Rockswold Sarah B, Rockswold Gaylan L, Defillo Archie
Division of Neurosurgery, Department of Surgery, Hennepin County Medical Center, Department of Neurosurgery, University of Minnesota, 701 Park Avenue, Minneapolis, MN 55415, USA.
Neurol Res. 2007 Mar;29(2):162-72. doi: 10.1179/016164107X181798.
This critical literature review examines historical and current investigations on the efficacy and mechanisms of hyperbaric oxygen (HBO) treatment in traumatic brain injury (TBI). Potential safety risks and oxygen toxicity, as well as HBO's future potential, are also discussed.
Directed literature review.
Historically, cerebral vasoconstriction and increased oxygen availability were seen as the primary mechanisms of HBO in TBI. HBO now appears to be improving cerebral aerobic metabolism at a cellular level, namely, by enhancing damaged mitochondrial recovery. HBO given at the ideal treatment paradigm, 1.5 ATA for 60 minutes, does not appear to produce oxygen toxicity and is relatively safe.
The use of HBO in TBI remains controversial. Growing evidence, however, shows that HBO may be a potential treatment for patients with severe brain injury. Further investigations, including a multicenter prospective randomized clinical trial, will be required to definitively define the role of HBO in severe TBI.
本批判性文献综述探讨了高压氧（HBO）治疗创伤性脑损伤（TBI）的疗效和机制的历史及当前研究。还讨论了潜在的安全风险和氧中毒，以及HBO的未来潜力。
定向文献综述。
从历史上看，脑血管收缩和氧供应增加被视为HBO治疗TBI的主要机制。现在看来，HBO正在细胞水平上改善脑有氧代谢，即通过增强受损线粒体的恢复。在理想治疗模式下给予HBO，即1.5ATA持续60分钟，似乎不会产生氧中毒，且相对安全。
HBO在TBI中的应用仍存在争议。然而，越来越多的证据表明，HBO可能是重度脑损伤患者的一种潜在治疗方法。需要进一步的研究，包括多中心前瞻性随机临床试验，以明确界定HBO在重度TBI中的作用。
