The possible role of hyperbaric oxygen therapy for traumatic brain surgery is still debated by several experts and researchers. While many proponents believe it may hold the key to managing symptoms of TBI, research on these effects are limited. In this article, we would look at the possible roles and benefits of hyperbaric chamber for TBI.

Does hyperbaric chamber work for traumatic brain injury?

Yes, some research has shown a good promise in the area of HBOT for TBI. HBOT has shown neuroprotective effects during the acute and chronic phase of Traumatic Brain Injury (TBI), typically within 24 hours post-injury. Studies using rat models have indicated that HBOT starting as early as 3 hours after injury, can significantly decrease cell apoptosis and reduce secondary brain damage. This neuroprotective effect appears to be mediated by inhibiting the mitochondrial permeability transition pore. Additionally, HBOT has been found to reduce neuroinflammation and the expression of certain enzymes associated with brain injury.

Further research in mouse models of TBI demonstrated that HBOT initiated 3 hours after injury led to increased levels of interleukin-10, resulting in reduced lesion volume, less cerebral edema, and improved neurological status. Investigations into the optimal timing for HBOT treatment have suggested that initiating therapy early, within 3 hours of injury, can inhibit inflammation and stimulate processes like angiogenesis and neurogenesis.

In the chronic stage of TBI, HBOT has shown promise in improving motor functions and cognitive abilities in animal models, as well as in clinical trials with TBI patients. Repetitive long-term HBOT treatments have been associated with enhanced recovery of motor functions, likely through promoting axonal sprouting and synapse remodeling. Similarly, prolonged HBOT sessions initiated months after the initial brain injury have resulted in increased vascular density in affected brain regions and improved cognitive function.

Benefits of Hyperbaric chamber for traumatic brain injury

Hyperbaric oxygen therapy (HBOT) offers several potential benefits for traumatic brain injury (TBI) patients:

1. Improved Oxygenation: HBOT delivers high concentrations of oxygen to damaged brain tissues, compensating for reduced oxygen supply due to compromised circulation. This promotes tissue healing and supports neural function.
2. Neuroprotection: Oxygen is essential for neuronal survival. HBOT may protect neurons from further damage, potentially mitigating the extent of injury and preserving neurological function.
3. Reduced Inflammation: HBOT has anti-inflammatory effects, which may help alleviate inflammation associated with TBI, reducing tissue damage and symptom severity.
4. Enhanced Neuroplasticity: HBOT may promote neuroplasticity, enabling the brain to adapt and reorganize in response to TBI-related changes, potentially improving functional outcomes.
5. Symptom Management: HBOT has been associated with improvements in various TBI symptoms, including cognitive dysfunction, memory deficits, headaches, and mood disturbances, enhancing overall quality of life.

Side effects of Hyperbaric chamber for traumatic brain injury

While hyperbaric oxygen therapy (HBOT) is generally considered safe, there are potential side effects and risks associated with its use for traumatic brain injury (TBI) patients:

1. Barotrauma: Changes in pressure, particularly during descent or ascent in the hyperbaric chamber, can cause barotrauma, leading to ear or sinus pressure injuries. This can result in ear pain, ringing in the ears, or sinus discomfort.
2. Oxygen Toxicity: Breathing high concentrations of oxygen under increased pressure can lead to oxygen toxicity. Symptoms may include dizziness, nausea, vomiting, twitching, seizures, or changes in vision. Oxygen toxicity is more likely with prolonged or repeated HBOT sessions at high pressures.
3. Claustrophobia: Some TBI patients may experience feelings of claustrophobia or anxiety while inside the hyperbaric chamber, particularly if they are uncomfortable with confined spaces. This psychological discomfort can make the HBOT experience distressing for some individuals.
4. Fatigue and Decompression Sickness: After HBOT sessions, TBI patients may experience fatigue, lightheadedness, or a feeling of “being off balance.” In rare cases, decompression sickness, also known as “the bends,” can occur when ascending too quickly from high pressure to normal pressure. Symptoms may include joint pain, dizziness, shortness of breath, or neurological symptoms.
5. Fire Hazard: Oxygen supports combustion, so there is a risk of fire inside the hyperbaric chamber if proper safety precautions are not followed. Smoking, using electronic devices that generate sparks, or bringing flammable materials into the chamber should be strictly prohibited.

Frequently asked questions

Sources

Hu, Q., Manaenko, A., Xu, T., Guo, Z., Tang, J., & Zhang, J. H. (2016). Hyperbaric oxygen therapy for traumatic brain injury: Bench-to-bedside. Medical Gas Research, 6(2), 102-110. https://doi.org/10.4103/2045-9912.184720

Prakash, A., Parelkar, S. V., Oak, S. N., Gupta, R. K., Sanghvi, B. V., Bachani, M., & Patil, R. (2012). Role of hyperbaric oxygen therapy in severe head injury in children. Journal of Pediatric Neurosciences, 7(1), 4-8. https://doi.org/10.4103/1817-1745.97610

HADANNY, Amir; MAROON, Joseph; EFRATI, Shai. The Efficacy of Hyperbaric Oxygen Therapy in Traumatic Brain Injury Patients: Literature Review and Clinical Guidelines. Medical Research Archives, [S.l.], v. 11, n. 7.2, july 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/4161>. Date accessed: 01 mar. 2024. doi: https://doi.org/10.18103/mra.v11i7.2.4161.

Hadanny A, Abbott S, Suzin G, et al. Effect of hyperbaric oxygen therapy on chronic neurocognitive deficits of post-traumatic brain injury patients: retrospective analysis. BMJ Open 2018;8:e023387. doi: 10.1136/bmjopen-2018-023387