant intergroup differences were observed in the Glasgow Coma Scale (GCS) and U.S. National Institutes of Health Stroke Scale (NIHSS) scores before treatment. However, after oxygen treatment, compared with the control group, the experimental group showed higher GCS and lower NIHSS scores. The GCS score at admission, tracheotomy status, and first hyperbaric oxygen therapy duration were independent prognostic factors in patients with severe traumatic brain injury.

Conclusion: Hyperbaric oxygen therapy may promote recovery of neurological function and improve the cognitive function and prognosis of patients with severe traumatic brain injury.

Keywords: Hyperbaric oxygen therapy; brain injury; cognitive function; neurological function; randomized trial; recovery.

Figure 1.

Comparison of cerebral metabolism and cerebral blood flow indices before and after treatment between the control and experimental groups (a) Comparisons of systolic peak flow velocity (Vs) before and after treatment revealed no significant intergroup difference before treatment, significant increases in both groups after treatment (P < 0.05), and a higher Vs in the experimental group than in the control group after treatment (P < 0.05). (b) Comparisons of the mean velocity (Vm) before and after treatment revealed no significant intergroup difference before treatment, significant increases in both groups after treatment (P < 0.05), and a higher Vm in the experimental group than the control group after treatment (P < 0.05). (c) Comparisons of the pulsatility index (PI) before and after treatment revealed no significant intergroup difference before treatment, significant decreases in both groups after treatment (P < 0.05), and a lower PI in the experimental group than in the control group after treatment (P < 0.05). (d) Comparisons of the intracranial pressure before and after treatment revealed no significant intergroup difference before treatment, significant decreases in both groups after treatment (P < 0.05), and a lower intracranial pressure in the experimental group than in the control group after treatment (P < 0.05). (e) Comparisons of the brain oxygen uptake rate before and after treatment revealed no significant intergroup difference before treatment, significant increases in both groups after treatment (P < 0.05), and a higher brain oxygen uptake rate in the experimental group than in the control group after treatment (P < 0.05). Note: * indicates a comparison with the before treatment condition, P < 0.05; # indicates a comparison with the control group after treatment, P < 0.05.

Figure 2.

Comparison of Glasgow Coma Scale (GCS) and U.S. National Institutes of Health Stroke Scale (NIHSS) scores before and after treatment between the control and experimental groups (a) Comparisons of GCS scores before and after treatment revealed no significant intergroup difference before treatment, significant increases in both groups after treatment (P < 0.05), and a significantly higher GCS score in the experimental group than in the control group after treatment (P < 0.05). (b) Comparisons of the NIHSS scores before and after treatment revealed no significant intergroup difference before treatment, significant increases in both groups after treatment (P < 0.05), and a significantly higher NIHSS score in the experimental group than in the control group after treatment (P < 0.05). Note: * indicates a comparison with the before treatment condition, P < 0.05; # indicates a comparison with the control group after treatment, P < 0.05.