Hyperbaric oxygen therapy (HBOT) is the use of oxygen at
concentrations and pressures higher than those in daily life as a
form of treatment for a health problem. The treatment has been
scientifically proven to be effective for conditions such as carbon
monoxide poisoning, decompression sickness and difficult-to-treat
infections in parts of the body with poor blood supply.
HBOT has also been proposed for cerebral palsy. This idea is based
on the theory that, among damaged brain cells, there are inactive or
dormant cells that have the potential to recover. Some people think
that pressurized oxygen reactivates the dormant cells so they can
function normally. Unfortunately, that is a peculiar interpretation
of biology that is not supported by research.
HBOT and Cerebral Palsy: Just the Facts
Authors of several publications have demonstrated that for cerebral
palsy, HBOT is no better than pressurized air. For instance, Collet
and colleagues (2001), and more recently Lacey and colleagues
(2012), carried out elegantly designed placebo-controlled trials –
the highest quality of research possible. In the studies, children
with cerebral palsy were exposed to either pressurized oxygen or
pressurized regular air. There were no differences between the two
groups in any of the outcomes measured. That means that HBOT is no
more effective than compressed room air for the management of
symptoms associated with cerebral palsy.
HBOT Cerebral Palsy Benefits
In spite of the shortage of evidence to support them, reports
touting the benefits of HBOT for the management of cerebral palsy
continue to surface. Not surprisingly, the reports are either
testimonials or single-patient, poorly designed experiments from
HBOT facilities. In a 2013 article, Novak and Badawi analyze all
appropriately obtained scientific data on the subject and once again
concluded that “hyperbaric oxygen does not have a clinically
important effect on gross motor and self-care function in children
with cerebral palsy.”
It is also important to mention that HBOT is not risk-free.
Potential side effects of HBOT include ear pain, tympanic membrane
perforation, lung collapse and seizures. These are in addition to
the inherent risk of fire inside a closed chamber filled with
oxygen, which in high concentrations is a highly flammable gas.
As pediatricians, it is our responsibility to warn well-meaning
parents about so-called “therapies” that are based on, at best,
anecdotal evidence and, at times, the rather unusual ideas about the
biology of the health conditions to which they are being applied.
If your child has cerebral palsy, don’t put your faith in HBOT.
Instead of trying untested and possibly dangerous therapies, talk
with your child’s doctor about the best options for your child’s
care.
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