Nancy Faass interviews Dr. Paul Harch on the Effectiveness of Hyperbaric Oxygen Therapy for Traumatic Brain Injury.

In the treatment of traumatic brain injury, the research suggests that hyperbaric oxygen is the most effective therapy currently available at all levels of severity and all time points in the disease process. Mortality from acute, severe traumatic brain injury (TBI) can be reduced with just a few treatments, early on, documented in randomized clinical trials. One to three sessions of hyperbaric oxygen therapy (HBOT) in the acute phase can decrease mortality by 50% to 60%, the greatest reduction in mortality of any known therapy. There is also evidence that HBOT is therapeutic for acute concussion, as well as post-concussion symptoms. HBOT is the only therapy that directly treats the underlying disease processes in TBI wounds:  decreased oxygen, decreased blood flow, swelling, constriction of blood vessels, acidosis, and anaerobic metabolism.

Significance. In the US, accidents are now the leading cause of death among every age cohort from childhood through age 44. Among the survivors, the official number of brain injuries is approximately two million annually in the US and ten million worldwide. This means that more than two million brain-injured individuals are added to our population every year. Over 75% of these brain injuries are concussions. Approximately half of all mild TBI patients develop persistent post-concussion syndrome, characterized by cognitive symptoms such as memory loss, headaches, mood swings (irritability, anxiety, depression, apathy), sleep disruption, fatigue, dizziness, and changes in personality.

In terms of potential therapeutics, two randomized trials have been conducted showing significant improvement in moderate to severe TBI in the subacute phase utilizing HBOT. There are multiple randomized trials on mild TBI in the chronic phase, showing the therapeutic benefit of HBOT.

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