Clinical observation on the effect of HBO coupled with mild hypothermia on 88 cases of severe traumatic brain injury

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Author:
FENG Shao-jie(Longkou People’s Hospital, Longkou 265701, China)
Journal Title:
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
Issue:
Volume 19, Issue 04, 2012
DOI:
10.3760/cma.j.issn.1009-6906.2012.04.006
Key Word:
Hyperbaric oxygen;Mild hypothermia;Severe traumatic brain injury;Complications

Abstract: Objective To explore the therapeutic effect of HBO coupled with mild hypothermia on 88cases of severe traumatic brain injury and to study the effect of HBO on complications.Methods Two hundred and twenty-two cases of severe traumatic brain injury were divided into the HBO therapy coupled with mild hypothermia group ( or the combined group ),the mild hypothermia therapy group ( or the mild hypothermia group),and the HBO therapy group ( or the HBO group).Mild hypothermia treatment time was 1 to 11 days,after the onset of severe traumatic brain injury.Both the combined group and the HBO groups were given HBO therapy.Following treatment,the rate of complications,the therapeutic effects,the scores of Glasgow Coma Scale (GCS) after 3 months of treatment,the scores of Glasgow Outcome Scale (GOS) and scores of long-term Life Quality Assessment Scale after 6 months of treatment were compared and analyzed.Results The rate of pulmonary infection for the mild hypothermia group was 41.7% and the rate of renal dysfunction accounted for 25.0%,and statistical differences could be seen,when they were compared with those of the other two groups ( P < 0.05 ).For the combined group,significant therapeutic effect accounted for 64.8%,with a total effective rate of 93.2%,and statistical differences could be seen,when they were compared with those of the other 2groups (P < 0.01 ).After 3 months of treatment,the scores of GCS and GOS of the combined group were significantly higher than those of the other 2 groups (P <0.05 or P <0.01 ).After 6 months of treatment,the scores of long-term Life Quality Assessment Scale of the combined group were also significantly higher than those of the other 2 groups ( P < 0.05 or P < 0.01 ).Conclusions HBO therapy combined with mild hypothermia could significantly decrease the morbidity and mortality,obviously improve the neurological function and considerably improve prognosis of patients with severe traumatic brain injury.

  • [1]只达石.亚低温脑保护的发展与现状.现代神经疾病杂志,2002,2(3):133-135.
  • [2]中华神经科学会.各类脑血管疾病诊断要点.中华神经科杂志,1996,29(6):379-380.
  • [3]Leonov Y,Safar P,Sterz F,et al.Extending the golden hour of hemorrhagic shock tolerance with oxygen plus hypothermia in awake rats an exploratory study.Resuscitation,2002,52(2):193-202.
  • [4]Rose C.Michalak A,Pannunzio M,et al.Mild hypothermia delays the onset of coma and prevents brain edema and extracellular brain glutamate accumulation in rats with acute liver failure.Hepatology,2000,31(4):872-877.
  • [5]Kvrivishvili G.Glycine and neuroprotective effect of hypothermia in hypoxic-ischemic brain damage.Neuroreport,2002,13(16):1995-2000.
  • [6]Harada K,Maekawa T,Tsuruta R,et al.Hypothermia inhibits translocation of CaM kinase Ⅱ and PKC-alpha,beta,gamma isoforms and fodrin proteolysis in rat brain synaptosome during ischemia-reperfusion.J Neurosci Res,2002,67(5):664-669.
  • [7]Eberspacher E,Wemer C,Engelhard K,et al.The effect of hypothermia on the expression of the apeptosis-regulating protein Bax after incomplete cerebral ischemia and reperfusion in rats.J Neurosurg Anesthesiol,2003,15(3):200-208.
  • [8]Prakasa BP,Yoshida Y,Su M,et al.Immunohistochemical expression of Bcl-2,Bax and cytochrome c following focal cerebral ischemia and effect of hypothermia in rat.Neurosci Lett,2000,291(3):196-200.
  • [9]Phanithi PB,Yoshida Y,Santana A,et al.Mild hypothermia mitigates post-ischemic neuronal death following foeal cerebral ischemia in rat brain:immunohistochemical study of Fas,caspase3 and tunel.Neuropathology,2000,20(4):273-282.
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