9 or less for at least 6 hours, admitted to Level 1 Trauma Center at Hennepin County Medical Center, with a mean age of 32.5 +/- NDa Standard care 84(ND) Standard care 84(ND)e compression and decompression times) of 100% O2 at 1.5 ATA every 8 hours over 2 weeks or until patient recovered (alert and oriented) or declared brain dead. Compression: 1 psi / min; Plateau: 60 min; Decompression: 1 psi / min. Standard care: Neurosurgical care, medical treatment, and management of Intracranial pressure. treatment for 2 weeks; Control group - hourly for 2 weeks. VITAL: Intracranial pressure (ICP). NS bt groups. Time points unclear. Time points: Unclear GOS & MORTALITY: Mortality rate. The mortality rate was 17% for the 84 hyperbaric oxygen-treated patients and 32% for the 82 control patients, a statistically significant difference. test, 1 df, p = 0.037). The difference in mortality rate between the hyperbaric oxygen-treated and control patients with GCS scores of 4 to 6 was statistically significant by the chi-squared test (1 df, p = 0.04). Hyperbaric patients with ICP's higher than 20 mm Hg for over 20 minutes had a mortality rate of 21%, as compared to 48% for the control group (chi-squared test, 1 df, p = 0.02). treated with phenytoin sodium (n=2); hemotympanum (n=2). Researchers performed bilateral myringotomies on the last 46 of the 84 HBO2 patients because of intracranial pressure possibly due to inner ear pain. favorable outcome categories (good recovery and moderate disability). The possibility that a different hyperbaric oxygen treatment paradigm or the addition of other agents, such as a 2 l-aminosteroid, may improve quality of survival is being explored.
Rockswold, 201028 69 patients treated for severe TBI (defined as GCS of 8 or less) at Hennepin County Medical Center, after resuscitation (58M, 11F) with a mean age of 35 +/- NDa HBO2 + Standard care 26(ND) Normobaric hyperoxia + Standard care (NBH) 21(ND) Standard care 22(ND)e HBO2: 94 min sessions of 100% FiO2 at 1.5 ATA daily x 3 sessions Compression: 17 min; Plateau 60 min; Decompression: 17 min. 1) NBH: 3-hour sessions of 100% FiO2 at 1 ATA x 3 sessions 2) Standard care: Intensive neurosurgical care closely paralleling Brain Trauma Foundation’s “Guidelines for the Management of Severe TBI, 3rd Edition”, including stabilization with early intubation, surgical evacuation of significant hematomas, Time points: baseline, 24 hours VITAL SIGNS: Intracranial Pressure (ICP). ICP was significantly lower statistically after HBO2 until the next treatment session (p < 0.001) in comparison with levels in the control group. The post-treatment effect was the same for all 3 days. The NBH group’s ICP measures did not differ significantly from those in the control group following each treatment session. Not reported. Data in this study can be summarized by the following 7 major points: 1) Hyperbaric O2 had a significantly greater positive effect than NBH on oxidative cerebral metabolism and ICP. 2) Although the treatment effect was not an phenomenon, a critical brain tissue pressure of oxygen (PO2) level of 200 mm Hg seemed important to achieve a robust positive effect on cerebral metabolism, especially cerebral metabolic rate for oxygen (CMRO2), which reflects mitochondrial function. Brain tissue PO2 monitoring to determine O2 delivery in the injured brain during O2 therapy appeared to be important as well. 3) Hyperbaric O2 had a effect lasting at least 6 hours, which means that HBO2 can be delivered intermittently to maintain the treatment effect over many days and reduce potential O2 toxicity. 4) The treatment effect was as great on Day 3 as it was in the first 24 hours that is, the treatment effect was the same (0)
Decompression: 20 min. Standard care: ND Note: After 10 daily sessions, there was a four-day intermission. This cycle was repeated until patient recovered consciousness or died. CONSCIOUSNESS: Consciousness recovery rate. In subgroup 5 HBO2 group had statistically significant higher rates of recovered consciousness at 1 month (p<0.03). Time points: 1 month CONSCIOUSNESS: Persistent Coma Rate in survivors. NS bt groups at 1 month. In subgroup 5 HBO2 group had statistically significant lower rates of persistent coma at 1 month (p<0.03). pneumonia interrupting treatments (n=5). of recovered consciousness at 1 month was significantly higher when OHP was used. These patients were under 30 and had a brain stem contusion without supratentorial mass lesion. The view is defended that, besides its toxic action on the normal nervous tissue, OHP can counteract edema and ischemia in the zones of brain injuries. Rockswold, 198530 30 patients with severe brain injury, defined as persisting unconsciousness with inability to obey commands or express recognizable words and GCS score of less than 10, with a mean age of NDa Overall 30(ND) HBO ND(ND) Standard Hospital Treatment ND(ND)e HBO: 60 min sessions of 100% O2 at 1.5 ATA every 4 or 8 hours over 2 weeks (or until patient recovered being alerted and oriented or declared brain dead). Standard Hospital Treatment: ND Time not described GOS & MORTALITY: Mortality. NS bt groups for survival rate in those with GCS scores of 3 or 7-9. Among patients with GCS scores between 4-6 increased survival occurred in the HBO group compared with the control group but difference was NS (p=0.100) Not reported. Based on the experience in the literature cited previously and on our own initial experience, we hope in the future to convincingly demonstrate that the treatment of severe brain-injured patients with HBO will result in an overall beneficial response in terms of long-term functional recovery and decreased mortality rate. Completion of this clinical will hopefully demonstrate whether the treatment of (0)