Hyperbaric oxygenation as an adjuvant therapy for traumatic brain injury: a review of literature
Апстракт:
In recent years significant amount of data have been published in the
filed of hyperbaric oxygenation (HBO) and traumatic brain injury (TBI).
The main rational for the research in this field is that in TBI patients
with the existence of dormant neural tissues that maintain cellular
homeostasis but are unable to participate in neurotransmission, the
addition of HBO provides a favourable environment by which neuronal
reactivation can be achieved. As hyperbaric oxygen therapy is not
all-or-nothing phenomena and the consequences of TBI can vary from mild
to moderate and severe, it is important to evaluate each TBI patient
before referring him/her to hyperbaric oxygen therapy (HBOT). Reports
from the clinical trial that were investigating the effects of HBO on
severe TBI show promising results. For example, significant reduction in
mortality rates and improvement in favourable neurological outcomes were
reported. However, conflicting results have been reported from trials
that investigated the effects of HBO on mild and moderate TBI. The
results from the experimental studies indicate that HBO can preserve
mitochondrial function, reduce apoptosis and neuroinflammation and
promote neuronal plasticity. Therefore, conducting of
methodologically-based multicentric clinical trials is necessary to
determine proper guidelines for inclusion of TBI patients in HBOT. As
many reports have stated that even a few exposures to HBO can contribute
to the recovery process, future research must be aimed at establishing
most effective HBO protocol for TBI patients.