Long COVID symptoms typically occur within 3 months of an initial COVID-19 infection,last for more than 2 months,and cannot be explained by other diagnoses.The most common symptoms include fatigue,dyspnea,coughing,and...Long COVID symptoms typically occur within 3 months of an initial COVID-19 infection,last for more than 2 months,and cannot be explained by other diagnoses.The most common symptoms include fatigue,dyspnea,coughing,and cognitive impairment.The mechanisms of long COVID are not fully understood,but several hypotheses have been put forth.These include coagulation and fibrosis pathway activation,inflammatory and autoimmune manifestations,persistent virus presence,and Epstein-Barr virus reactivation.Hyperbaric oxygen therapy(HBOT)is a therapeutic method in which a person inhales 100%oxygen under pressure greater than that of the atmosphere.HBOT has some therapeutic effects,including improvement of microcirculation,inhibition of cytokine release leading to a reduction in inflammatory responses,inhibition of autoimmune responses,and promotion of neurological repair.Several clinical trials have been carried out using HBOT to treat long COVID.The results suggest that HBOT helps to improve symptom severity,reduce symptom duration,and enhance patients’quality of life.It is believed that HBOT is an effective option for patients with long COVID,which is worth actively promoting.展开更多
Radiotherapy(RT)is the backbone of multimodality treatment of more than half of cancer cases.Despite new modern RT techniques,late complications may occur such as radiation proctitis(RP).The natural history of RP is u...Radiotherapy(RT)is the backbone of multimodality treatment of more than half of cancer cases.Despite new modern RT techniques,late complications may occur such as radiation proctitis(RP).The natural history of RP is unpredictable.Minor symptoms may resolve spontaneously or require conservative treatment.On the other hand,for similar and uncomplicated clinical contexts,symptoms may persist and can even be refractory to the progressive increase in treatment measures.Over the last decades,an enormous therapeutic armamentarium has been considered in RP,including hyperbaric oxygen therapy(HBOT).Currently,the evidence regarding the impact of HBOT on RP and its benefits is conflicting.Additional prospective and randomised studies are necessary to validate HBOT’s effectiveness in the‘real world’clinical practice.This article reviewed the relevant literature on pathophysiology,clinical presentation,different classifications and discuss RP management including a proposal for a therapeutic algorithm with a focus on HBOT.展开更多
Although hyperbaric oxygen(HBO) therapy can promote the recovery of neural function in patients who have suffered traumatic brain injury(TBI),the underlying mechanism is unclear.We hypothesized that hyperbaric oxygen ...Although hyperbaric oxygen(HBO) therapy can promote the recovery of neural function in patients who have suffered traumatic brain injury(TBI),the underlying mechanism is unclear.We hypothesized that hyperbaric oxygen treatment plays a neuroprotective role in TBI by increasing regional transcranial oxygen saturation(rSO_2) and oxygen partial pressure(PaO_2).To test this idea,we compared two groups: a control group with 20 healthy people and a treatment group with 40 TBI patients.The 40 patients were given 100% oxygen of HBO for 90 minutes.Changes in rSO_2 were measured.The controls were also examined for rSO_2 and PaO_2,but received no treatment.rSO_2 levels in the patients did not differ significantly after treatment,but levels before and after treatment were significantly lower than those in the control group.PaO_2 levels were significantly decreased after the 30-minute HBO treatment.Our findings suggest that there is a disorder of oxygen metabolism in patients with sub-acute TBI.HBO does not immediately affect cerebral oxygen metabolism,and the underlying mechanism still needs to be studied in depth.展开更多
