Oxygénothérapie hyperbare et gaz inertes dans l’ischémie cérébrale et le traumatisme crânien

Chhor, Vibol; Canini, Frédéric; Rudnicki, S. de; Dahmani, Souhayl; Gressèns, Pierre; Constantin, Pascal

doi:10.1016/j.annfar.2013.09.005

Cited by 3 publications

(1 citation statement)

References 56 publications

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“…Experimental studies showed that delay in initiating HOT was inversely related to its efficacy [19]. Benefits were shown, however, even if the treatment started 12 h after the ischemia when it was a single session treatment [20], and 24 h for a daily session during a week of treatment [21].…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Delayed hyperbaric oxygen therapy for air emboli after open heart surgery: case report and review of a success story

Niyibizi

Kembi

Lae

et al. 2016

J Cardiothorac Surg

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BackgroundThe current case describes a rare diagnosis of iatrogenic air emboli after elective cardiopulmonary bypass that was successfully treated with delayed hyperbaric oxygen therapy, with good clinical evolution in spite of rare complications.Case presentationA 35 years old male was admitted to the intensive care unit (ICU) for post-operative management after being placed on cardiopulmonary bypass (CPB) for an elective ventricular septal defect closure and aortic valvuloplasty. The patient initially presented with pathologically late awakening and was extubated 17 h after admission. Neurologic clinical status after extubation showed global aphasia, mental slowness and spatio-temporal disorientation. The injected cerebral CT scan was normal; the EEG was inconclusive (it showed metabolic encephalopathy without epileptic activity); and the cerebral MRI done 48 h after surgery showed multiple small subcortical acute ischemic lesions, mainly on the left fronto- parieto- temporo-occipital lobes. He was taken for hyperbaric oxygen therapy (HOT) over 54 h after cardiac surgery. The first session ended abruptly after 20 min when the patient suffered a generalised tonico-clonic seizure, necessitating a moderately rapid decompression, airway management, and antiepileptic treatment. In total, the patient received 7 HOT sessions over 6 days. He demonstrated full neurological recovery at 4 weeks and GOS (Glasgow Outcome Scale) of 5 out of 5 even after a long delay in initial management. Convulsions are a rare complication of HOT either due to reperfusion syndrome or hyperoxic toxicity and can be managed. Prior imaging by MRI or tympanic paracentesis (myringotomy) should not add further delay of treatment.ConclusionHOT should be initiated upon late awakening and/or neurologic symptoms after CPB heart surgery, after exclusion of formal counter-indications, even if the delay exceeds 48 h.

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Section: Discussion and Literature Reviewmentioning

confidence: 99%

Delayed hyperbaric oxygen therapy for air emboli after open heart surgery: case report and review of a success story

Niyibizi

Kembi

Lae

et al. 2016

J Cardiothorac Surg

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To compare the effects of multiple sessions of Hyperbaric Oxygen Therapy in neurological improvement in head injury patients: A prospective randomized trial

Yadav

Pawar

Garg

et al. 2015

Journal of Neuroanaesthesiology and Critical Care

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Introduction: Hyperbaric oxygen therapy (HBOT) is used to improve functional outcome following brain injuries. Different number of sessions of HBOT have been reported but the frequency of HBOT sessions in head injured patients has not been standardized. We planned this prospective randomized study with an aim to compare the neurological effects of 10, 20 and 30 sessions of HBOT in the head injured patients. Materials and Methods: After review board approval, this study was conducted in 60 head injury patients with Glasgow Coma Scale (GCS) score ≤ 9. All patients were resuscitated, stabilized and received neurological care according to institutional protocol. Patients were randomly allotted to–Group H10 (n-20)–which received 10 sittings of HBOT, Group H20 (n-20)–which received 20 sittings of HBOT, Group H30 (n-30)–which received 30 sittings of HBOT. GCS score was recorded after every 10 sittings and at 30 days from initiation of HBOT. Improvement Global rating and Glasgow outcome scale (GOS) were recorded after 30 days. Results: The maximum improvement in GCS scores was seen in group H30. The difference in the average improvement global rating scale was significant between group H10 and group H20, between group H10 and group H30 but was comparable between groups H20 and H30. The GOS was better after 30 sessions as compared to 10 sessions. Patients of all groups showed improvement in spasticity but group H30 showed a maximum improvement. Conclusion: A minimum of 30 HBOT sessions should be considered in head injury patients to show improvement with HBOT. Progressive improvement in GCS scores, GOS, spasticity, mood swings was better seen with increased number of HBOT sessions.

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Hyperbaric Oxygen Therapy in Traumatic Brain Injury: Cellular and Molecular Mechanisms

Peković¹,

Đačić²,

Krstić³

et al. 2018

Hyperbaric Oxygen Treatment in Research and Clinical Practice - Mechanisms of Action in Focus

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Traumatic brain injuries (TBI) are among the leading causes of death and chronic disability worldwide. TBI is a complex process encompassing primary injury to the brain tissue and cerebral vasculature induced by the initial impact, secondary injury, including cascade of subsequent neuroinflammatory processes, and regenerative responses with enhanced neurogenesis and angiogenesis. To date, there remains no approved pharmacological therapy that is able to prevent the secondary injury. Therefore, the development of safe and efficacious neuroprotective treatments currently represents the greatest unmet need in the management of TBI. Increasing number of experimental and clinical studies present convincing evidence that hyperbaric oxygen therapy (HBOT), as an adjunctive therapy, may be the suitable neurotherapeutic method for improving neurological outcome after TBI. Irrespective to treatment protocol HBOT appeared to alleviate the detrimental and neurotoxic effects of pathological sequel initiated by TBI and to stimulate endogenous reparative mechanisms. However, the exact mechanisms by which HBOT exerts its beneficial effects on recovery after brain injury are still deficient. In this review we will summarize up to date results of HBOT in experimental and clinical TBI and try to put more light on cellular and molecular mechanisms underlying beneficial effects of HBOT on functional recovery after brain injury.

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Oxygénothérapie hyperbare et gaz inertes dans l’ischémie cérébrale et le traumatisme crânien

Cited by 3 publications

References 56 publications

Delayed hyperbaric oxygen therapy for air emboli after open heart surgery: case report and review of a success story

Delayed hyperbaric oxygen therapy for air emboli after open heart surgery: case report and review of a success story

To compare the effects of multiple sessions of Hyperbaric Oxygen Therapy in neurological improvement in head injury patients: A prospective randomized trial

Hyperbaric Oxygen Therapy in Traumatic Brain Injury: Cellular and Molecular Mechanisms

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