Traumatic brain injury is a major cause of death and disability. Not
all damage to the brain occurs at the moment of injury; a reduction
of the blood flow and oxygen supply to the brain can occur
afterwards and cause further secondary brain damage that is itself
an important cause of avoidable death and disability. In the early
stages after injury, it is therefore important that efforts are made
to minimise secondary brain damage to provide the best chances of
recovery.
Hyperbaric oxygen therapy (HBOT) has been proposed as a treatment
for minimising secondary brain damage by improving the oxygen supply
to the brain. Patients undergoing HBOT are placed inside a specially
designed chamber in which 100% oxygen is delivered at a greater than
normal atmospheric pressure. It is sometimes used as a treatment to
increase the supply of oxygen to the injured brain in an attempt to
reduce the area of brain that will die.
The effectiveness of HBOT on the recovery of brain-injured patients
is uncertain. There is also concern regarding potential adverse
effects of the therapy, including damage to the ears, sinuses and
lungs from the effects of pressure, temporary worsening of
short-sightedness, claustrophobia and oxygen poisoning.
HBOT for Healing Traumatic Brain Injury
In an attempt to address the uncertainty surrounding the use of
HBOT, the authors of this review identified all studies which were
randomied controlled trials investigating the effects of HBOT in
traumatically brain-injured people of all ages.
The authors found seven eligible studies involving 571 people. The
combined results suggest that HBOT reduces the risk of death and
improves the level of coma; however, there is no evidence that these
survivors have an improved outcome in terms of quality of life. It
is possible, therefore, that the overall effect of hyperbaric oxygen
is to make it more likely that people will survive with severe
disability after such injuries. The authors conclude that the
routine use of HBOT in brain-injured patients cannot be justified by
the findings of this review.
Due to the small number of trials with a limited number of people,
it is not possible to be confident in the findings. Further large,
high quality trials are required to define the true extent of
benefit from HBOT.
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