Effect of different pressure hyperbaric oxygen therapy on patients with diffuse axonal injury

Objective To investigate the value of different pressure hyperbaric oxygen (HBO) therapy on clinical outcomes and effect on prognosis of the patients with severe diffuse axonal injury (DAI). Methods Thirty cases of diffuse axonal injury admitted into our hospital from September 2013 to March 2015 were randomly divided into 3 groups: the control group, the lower hyperbaric oxygen group (or the lower HBO group) and the higher hyperbaric oxygen group (or the higher HBO group), each consisting of 10 cases. The control group was just given routine treatment, the lower HBO group received 3 courses of 0.2 MPa HBO therapy in addition to routine treatment after vital signs became stable, and the higher HBO group received 3 courses of 0.25 MPa HBO therapy in addition to routine treatment. Neural functions of the 3 groups were evaluated by using GOS and NIHSS. Magnetic resonance spectroscopy was used to observe changes in the indicators of N-acetylaspartate (NAA)/ creatine (Cr), choline-containing compounds (Cho)/Cr and mINs/Cr. Results Statistical differences could be seen in the scores of GOS and NIHSS, when comparisons were made between the groups (P<0.05 or P<0.01). As compared with those of the lower HBO group and the control group, the levels of NAA/Cr, Cho/Cr, mlNs/Cr in the splenium of corpus callosumin, and NAA/Cr and Cho/Cr in basal ganglia for the 0.25 MPa HBO group were either elevated or decreased, with statistical significance (P<0.05 or P<0.01). Conclusions For the patients with severe diffuse axonal injury, higher pressure HBO therapy could obviously enhance metabolism of brain tissues in the splenium of corpus callosumin and basal ganglia and improve neurological deficits prognosis of the disorder. Key words: Diffuse axonal injury; Magnetic resonance imaging; Magnetic resonance spectroscopy; Hyperbaric oxygen therapy