The Analysis Of The Indications And Adverse Events Of Hyperbaric Oxygen Therapy In Brain Trauma

Objective:Hyperbaric oxygen treatment(HBOT)is increasingly used in traumatic brain injury(TBI).Many studies have confirmed HBO is helpful in TBI.However,the potential adverse reactions of HBO is still confusing.When facing patients with tracheotomy,decompressive craniectomy,coma,fever and infection,or epilepsy,there is still no clear consensus on whether those patients are suitable for hyperbaric oxygen therapy,and whether these situations were related to the incidence of adverse events is needed to be further explored.The purpose of this study is to analyze the indications and adverse events of hyperbaric medicine in traumatic brain and may provide references for the application of Hyperbaric medicine in traumatic brain injury.Materials and methods:A retrospective analysis of 216 patients with traumatic brain injury treated with hyperbaric medicine in our hospital from 2010 to 2021.The data we collected included age,sex,GCS score before hyperbaric oxygen treatment,body temperature,heart rate,blood pressure,whether the bone flap had been removed,whether tracheostomy had been performed,whether the cortex was involved,whether it had seizures,whether it regularly took anti-epileptic drugs,as well as adverse events and reasons for discontinuation of treatment.Statistical methods:using statistical tools such as SPSS 27.0 calculate the incidence of adverse events after hyperbaric oxygen intervention in traumatic brain injury.These data were expressed as the frequency and percentage as nonparametric variables.Logistics single factor analysis was used to determine the significant variables.Logistic multivariate regression was performed to control for potential confounders and to determine independent predictors for a specific adverse event.Results:After hyperbaric oxygen treatment,12.5%of patients experienced fever,12.5%of patients experienced epilepsy,12%of patients experience restlessness and depression,6%of patients experience dizziness and headache,and 3.7%of patients experience ear discomfort,the incidences of blood pressure increase,chest tightness,rapid heart rate,dyspnea,visual impairment,allergic rashes and claustrophobia were respectively 2.8%,1.4%,6.9%,1.4%,0.5%,4.6%,and 0.5%.No severe adverse events such as oxygen toxicity and pulmonary barotrauma were observed.In the analysis of the influencing factors for incidence of adverse events,tracheotomy had a significant effect on hyperpyrexia,while cortical involvement,seizures before HBOT,and regular use of antiepileptic drugs were associated with hyperbaric medicine seizures.Age≥60 years was a risk factor for increased blood pressure during hyperbaric therapy.Tracheotomy could affect the heart rate.The main reason for the interruption of hyperbaric oxygen is the exacerbation of pulmonary infection.Most patients have no symptoms after treatment and can continue to hyperbaric medicine after treatment.Conclusion:Tracheotomy was a risk factor for hyperpyrexia,while cortical involvement,seizures before HBOT were risk factors for seizures during or after HBOT,and regular use of antiepileptic drugs could reduce the incidence of seizures.Age≥60 years was a risk factor for increased blood pressure during hyperbaric therapy.most of the adverse events in patients with traumatic brain injury are benign,without long-term residual adverse events,and can continue hyperbaric medicine after control.