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HBOT and Near-Drowning - Hyperbaric Oxygen Therapy

 

 

HBOT in Near-Drowning

HBOT - Harch HyperbaricsNear-drowning is a form of global ischemia/hypoxia that is similar to cardiac arrest and has equivalent devastating consequences. Unfortunately, the data for HBOT in this setting is scant, but was included by Drs. Harch and Neubauer in some of the studies mentioned in Chapter 18 of the K.K. Jain Textbook, 1999 (4). The earliest cases of HBOT in chronic near-drowning were treated and presented by Drs. Harch and Neubauer in the early 1990's. Dr. Harch has now treated a steadily increasing number of these chronic severe patients with modest results. While the patients show improvements in awareness and a reduction in seizures their progress is slower than nearly every other chronic neuropathology treated with HBOT. In the acute setting, however, HBOT has great potential. Dr. Harch had the opportunity to treat such a patient in 1997 within 2 hours of the event. The child made a total recovery and returned to school after a single treatment. He was featured in the Methodist Hospital national magazine that same year and presented at the 5/1998 Congress on Cerebral Ischemia, Vascular Aging, and Dementia in Washington, D.C., along with a case of HBOT in acute cardiac arrest who subsequently returned to work (31). Two of Dr. Harch's chronic cases were presented in 1994 at the UHMS meeting (3) and subsequently published in the 1999 K.K. Jain Textbook. One of them is featured below.

Case Presentation:

The patient is a 4 year old boy who presented 16 months after a 5 minute submersion which required 45 minutes of CPR to regain a pulse. He was subsequently wheelchair-bound with diffuse spasticity, motor impairment, and cognitive problems. He underwent SPECT imaging before and after a single (Figures 1 and 2) and 80 (Figure 3) HBOT's which demonstrated global improvement in brain blood flow (more yellow) that paralleled clinical improvements in cognition, tone, and motor abilities. Figures 4, 5, and 6 are three dimensional surface reconstructions of Figures 1, 2, and 3.

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3. Harch PG, et al. HMPAO SPECT brain imaging and low pressure HBOT in the diagnosis and treatment of chronic traumatic, ischemic, hypoxic and anoxic encephalopathies. Undersea and Hyperbaric Medicine, 1994;21(Suppl):30.

4. Harch PG and Neubauer RA. Hyperbaric oxygen therapy in global cerebral ischemia/anoxia and coma, Chapter 18. Textbook of Hyperbaric Medicine, 3rd Edition. Editor: K.K. Jain. Hogrefe and Huber Publishers, Seattle, 1999.

31. Harch PG. Hyperbaric oxygen therapy: Pharmacology and effects on pathophysiology in acute central nervous system ischemia and anoxia. Congress on Cerebral Ischemia, Vascular Dementia, Epilepsy and CNS Injury, Washington Marriott Wardman Park Hotel, Washington, DC, May 9-13, 1998, SP-12. Copies available from the National Stroke Research Center, Winston-Salem, N.C., and the office of Dr. Harch.