Hyperbaric Oxygen Preconditioning Reduces Postoperative Brain Edema and Improves Neurological Outcomes After Surgical Brain Injury

Abstract

The present study was designed to examine if hyperbaric oxygen preconditioning (HBO-PC) is neuroprotective in a mouse model of surgical brain injury (SBI). C57BL mice were administered 100% oxygen for 1 h at 2.5 ATA for 5 consecutive days and subjected to SBI on the following day. The HBO-PC + SBI animals were compared to sham and normoxia + SBI groups for brain water content in different brain regions at 24 and 72 h after surgery. Blood-brain barrier (BBB) permeability was evaluated using Evan's blue dye extravasation at 24 h. Neurological assessment of the animals was done by a blinded observer at 24 and 72 h. The results showed that brain water content was significantly increased in the right (ipsilateral) frontal lobe surrounding the site of resection. This was attenuated by HBO-PC at 24 and 72 h. However, HBO-PC did not have any effect on the increased BBB permeability observed after SBI. Significant neurological deficits were observed after SBI. HBO-PC improved neurological deficits at 72 h on the 21-point sensorimotor scale and at 24 and 72 h on the wire hang and beam balance scoring. In conclusion, HBO-PC attenuates post-operative brain edema and improves neurological outcomes following SBI.

Hyperbaric Oxygen Preconditioning Attenuates Hemorrhagic Transformation Through Reactive Oxygen Species/Thioredoxin-Interacting Protein/Nod-Like Receptor Protein 3 Pathway in Hyperglycemic Middle Cerebral Artery Occlusion Rats

“…Jadhav et al (22) reported that HBO preconditioning reduces postoperative brain edema and improves neurologic outcomes. Peng et al (29) found that HBO preconditioning can prevent permeability in the bloodbrain barrier and brain edema caused by hypoxia exposure.…”

“…HBO preconditioning has been reported to reduce neuronal injuries in animal models of neurologic pathologies, such as ischemic stroke (20), cognitive impairment (21), and surgical brain injury (22). The mechanisms and pathways, which may involve neuroprotection and antiinflammation, remain unclear in the scientific research community.…”

Hyperbaric oxygen preconditioning attenuates hyperglycemia-enhanced hemorrhagic transformation by inhibiting matrix metalloproteinases in focal cerebral ischemia in rats

“…Various types of preconditioning, for example ischemic preconditioning, anesthetic preconditioning and pharmacological preconditioning over the past decades have resulted in various promising therapeutic effects for the treatment of patients with acute brain injury (Dirnagl, et al, 2009, Xi, 2010). HBO-PC, as one of the most common and attractive preconditioning strategies has been demonstrated to be neuroprotective in several animal models of neurological diseases, such as focal and global cerebral ischemia (Ostrowski, et al, 2008, Soejima, et al, 2012), spinal cord ischemia (Nie, et al, 2006), traumatic and surgical brain injury (Hu, et al, 2008, Jadhav, et al, 2010). Recently, studies showed that HBO increased ROS generation (Thom, 2009) and that increased ROS levels up-regulated the expression of transcription factor hypoxia-inducible factor-1α (HIF-1α) (Peng, et al, 2008).…”

The Protective Mechanism for the Blood–Brain Barrier Induced by Aminoguanidine in Surgical Brain Injury in Rats

“…Surgical brain injury (SBI) is an unavoidable brain damage during many neurosurgical procedures, which result in post-operative complications including brain edema, blood-brain barrier (BBB) disruption, and cell death in susceptible areas (Jadhav et al 2010;Blyth et al 2009). The drugs that reduce BBB breakdown would tend to improve outcomes in SBI, which might limit complications and permit more aggressive surgical resection in confined spaces.…”