Clinical, brain electric earth map, endothelin and transcranial ultrasonicDoppler findings after hyperbaric oxygen treatment for severe brain injury

Objective To analyze the effect and mechanism of hyperbaric oxygen (HBO) tr eatment for severe brain injury (SBI). Methods Fifty-five patients were divided into a treatment group of 35 patie nts and a control group of 20 patients. We observed the alterations of clin ical, brain electric earth map (BEAM), endothelin (ET) and transcranial ult rasonic Doppler (TCD) findings before and after HBO treatment as well as ou tcome. Results In the treatment group, Glasgow coma scale, BEAM and outcome improv ed after HBO treatment; compared with that of the control group, it showed a significant difference. After one course of treatment, treatment group ET was reduced from 91.24 +/- 12.18 ng/L to 68.88 +/- 14.37 ng/L ( P < 0.01); in control group, ET was reduced from 90.78 +/- 15.71 ng/L to 83.12 +/- 12 .22 ng/L, with a statistically significant difference (P < 0.05). TCD recor ds of MCA mean velocity (Vm) was reduced from 64.2 +/- 4.8 cm/s to 51.6 +/- 4.2 cm/s ( P < 0.01), and a decrease in MCA systolic velocity (Vs) and pul se index (PI) values was statistically significant (P < 0.01). Conclusion HBO treatment can improve the clinical, BEAM and outcome of seve rely brain injured patients, by decreasing acute stage ET and improving the blood velocity of MCA and decreasing cerebral vascular resistance. HBO tre atment can reduce cerebral vascular spasms, cerebral ischemia and hypoxia. One of the important mechanisms of HBO treatment for severe brain injury is the lowering of intracranial pressure.