Traumatic brain injury (TBI) remains a major public health challenge, often leading to long-term disability or death. Researchers have studied whether hyperbaric oxygen therapy (HBOT) for the adjunctive treatment of traumatic brain injury could improve outcomes when combined with conventional care.
Study Overview
This review included seven randomized studies with 571 participants: 285 who received HBOT and 286 in control groups. HBOT involved delivering 100% oxygen in a pressurized chamber, which can increase oxygen availability to brain tissue and potentially reduce secondary injury processes.
Key Results
- Reduced Mortality: Pooled data suggested that HBOT lowered the risk of death, with an estimated number needed to treat of seven to prevent one additional fatality.
- Neurological Outcomes: Some trials reported improved scores on the Glasgow Outcome Scale (GOS) one month after HBOT, indicating fewer patients with severely unfavorable outcomes.
- Intracranial Pressure: In certain studies, HBOT patients with myringotomy showed lower intracranial pressure compared to controls.
- Glasgow Coma Scale (GCS): Two small studies reported improvements of about 2.7 points in GCS for HBOT patients, though the significance of this depended on baseline severity.
- Risks Noted: Adverse effects were observed, including pulmonary complications in 13% of HBOT patients versus none in the control group. Pressure-related injuries to the ears, sinuses, or lungs also remain concerns.
Interpretation
The findings suggest HBOT may reduce the risk of death and influence certain neurological measures in TBI patients. However, the studies reviewed were small, varied in quality, and often lacked rigorous blinding or randomization. Importantly, while survival may improve, evidence is limited on whether HBOT consistently enhances meaningful recovery or long-term independence.
Future Directions
Researchers emphasize the need for larger, high-quality trials to determine which patients, if any, benefit most from HBOT in traumatic brain injury care. Until then, HBOT remains an investigational adjunctive therapy—showing promise in survival outcomes but requiring caution regarding functional recovery and potential side effects.
Check out the PubMed article here: https://pubmed.ncbi.nlm.nih.gov/23235612/
