oxygen chamber, hyperbaric chamber, hyperbaric oxygen chamber, oxygen therapy, brain injury, tbi

Hyperbaric Oxygen Therapy 

Hyperbaric oxygen therapy (HBOT) is a form of oxygen therapy that involves breathing pure oxygen in a sealed and pressurized environment or chamber. The air pressure the individual breathes is 2 to 3 times more pressurized, allowing the individual to intake more oxygen into their lungs than the average amount. This allows the blood to receive and carry more oxygen throughout the body which may providing benefits such as improving wound healing through the release of growth factors and stem cells, immunity, mental functioning, and a variety of other benefits (e.g., improving sleep and stress).  

Hyperbaric oxygen therapy has been used on health conditions such as traumatic brain injuries, brain abscess, burns, and other diagnoses. It has also been used to help treat ischemia (inadequate blood supply to parts of the body), hypoxia (inadequate oxygen in the tissues), and cerebral edema (swelling/fluid in the brain) and reduce intracranial pressure to prevent secondary complications that develop and may worsen after a TBI.  It can also be used to benefit the body on a cellular level such as improving metabolism and decreasing cell and tissue damage or death, commonly seen as secondary brain damage. Oxygen levels are also crucial for the healing process after a BI and for the brain’s neuroplasticity, a term for the brain being able to form new neural connections when other connections have been damaged. Additional research has shown the following benefits and risks: 

Additional benefits from research 

(Benefits depend on dosage and duration of HBOT) 

Additional risks and concerns from research 
  • Wang, Wang, Sun, & Yu (2016) found HBOT can improving the individual’s Glasgow Coma Scale score for TBI and Post-Concussion Syndrome (PCS) & decreasing mortality rates when compared to the standard oxygen therapy (these findings remain controversial) 
  • However, there was NO improved quality of life for individuals 
  • Other studies indicate that oxygen therapy from a nasal cannula or facemask is equally effective in improving clinical outcomes and reduced mortality rates in severe TBI patients 
  • Early and delayed sessions of HBOT can reduce intracranial pressure (pressure around the brain), decrease mortality, and improve neurobehavioral recovery 

(Huang & Obenaus, 2011) 

  • Provides significant increase in blood flow, thus improving cognition performance in older adults (study did not look at individuals with a brain injury) 

            (American Friends of Tel Aviv                               University. 2020) 

  • Significant improvements in Persistent Post-Concussion Syndrome (PPCS) and PTSD symptoms, cognition, depression, anxiety, quality of life, and brain blood flow which can be better explained from the known from the wound-healing effects from HBOT 

             (Harch, Andrews, Fogarty, Lucarini, &                 Van Meter 2017) 

  • A randomized control trial found improvement in post stroke patients (chronic late stage) was able to enhance neuroplasticity to help regain some sensation and motor functions 

            (Efrati et al. 2013) 

  • Not widely adopted standard therapy for TBI 
  • Not an FDA approved treatment yet 
  • There is not enough evidence showing improved clinical outcomes from the risks involved 
  • Risks include: Damage to ears, sinuses, and lungs 
  • Can trigger seizures with individuals who also have epilepsy  
  • May be difficult for individuals who have anxiety being in an enclosed space 
  • Benefits compared to risk factors when evaluating the individual’s quality of life is still under question 
  • More research needs to be conducted on the benefits of HBOT 
  • Additional notes: HBOT is not currently covered by insurances and can be costly to received treatment 

References:

Mayo Clinic Staff. (n.d.). Hyperbaric oxygen therapy. Mayo Clinic.   https://www.mayoclinic.org/tests-procedures/hyperbaric-oxygen-therapy/about/pac-20394380 

Wang, F., Wang, Y., Sun, T., & Yu, H. (2016). Hyperbaric oxygen therapy for the treatment of traumatic brain injury: a meta-analysis. Neurological Sciences, 37(5), 693-701. http://dx.doi.org.westcoastuniversity.idm.oclc.org/10.1007/s10072-015-2460-2  

FlintRehab. (2020). Hyperbaric Oxygen Therapy for Brain Injury: What Does the Science Support. https://www.flintrehab.com/hyperbaric-oxygen-therapy-for-brain-injury/ 

Liu, S., Shen, G., Deng, S., Wang, X., Wu, Q., & Guo, A. (2013). Hyperbaric oxygen therapy improves cognitive functioning after brain injury. Neural Regeneration Research, 8(34), 3334-3343. http://westcoastuniversity.idm.oclc.org/login?url=https://www-proquest-com.westcoastuniversity.idm.oclc.org/docview/2382784721?accountid=162765 

Huang, L., & Obenaus, A. (2011). Hyperbaric oxygen therapy for traumatic brain injury. Medical gas research1(1), 21. https://doi.org/10.1186/2045-9912-1-21      

Harch, P., Andrews, S., Fogarty, E., Lucarini, J., & Van Meter, K. (2017). Case control study: Hyperbaric oxygen treatment of mild traumatic brain injury persistent post-concussion syndrome and post-traumatic stress disorder. Medical Gas Research, 7(3). http://dx.doi.org.westcoastuniversity.idm.oclc.org/10.4103/2045-9912.215745 

American Friends of Tel Aviv University. (2020). New hyperbaric oxygen therapy protocol can improve cognitive function of older adults: Research published today in peer-reviewed journal Aging. ScienceDailywww.sciencedaily.com/releases/2020/07/200715123143.htm 

Efrati S, Fishlev G, Bechor Y, Volkov O, Bergan J, Kliakhandler K, et al. (2013) Hyperbaric Oxygen Induces Late Neuroplasticity in Post Stroke Patients – Randomized, Prospective Trial. PLoS ONE 8(1): e53716. https://doi.org/10.1371/journal.pone.0053716 

https://www.medicalnewstoday.com/articles/313155 

https://www.myhdiet.com/healthnews/ampm/essential-health-benefits-of-having-oxygen-rich-blood/ 

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