Effects And Safety Of Hyperbaric Oxygen Therapy On The Newborns With Perinatal Hypoxia Ischemia

ObjectiveTo observe the effects of hyperbaric oxygen (HBO) therapy on cerebral perfusion, oxidative stress and brain damage in newborns with perinatal hypoxia ischemia as reflected by changes of the cerebral hemodynamic parameters, blood 8-iso-PGF2αand S100B protein levels after hyperbaric oxygen therapy. And to analyse the safety of HBO therapy on the neonatus with perinatal hypoxia ischemia.Materials and methods60 neonates with perinatal hypoxia ischemia from Dec.2008 to Jun.2009 were enrolled, which were further divided into HBO group (n=30) and control group (n=30) randomly. The two groups were treated routinely. Besides this, the HBO group was also treated with hyperbaric oxygen. The hemodynamic parameters of middle cerebral artery (MCA) were detected by color Doppler ultrasonography before and after every session of HBO therapy in HBO group. The levels of 8-iso-PGF2αand S100B protein in the blood samples were determined by enzyme linked immunosorbent assay.Results1. The hemodynamic parameters of MCA including systolic peak velocity (Vs), end-diastolic velocity (Vd), resistence index (RI) were successfully detected by color Doppler ultrasonography before and after every session of HBO therapy in HBO group.2. The levels of 8-iso-PGF2αand S100B protein in the blood samples of the two groups were successfully detected by enzyme linked immunosorbent assay.3. There were no obvious differences in all hemodynamic parameters before and after the 1st and 2nd day's therapy (P>0.05). After the 3rd day's treatment, Vs was significantly lower than before therapy(P<0.05), Vd was highly significantly lower (P<0.01),while RI was highly significantly higher (P<0.01). After the 4th day's therapy, both Vs and Vd were highly significantly lower than before treatment (P<0.01), and RI was highly significantly higher (P<0.01).4. Before the treatment, there was no significant difference of the 8-iso-PGF2αlevel between two groups (P>0.05). After the therapy, the 8-iso-PGF2αlevel in the HBO group was significantly higher than control group (P<0.05).5. Blood 8-iso-PGF2αlevels measured after treatment were lower than before both in two groups .The decrease was highly statistically significant (P<0.01) in the control group, but not in HBO group (P>0.05).6. Blood S100B protein levels detected after treatment were lower than before both in two groups. Both decreases were not statistically significant (P>0.05). Before treatment, there was no significant difference of the S100B protein level between two groups (P>0.05). After therapy, there was no significant difference of the S100B protein level between two groups either (P>0.05).ConclusionThe later stage of HBO treatment course could induce vasoconstriction and a decrease in cerebral blood flow in the newborns with perinatal hypoxia ischemia .Treatment with HBO might cause oxidative stress, but that effect was slight, it didn't lead to brain damage.