Eden Carlson experienced brain damage after she nearly drowned in a
swimming pool. A controversial report claims that oxygen therapy
reversed her brain damage, but experts are very skeptical.
Two doctors claim to have used controversial oxygen treatments to
reverse brain damage in a 2-year-old from Arkansas who nearly died
by drowning in a cold swimming pool, but other experts are very
skeptical of the claims the doctors made in their report of the
case.
"I found the publication to be sufficiently suspect," said Dr. Ian
Miller, a pediatric neurologist and medical director of the
comprehensive epilepsy program at Nicklaus Children's Hospital in
Miami, who was not involved in the report. "I really worry that
other people who read about this on the internet will think that
this is a legitimate type of therapy" for people with brain damage,
when there is no proof of this, Miller told Live Science.
In the new report, the authors describe the case of 2-year-old Eden
Carlson, who fell into her family’s swimming pool last year and was
submerged in 41-degree-Fahrenheit (5 degrees Celsius) water, for
about 15 minutes. In total, she spent 2 hours without a heartbeat,
and was not expected to survive, her family said in a YouTube video.
Doctors were able to revive her, but she had experienced brain
damage. After a month in the hospital, she couldn't speak, walk or
respond to commands. An MRI showed she had damage to her brain's
gray and white matter.
Fifty-five days after the girl's near-drowning, Dr. Paul Harch,
clinical professor and director of hyperbaric medicine at Louisiana
State University Health Sciences Center, began an oxygen treatment
on the girl, giving her oxygen at the same air pressure as air at
sea level for 45 minutes twice a day. After these treatments, Eden
became more alert and started to speak and even laugh again,
according to the case report. Then, 78 days after her near-drowning,
the doctors gave Eden hyperbaric oxygen therapy (HBOT), which
provides oxygen in a pressurized chamber. Harch co-owns a company
that offers hyperbaric oxygen treatments.
HBOT for Healing Traumatic Brain Injury
After about 40 sessions of this therapy, Eden could walk again with
assistance and had normal cognition, Harch's report said. An MRI
after the hyperbaric treatments showed a "near-complete reversal" of
the brain damage, Harch and his co-authors said. The report was
published in the July issue of the journal Medical Gas Research.
But other experts had serious concerns about the report, saying that
the authors did not provide evidence that the oxygen treatments
helped at all in Eden's recovery. Rather, these experts said this
type of recovery could happen without these specific oxygen
treatments.
Miller said everyone can be grateful that Eden is doing so well.
However, Miller said he found the report "to be really underwhelming
in terms of its evidence."
For example, Miller said, the report did not provide evidence that
brain cell death occurred, or that these brain cells were
"resurrected" by the oxygen treatment.
"There is just no way that providing oxygen to a dead brain cell
makes the brain cell recover," Miller said. "That's not how the
brain responds to injury and to oxygen once neurological death has
occurred."
Dr. David Cifu, professor and chairman of the Department of Physical
Medicine and Rehabilitation at Virginia Commonwealth University
School of Medicine, was similarly concerned about the paper.
"This proves nothing," Cifu said. People can recover brain function
after near drowning, he said, and "it has nothing to do with
hyperbaric oxygen."
Recovery can happen because of the brain's plasticity, or
flexibility, meaning that different brain areas can take over for
those that have been damaged, Cifu said. Cifu has conducted
rigorously designed studies, some for the military, on the use of
hyperbaric oxygen treatment for people with traumatic brain
injuries. In these studies, participants received either a
hyperbaric oxygen treatment or a "sham" treatment that was not
expected to have an effect. But both groups showed the same level of
improvements in their symptoms, regardless of whether they received
the real or sham treatment. The hyperbaric oxygen "just didn't help
the people" any better than the control-group treatment, he said.
In addition, Miller said Eden's recovery may have been related to
the temperature of the water when she was submerged. It's known that
people who have near-drowning experiences in cold water tend to have
better outcomes than those in warmer water, because cold water can
have a "protective" effect on the brain.
When Live Science reached out to Harch about these criticisms in an
email, Harch said "the child made progressive accelerated
neurological improvement with each week of HBOT. That neurological
improvement can only be explained by improvement in brain function
which is consistent with the regrowth of brain tissue. Spontaneous
recovery and growth of tissue can possibly occur over time, but the
child was not improving at this rate until the introduction of each
of these therapies."
Miller said a recovery over months is not unexpected in someone with
a brain injury.
Harch added that his report did not claim to "resurrect" brain cells
with oxygen treatments, but rather, it said the oxygen treatments
led to the growth of brain tissue, likely because the oxygen
stimulated the expression of certain genes. In addition, Harch said
he refutes Cifu's studies, in part because he says the studies did
not include a proper sham control group.
Hyperbaric oxygen therapy is approved by the Food and Drug
Administration to treat certain conditions, including carbon
monoxide poisoning, decompression sickness (often called "the bends"
by divers) and burns caused by heat or fire.
Under the pressurized conditions of a hyperbaric oxygen chamber, the
lungs can take in more oxygen than they would when breathing at
normal air pressure. The increase of oxygen in the blood may improve
the delivery of oxygen to tissues and help minimize cell injury,
according to the FDA.
Studies on hyperbaric oxygen for treating brain injury have had
mixed results, with some studies suggesting a benefit in the case of
stroke patients, while other studies, like Cifu's research, finding
no effect.
Earlier this year, the FDA issued a warning to consumers that
hyperbaric oxygen therapy has been promoted as a treatment for many
conditions that it is not approved to treat. The FDA clarified that
hyperbaric oxygen therapy is not approved to treat brain damage,
Alzheimer's disease, autism, diabetes or many other conditions for
which it has been promoted.
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