SP-12

Hyperbaric Oxygen Therapy: Pharmacology and Effects on Pathophysiology in Acute Central Nervous System Ischemia and Anoxia
Paul G. Harch, M.D. USA

Hyperbaric oxygen therapy (HBOT) is the use of high pressure oxygen as a drug to treat pathophysiologic processes and diseases. In acute cerebral anoxia/ischemia, anoxia, ischemia edema, and reperfusion injury are present. HBOT is know to reverse anoxia and edema and has been shown to powerfully inhibit reperfusion injury in two animal models (acute carbon monoxide poisoning and peripheral ischemia) and has suggested such as effect in two others (acute myocardial infarction and cerebral decompression illness). HBOT also has beneficial effects on vasospasm and energy and glucose metabolism in injured brain, yet causes vasoconstriction in normal brain tissue. Most of the above effects are dose and time dependent, such that hyperacute intervention has very potent results. Later intervention requires repetitive HBOT to cause trophic and possible immunomodulatory changes.

The literature will be reviewed on the above topics, particularly with respect to the hyperacute (0-3 hour) period port-neurological insult and two illustrative cases presented, a 60 year old comatose male, status post cardiac arrest and an 11 year old near-drowning adolescent. A proposal for HBOT in acute stroke is offered with high pressure for the acute/hyperacute period and lower pressures thereafter.


“Congress on Cerebral Ischemia, Vascular Dementia, Epilepsy and CNS Injury”

New Aspects of Prevention and Treatment from Space and Underwater Explorations

World Federation of Neurology, May 9-13, 1998

Washington Marriott Wardman Park Hotel, 2660 Woodley Road at Connecticut Ave., NW, Washington, DC 20008