Hyperbaric oxygen and brain injury

  Hyperbaric oxygen has obvious effects on improving the developmental quotient of brain-injured children, and the longer the course of treatment, the higher the efficiency. The possible reasons for this are that hyperbaric oxygen has the following effects on injured brain tissues by increasing the partial pressure of oxygen, improving brain circulation, stabilizing cell membranes, etc. It improves the integrity of the blood-brain barrier; inhibits damage to brain tissues by free radicals; promotes repair of injured brain tissues and recovery of neurological functions; improves the utilization of sugar by brain tissues; reduces brain cell apoptosis after injury; enhance the expression of neurotrophic factors in the brain and reduce the level of plasma endothelin; increase the partial pressure of oxygen in the brainstem reticular activating system and other parts of the brain; and help improve wakefulness. The combined intervention has a synergistic effect on improving the clinical symptoms of brain injury.  Some scholars believe that hyperbaric oxygen can promote the formation of oxygen free radicals and aggravate neonatal brain injury; hyperbaric oxygen can also cause cerebral vasoconstriction and reduce cerebral blood flow, which is not conducive to brain cell recovery, therefore, the safety and long-term efficacy of hyperbaric oxygen therapy for neonatal brain injury are questionable.  In recent years, many clinical studies have demonstrated that the therapeutic effect of hyperbaric oxygen on brain injury in high-risk infants is positive. Research on the mechanism of hyperbaric oxygenation has found that hyperbaric oxygenation can increase blood oxygen concentration, improve the supply of oxygen to various organ tissues, improve brain tissue metabolism, and promote brain injury repair; hyperbaric oxygenation can cause vasoconstriction in brain tissues with normal oxygen supply and reduced cerebral blood flow, but can cause cerebral vasodilation in damaged areas, increase cerebral blood flow in ischemic areas, and reduce cerebral edema; increase the partial pressure of oxygen in the brainstem reticular activation system and other areas. thus exerting a protective and repairing effect on the brain at the time of neonatal brain injury.  Early intervention has an impact on the prognosis of brain injury, and the first few years of life are the period when the brain, intelligence, and social adaptation develop more rapidly than at any other time. Many studies have shown that the mature brain is significantly reversible in response to injury and that early infant stimulation can result in complete or partial recovery of function from neurological deficits caused by damage to brain structures. Infancy is a critical period for the development of intelligence, and early intervention promotes the development of intelligence.  Through observation, we have learned that the factors affecting hyperbaric oxygen therapy are: ① Dose selection: Hyperbaric oxygen therapy must choose the appropriate dose, including pressure, oxygen concentration, oxygen inhalation time and duration of treatment, one of which is insufficient or excessive can affect the efficacy. Adjunctive therapy: hyperbaric oxygen has synergistic effects with some drugs and so on.  ② Timing of treatment: Improving brain tissue hypoxia in the early stage of brain injury is the key to treating brain injury, but attention should be paid to the timing and method of hyperbaric oxygen therapy and the cooperation with other methods, paying attention to the early, sufficient amount and long course of use. In order to achieve the desired effect, it is necessary to use the means of screening to detect brain injured children in time, and strive for early diagnosis and treatment to control the further development of brain injury in time.  Early intervention for high-risk children with brain injury can significantly reduce the occurrence of sequelae and improve the prognosis of high-risk children with brain injury. In conclusion, cerebrolysin, cerebrofusion, salvia and hyperbaric oxygen can all play a protective role in brain injury by different mechanisms, and early intervention plays an important role in reducing the incidence of disability in children with high-risk brain injury. The main pathological changes are brain cell swelling, brain metabolic disorders, edema and increased intracranial pressure.  The longer the brain is deprived of oxygen, the more obvious the brain cell edema and the more serious the dysfunction. The mechanism of hyperbaric oxygen therapy for neonatal brain injury in high-risk infants is that oxygen absorption at more than 1 atm can increase the dissolved amount of arterial oxygen, improve the oxygen tension, promote the diffusion of oxygen from blood to tissues, alleviate the lack of oxygen in brain tissues, and make the cerebral blood vessels dilated at the early stage of the disease contract, reduce cerebral blood flow, release cerebral edema, lower intracranial pressure, block a series of pathological development of brain tissues caused by lack of oxygen, and promote the recovery of damaged It can also reduce the cerebral blood flow, release cerebral edema, reduce intracranial pressure, interrupt a series of pathological processes in brain tissue caused by hypoxia, and promote the recovery of damaged brain cells.