Effect Of Different Timing And Pressure Of Hyperbaric Oxygen Therapy Intervention On The Prognosis Of Patients With Traumatic Brain Injury

ObjectiveTraumatic brain injury has always been an important cause of unnatural death and disability and has created a heavy economic and social burden on patients and families.In recent years,several studies have shown that hyperbaric oxygen therapy can improve the prognosis of traumatic brain injury patients,but there is no uniform standard for specific treatment protocols.This study investigates the effects of different timing and pressure of hyperbaric oxygen therapy intervention on the prognosis of traumatic brain injury patients,determines the hyperbaric oxygen therapy protocols for traumatic brain injury patients,and provides a reference for the adjuvant treatment protocols for neurological rehabilitation of traumatic brain injury patients.MethodsThis study retrospectively included inpatients with moderate to severe traumatic brain injury who attended the Sixth Medical Center of the People’s Liberation Army General Hospital from December 2003 to December 2021 treated with hyperbaric oxygen,and all patients underwent 30 sessions of hyperbaric oxygen therapy.They were divided into low-pressure group(1.6 ATA)and high-pressure group(2.0 ATA)according to the different pressure of hyperbaric oxygen treatment.In the low pressure group,the patients were divided into early group(hyperbaric oxygen therapy within 30 days after traumatic brain injury,28 patients),intermediate group(hyperbaric oxygen therapy between 31 and 60 days after traumatic brain injury,41 patients)and late group(hyperbaric oxygen therapy after 61 days after traumatic brain injury,17 patients)according to the timing of hyperbaric oxygen therapy intervention.Also included in this study were 15 patients with early hyperbaric oxygen therapy in the hyperbaric group and 30 patients in the control group without hyperbaric oxygen therapy.Clinical data such as age,gender,whether head surgery was performed,changes in Glasgow Coma Scale(GCS)scores and Glasgow Prognostic Scale(GOS)scores were collected from all included patients,and the effects of different timing and pressure of hyperbaric oxygen therapy intervention on patients’ GCS and GOS scores were analyzed using SPSS 26.0 and RStudio 2022.12.0 software.ResultsThis study firstly analyzed the effects of different post-traumatic brain injury hyperbaric oxygen therapy intervention times on GCS scores and GOS scores of patients with traumatic brain injury under the same hyperbaric oxygen therapy pressure and duration(1.6 ATA,30 hyperbaric oxygen therapy sessions).The results revealed that the early group improved GCS scores more significantly than other groups after the beginning of treatment,and after 30 days of treatment,there was little difference in the control group to improve GCS scores compared with the intermediate and late groups,and both the early and intermediate groups were effective in impro ving GOS scores of patients on day 180.On this basis,this study also analyzed the effect of different hyperbaric oxygen therapy pressure on the prognosis of patients with traumatic brain injury under the same timing of hyperbaric oxygen therapy intervention(hyperbaric oxygen therapy within 30 days after traumatic brain injury).The results showed that 1.6ATA and 2.0ATA increased the and GOS scores in patients with moderate to severe traumatic brain injury,but there was no significant difference between the two different intervention pressures.The time to complete 30 sessions of hyperbaric oxygen therapy at 1.6 ATA was significantly shorter than that at 2.0 ATA.ConclusionThe time and pressure of hyperbaric oxygen therapy intervention factors influencing the neurological recovery of patients with moderate to severe traumatic brain injury.Hyperbaric oxygen therapy within 30 days after trauma significantly improves the prognosis of patients with brain injury,while there is no significant difference between the two different treatment pressures of 1.6 ATA and 2.0 ATA on the neurological recovery of patients with moderate to severe traumatic brain injury.Therefore,we suggest that for patients with moderate-to-severe traumatic brain injury,hyperbaric oxygen therapy should be performed as early as possible when the conditions of hyperbaric oxygen therapy allow.Although the effects of hyperbaric oxygen therapy are comparable between 1.6 ATA and 2.0 ATA,patients under 1.6 ATA pressure conditions have better compliance and tolerance for hyperbaric oxygen therapy and consume less medical resources,and are therefore more recommendable.