What Researchers Did
Researchers reviewed the medical evidence on whether hyperbaric oxygen therapy (HBOT) helps people with traumatic brain injury.
What They Found
This systematic review found two fair-quality randomized controlled trials of patients with severe brain injury that reported conflicting results. One trial found no difference in mortality (48% with HBOT vs 55% with control) or morbidity at 1 year, though among young patients with brainstem contusion significantly more regained consciousness at 1 month with HBOT (67%) than control (11%), p less than 0.03. The other trial found a significant decrease in mortality at 1 year (17% with HBOT vs 31% with control, p equals 0.037), but this decrease was accompanied by an increase in the proportion of patients with severe disability. In that same trial, patients with intracranial pressure greater than 20 mmHg or a Glasgow Coma Scale score of 4 to 6 had significantly lower mortality at 1 year than controls. Five observational studies did not provide better evidence of effectiveness or adverse events; two showed HBOT could initially reduce elevated intracranial pressure in some patients, but rebound pressure elevations above pretreatment levels occurred in some cases. Adverse events including seizures, pulmonary symptoms, and neurologic deterioration were reported, though no study systematically assessed adverse events or reported them in control groups.
Canadian Relevance
No direct Canadian connection identified.
Study Limitations
The two randomized trials produced conflicting results and adverse events were never systematically assessed or compared against control groups, so the review authors could not draw firm conclusions about HBOT's benefits or harms for traumatic brain injury.