Objective Hyperbaric oxygen treatment(HBOT)has demonstrated efficacy in improving hearing levels of patients with idiopathic sudden sensorineural hearing loss(ISSHL);however,the underlying mechanisms are not well unde...Objective Hyperbaric oxygen treatment(HBOT)has demonstrated efficacy in improving hearing levels of patients with idiopathic sudden sensorineural hearing loss(ISSHL);however,the underlying mechanisms are not well understood.HBOT alleviates the inflammatory response,which is mediated by Toll-like receptor(TLR)4 and nuclear factor(NF)-κB.In this study we investigated whether HBOT attenuates inflammation in ISHHL patients via alteration of TLR4 and NF-κB expression.Methods ISHHL patients(n=120)and healthy control subjects(n=20)were enrolled in this study.Patients were randomly divided into medicine group treated with medicine only(n=60)and HBO group receiving both HBOT and medicine(n=60).Audiometric testing was performed pre-and posttreatment.TLR4,NF-кB,and TNF-αexpression in peripheral blood of ISSHL patients and healthy control subjects was assessed by ELISA before and after treatment.Results TLR4,NF-κB,and TNF-αlevels were upregulated in ISSHL patients relative to healthy control subjects;the levels were decreased following treatment and were lower in the HBO group than that in the medicine group post-treatment(P<0.05 and P<0.01).Conclusion HBOT alleviates hearing loss in ISSHL patients by suppressing the inflammatory response induced by TLR4 and NF-κB signaling.展开更多
BACKGROUND:Hyperbaric oxygen(HBO)is an effective adjuvant therapy for ischemiareperfusion(I/R)injury of the brain,small intestine and testis in addition to crushing injury.Studies have shown that HBO increases the act...BACKGROUND:Hyperbaric oxygen(HBO)is an effective adjuvant therapy for ischemiareperfusion(I/R)injury of the brain,small intestine and testis in addition to crushing injury.Studies have shown that HBO increases the activity of villi of the ileum 30 minutes after I/R injury.The present study aimed to observe the effect of HBO on apoptosis of epithelial cells in the small intestine during different periods of I/R and to elucidate the potential mechanisms.METHODS:Rats were subjected to 60-minute ischemia by clamping the superior mesenteric artery and 60-minute reperfusion by removal of clamping.The rats were randomly divided into four groups:I/R group,HBO precondition or HBO treatment before ischemia(HBO-P),HBO treatment during ischemia period(HBO-I),and HBO treatment during reperfusion(HBO-R).After 60-minute reperfusion,samples of the small intestine were prepared to measure the level of ATP by using the colorimetric method and immunochemical expression of caspase-3.The levels of TNF-αin intestinal tissue were measured using the enzyme-linked immunosorbent assay method(Elisa).RESULTS:TNF-αlevels were significantly lower in the HBO-I group than in the HBO-P(P<0.05),HBO-R and I/R groups;there was no significant difference between the HBO-R and I/R groups(P>0.05).The expression of caspas-3 was significantly lower in the HBO-I group than in the HBO-P group(P<0.05);it was also significantly lower in the HBO-P group than in the I/R and HBO-R groups(P<0.05).ATP level was significantly lower in the HBO-I group than in the HBO-P group(P<0.05),and also it was significantly lower in the HBO-P group than in the I/R and HBO-R groups(P<0.05).CONCLUSIONS:There is an association between HBO,small intestinal I/R injury,and mucosa apoptosis.HBO maintains ATP and aerobic metabolism,inhibites TNF-αproduction,and thus prevents intestinal mucosa from apoptosis.Best results can be obtained when HBO is administered to patients in the period of ischemia,and no side effects are produced when HBO is given during the Period of Reperfusion.展开更多
Non-healing wounds impart serious medical problems to people with diabetes.Amongst 15%of diabetic patients,the incidence of foot ulcer is the most prevailing,which confers a significant risk of limb amputation,mainly ...Non-healing wounds impart serious medical problems to people with diabetes.Amongst 15%of diabetic patients,the incidence of foot ulcer is the most prevailing,which confers a significant risk of limb amputation,mainly due to hypoxia and impairment in cell signaling.Alteration in the expression of chemokines and the related factors in diabetic conditions delays the recruitment of different cell types,including fibroblasts,keratinocytes,and immune cells such as macrophages to the site of injury,further impairing neovasculogenesis,reepithelialization,and extracellular matrix formation.Thus,proper activation of effector cells through an accurate signal pathway is necessary for better therapeutic application.Hyperbaric oxygen therapy(HBOT)is the current treatment prescribed by medical practitioners,shown to have increased the wound healing rate by reducing the need for significant amputation among the diabetic population.However,the risk of morbidity associated with HBOT needs complete attention through rigorous research to avoid adverse outcomes.Altering the level of pro-angiogenic chemokines may regulate the inflammatory response,further promote vascularization,and enhance the complete healing of wounds in diabetic patients.Thus,a combination of better therapeutic approaches could pave the way for developing a successful treatment for diabetic foot and wound healing.展开更多
