For brain injury there is a strong sense that conventional treatment has had little impact on outcome.
A traumatic brain injury (TBI) can be a life-altering event for a child, causing temporary or permanent cognitive, emotional, and physical impairments. Accurately predicting the outcome of pediatric TBI remains a formidable challenge, as existing prognostic tools often fall short in providing precise individual assessments. In the quest to enhance recovery and minimize complications, hyperbaric oxygen therapy (HBOT) has emerged as a potential ally for pediatric patients with severe head injuries.
Materials and Methods
Our study involved 54 patients with head injuries, out of which 28 received HBOT. Specifically, we focused on cases with severe head injuries (Glasgow Coma Scale, GCS < 8) and no other associated injuries in the study group. After an initial period of resuscitation and conservative management spanning 10 days, these patients underwent three sessions of HBOT at weekly intervals. We meticulously compared this study group to a matched control group with similar head injury severity (GCS < 8) selected through randomization.
Understanding Hyperbaric Oxygen Therapy
HBOT delivers 100% oxygen inside a hyperbaric chamber pressurized to greater than 1 atmosphere (atm). This increased pressure and hyperoxia provide both mechanical and physiological effects. It enhances blood oxygenation and reduces the volume of gases in the blood, effectively aiding in various medical conditions.
The study and control groups were compared on multiple parameters, including duration of hospitalization, GCS scores, disability reduction, and social behavior. The patients who received HBOT exhibited significant advantages over the control group. These advantages included reduced hospital stays, improved GCS scores, and substantial reductions in disability.
HBOT shows promise in addressing the challenges of TBI. It is known that TBI can lead to hypoxia and ischemia, causing secondary damage to brain cells. HBOT’s ability to increase blood flow to damaged brain areas has been documented through various imaging techniques. Additionally, experimental models have shown that HBOT can prevent cell death and reduce inflammation, contributing to improved outcomes.
HBOT appears to have a role not only in acute brain injury but also in chronic brain injury. It is based on the theory that inactive brain cells in the ischemic penumbra have the potential to recover with increased oxygen availability, stimulating metabolic and electrical activity.
The oxygen availability to these cells stimulates the cells to function normally, reactivating them metabolically or electrically.
In conclusion, HBOT holds substantial promise in enhancing the outcomes and quality of life for children with traumatic brain injuries. While further research is needed to validate its effectiveness, especially in individual patients, the potential benefits are compelling. A more comprehensive and standardized approach to diagnosis and follow-up tests, such as SPECT scans, could provide valuable insights into the true impact of HBOT.
Prakash, A. (2012, January 1). Role of hyperbaric oxygen therapy in severe head injury in children. National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3401652