Medical researchers report the case of
the reversal of brain volume loss in a 2-year-old drowning victim
unresponsive to all stimuli treated with normobaric oxygen (oxygen
at sea level) and hyperbaric oxygen therapy.
A low-risk medical treatment appears to have had a profound effect
on the recovery of a toddler-age drowning victim who suffered
serious neurological damage.
Dr. Paul Harch, Clinical Professor and Director of Hyperbaric
Medicine at LSU Health New Orleans School of Medicine, and Dr.
Edward Fogarty, at the University of North Dakota School of
Medicine, report the case of the reversal of brain volume loss in a
two-year-old drowning victim unresponsive to all stimuli treated
with normobaric oxygen (oxygen at sea level) and hyperbaric oxygen
therapy (HBOT).
The two-year-old girl experienced cardiac arrest after a cold water
drowning accident in a swimming pool. After resuscitation at
Arkansas Children's Hospital, MRI revealed deep gray matter injury
and cerebral atrophy with gray and white matter loss. She had no
speech, gait or responsiveness to commands with constant squirming
and head shaking at hospital discharge.
Dr. Harch was consulted, and because
hyperbaric oxygen therapy was not available in the patient's
location, he began a bridging treatment to prevent permanent tissue
degeneration until he could get the patient to a hyperbaric
treatment center. Fifty-five days post-drowning, he began short
duration treatment with 100% normobaric oxygen for 45 minutes twice
a day through a nasal cannula. The patient became more alert, awake
and stopped squirming. Her rate of neurological improvement
increased with laughing, increased movement of arms, hands, grasp
with the left hand, partial oral feeding, eye tracking and
short-sequenced speech (pre-drowning speech level, but with
diminished vocabulary).
The patient and family then traveled to New Orleans where 78 days
post-drowning, Dr. Harch began treating her with hyperbaric oxygen
therapy. She "dove" in a hyperbaric chamber for 45 minutes a day,
five days a week for 40 sessions. At the beginning of each session,
the patient showed visually apparent and/or physical
examination-documented neurological improvement. After 10 HBOT
sessions, the patient's mother reported that her daughter was "near
normal" except for gross motor function, and physical therapy was
re-instituted. After 39 HBOT sessions, the patient exhibited
assisted gait, speech level greater than pre-drowning, near normal
motor function, normal cognition, improvement on nearly all
neurological exam abnormalities, discontinuance of all medications,
as well as residual emotional, gait and temperament deficits. Gait
improvement was documented immediately upon returning home. An MRI
at 27 days following HBOT session 40 and 162 days post-drowning
demonstrated mild residual injury and near-complete reversal of
cortical and white matter atrophy.
The synergy of increased oxygen and increased oxygen with pressure
in the hormone-rich environment in a child's growing brain is
consistent with the synergy of growth hormones and hyperbaric oxygen
caused by normobaric and hyperbaric oxygen-induced activation of
genes that reduce inflammation and promote cell survival.
"The startling regrowth of tissue in this case occurred because we
were able to intervene early in a growing child, before long-term
tissue degeneration," notes Harch. "Although it's impossible to
conclude from this single case if the sequential application of
normobaric oxygen then HBOT would be more effective than HBOT alone,
in the absence of HBOT therapy, short duration, repetitive
normobaric oxygen therapy may be an option until HBOT is available.
Such low-risk medical treatment may have a profound effect on
recovery of function in similar patients who are neurologically
devastated by drowning."
