Clinical, brain electric earth map, endothelin and transcranial ultrasonic Doppler findings after hyperbaric oxygen treatment for severe brain injury

OBJECTIVE: To analyze the effect and mechanism of hyperbaric oxygen (HBO) treatment for severe brain injury (SBI). METHODS: Fifty-five patients were divided into a treatment group of 35 patients and a control group of 20 patients. We observed the alterations of clinical, brain electric earth map (BEAM), endothelin (ET) and transcranial ultrasonic Doppler (TCD) findings before and after HBO treatment as well as outcome. RESULTS: In the treatment group, Glasgow coma scale, BEAM and outcome improved after HBO treatment; compared with that of the control group, it showed a significant difference. After one course of treatment, treatment group ET was reduced from 91.24 +/- 12.18 ng/L to 68.88 +/- 14.37 ng/L (P < 0.01); in control group, ET was reduced from 90.78 +/- 15.71 ng/L to 83.12 +/- 12.22 ng/L, with a statistically significant difference (P < 0.05). TCD records of MCA mean velocity (Vm) was reduced from 64.2 +/- 4.8 cm/s to 51.6 +/- 4.2 cm/s (P < 0.01), and a decrease in MCA systolic velocity (Vs) and pulse index (PI) values was statistically significant (P < 0.01). CONCLUSION: HBO treatment can improve the clinical, BEAM and outcome of severely brain injured patients, by decreasing acute stage ET and improving the blood velocity of MCA and decreasing cerebral vascular resistance. HBO treatment can reduce cerebral vascular spasms, cerebral ischemia and hypoxia. One of the important mechanisms of HBO treatment for severe brain injury is the lowering of intracranial pressure.