[Time selection and course of treatment of cerebral resuscitation with hyperbaric oxygen].

OBJECTIVE

To explore the effect of treatment opportunity and course of hyperbaric oxygen (HBO) on the curative effect of cerebral resuscitation patients after successful cardiopulmonary resuscitation (CPR).

METHODS

Eighty-nine patients who underwent cerebral resuscitation after CPR admitted to the second department of the First Hospital of Jilin University from June 2015 to June 2019 were enrolled. All patients underwent conventional drug therapy after admission, and HBO therapy was added on the basis of conventional drug therapy at different intervention times, and all patients received at least 3 courses of HBO treatment. Glasgow coma scale (GCS) score and amplitude-integrated electroencephalography (aEEG) score on different treatment opportunity (i.e. intervention of HBO within 12 hours, 12-72 hours, 4-7 days, 8-21 days after successful CPR) and different course of HBO (i.e. 1, 2 and 3 courses of treatment) were recorded. Repeated measurement analysis of variance was used to assess whether the treatment opportunity or course of treatment affects the GCS score and aEEG score. Then, paired sample t test was used to further analyze the results of repeated measurement analysis of variance and evaluate the specific effect of treatment course or intervention time on the efficacy.

RESULTS

A total of 89 patients were enrolled. 8, 20, 33 and 28 patients started HBO treatment at < 12 hours, 12-72 hours, 4-7 days and 8-21 days after successful CPR. (1) GCS score: repeated measurement analysis of variance (the Greenhouse-Geisser correction method was used) showed that the effect of course of HBO treatment on GCS score was statistically significant (F = 71.735, P = 0.000). The interaction between the duration of HBO treatment and the timing of intervention was not statistically significant (F = 0.455, P = 0.817). Paired sample t test showed that the means of GCS scores before HBO treatment and treatment 1, 2, 3 courses were 3.56, 4.80, 5.55 and 6.49 respectively, and the difference of pairwise pairing between different groups were statistically significant (all P < 0.01). (2) aEEG score: repeated measurement analysis of variance (the Greenhouse-Geisser correction method was used) showed that the effect of course of HBO treatment on aEEG score was statistically significant (F = 96.965, P = 0.000).The interaction between the duration of HBO treatment and the timing of intervention was not statistically significant (F = 1.735, P = 0.112). Paired sample t test showed that the means of aEEG scores before HBO treatment and treatment 1, 2, 3 courses were 1.71, 2.21, 2.52 and 3.03 respectively (all P < 0.01).

CONCLUSIONS

The effect of HBO on cerebral resuscitation after CPR is obvious. The longer the course of HBO is, the more significant the effect of cerebral resuscitation is. Within 21 days after successful CPR, the treatment opportunity of HBO had no significant effect on the effect of cerebral resuscitation.