Hajek Michal, Jor Ondrej, Tlapak Jakub, Chmelar Dittmar
Centre of Hyperbaric Medicine, Ostrava City Hospital, Ostrava, Czech Republic.
Institute of Laboratory Medicine, Institute of Microbiology, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
Int J Med Sci. 2025 Jan 1;22(3):473-481. doi: 10.7150/ijms.102884. eCollection 2025.
Some experimental studies on brain injury associated with traumatic brain injury (TBI) and hypoxic-ischaemic encephalopathy (HIE) reveal a positive effect of hyperbaric oxygen therapy (HBOT). However, in clinical medicine, most of the scientific evidence available in the current literature relates only to TBI. The primary objective is to empirically assess the efficacy of HBOT in mitigating the symptoms of disability associated with brain injury in children, with a view to elucidating its therapeutic potential and clinical benefits. A total of 21 patients have been treated with HBOT. The mean age was 6±4.6 years. There were 12 cases (57%) of TBI, 8 cases (38%) of HIE and 1 case (5%) of ischaemic stroke. The mean initial Glasgow Coma Scale (GCS) at hospital admission immediately after accident was 3.3±0.9. The mean time from injury to HBOT was 5.2 ± 3.8 weeks. The mean number of HBOT exposures was 10±4.3. The mean GCS pre-HBOT was 10.7±3.7 and 12.3±3.4 (p=0.004) after post-HBOT, respectively. The mean Glasgow Outcome Scale (GOS) was 3.3±0.8 pre-HBOT, and 3.9±1.1 (p<0.001) after post-HBOT, respectively. Eighteen cases were included in response to HBOT assessment. Six cases (33%) were evaluated as large clinically significant response (CSR), 7 cases (39%) were evaluated as partial response with minimally important difference (MID). Five cases (28%) were evaluated as non-response. The results showed better response to HBOT in cases of starting HBOT up to 4 weeks (p=0.02) after the injury. There was no serious HBOT-related complication or injury. Results of our study demonstrate both clinical and statistically significant patient response to HBOT. Our data also suggest that the earlier HBOT started after diagnosis up to 4 weeks, the more pronounced patients' response to HBOT was achieved. The provision of HBOT to pediatric patients is feasible in large regional hyperbaric centers.
一些关于创伤性脑损伤（TBI）和缺氧缺血性脑病（HIE）相关脑损伤的实验研究显示了高压氧治疗（HBOT）的积极效果。然而，在临床医学中，当前文献中可用的大多数科学证据仅与TBI相关。主要目的是通过实证评估高压氧治疗在减轻儿童脑损伤相关残疾症状方面的疗效，以阐明其治疗潜力和临床益处。共有21名患者接受了高压氧治疗。平均年龄为6±4.6岁。其中有12例（57%）为TBI，8例（38%）为HIE，1例（5%）为缺血性中风。事故后入院时的初始格拉斯哥昏迷量表（GCS）平均分为3.3±0.9。从受伤到接受高压氧治疗的平均时间为5.2±3.8周。高压氧治疗的平均次数为10±4.3次。高压氧治疗前GCS平均分为10.7±3.7，治疗后为12.3±3.4（p = 0.004）。格拉斯哥预后量表（GOS）治疗前平均分为3.3±0.8，治疗后为3.9±1.1（p<0.001）。18例患者纳入高压氧治疗反应评估。6例（33%）被评估为具有重大临床意义的反应（CSR），7例（39%）被评估为具有最小重要差异（MID）的部分反应。5例（28%）被评估为无反应。结果显示，在受伤后4周内开始高压氧治疗的病例对高压氧治疗反应更好（p = 0.02）。没有与高压氧治疗相关的严重并发症或损伤。我们的研究结果表明患者对高压氧治疗在临床和统计学上均有显著反应。我们的数据还表明，诊断后至4周内越早开始高压氧治疗，患者对高压氧治疗的反应就越明显。在大型区域高压氧中心为儿科患者提供高压氧治疗是可行的。