Accumulating studies have demonstrated that hyperbaric oxygen(HBO)treatment alleviates spinal cord injury(SCI).However,the underlying mechanism by which HBO alleviates SCI remains to be elucidated.In this study,we per...Accumulating studies have demonstrated that hyperbaric oxygen(HBO)treatment alleviates spinal cord injury(SCI).However,the underlying mechanism by which HBO alleviates SCI remains to be elucidated.In this study,we performed genome-wide transcriptional profiling of the spinal cord between SCI mice and mice that received HBO treatment by high-throughput RNA sequencing at 1 week after SCI.We also compared genome-wide transcriptional profiles from SCI mice and sham-operated mice.We found 76 differentially co-expressed genes in sham-operated mice,SCI mice,and HBO-treated SCI mice.Using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis,we identified the biological characteristics of these differentially expressed genes from the perspectives of cell component,biological process,and molecular function.We also found enriched functional pathways including ferroptosis,calcium signaling pathway,serotonergic synapse,hypoxia-inducible factor-1 signaling pathway,cholinergic synapse,and neuroactive ligand-receptor interaction.We performed quantitative reverse transcription-polymerase chain reaction and validated that HBO treatment decreased the expression of Hspb1(heat shock protein beta 1),Hmox1(heme oxygenase 1),Ftl1(ferritin light polypeptide 1),Tnc(tenascin C)and Igfbp3(insulin-like growth factor binding protein 3)and increased the expression of Slc5a7(solute carrier family 5 choline transporter member 7)after SCI.These results revealed the genome-wide transcriptional profile of the injured spinal cord after HBO treatment.Our findings contribute to a better understanding of the mechanism by which HBO treats SCI and may provide new targets for SCI intervention.展开更多
Background: Acute acoustic trauma (AAT) is an acute hearing impairment caused by intense noiseimpact. The current management strategy for AAT with substantial hearing loss in the Dutch militaryis the combination thera...Background: Acute acoustic trauma (AAT) is an acute hearing impairment caused by intense noiseimpact. The current management strategy for AAT with substantial hearing loss in the Dutch militaryis the combination therapy with corticosteroids and hyperbaric oxygen therapy (HBOT). In a previousstudy, early initiation of the combination therapy was associated with better outcomes. Therefore, weperformed a new analysis to assess the difference in hearing outcome between patients in whomcombination therapy was started within two days, versus after more than two days.Methods: A retrospective analysis was performed on military patients diagnosed with AAT with substantial hearing loss who presented between February 2018 and March 2020. Absolute and relativehearing improvement between first and last audiograms were calculated for all affected frequencies(defined as loss of 20 dB on initial audiogram). We also determined the amount of patients whorecovered to the level of Dutch military requirement, and performed speech discrimination tests.Results: In this analysis, 30 male patients (49 ears) with AAT were included. The median age was 24.5years (IQR 23e29). The median time to initiation of therapy with corticosteroids and HBOT were one andtwo days, respectively. HBOT was started within two days in 31 ears, and after more than two days in 18ears. The mean absolute and relative hearing gains were 18.8 dB (SD 14.6) and 46.8% (SD 31.3) on allaffected frequencies. The 100% discrimination/speech perception level improved from 64.0 dB to 51.7 dB(gain 12.3 dB ± 14.1). There was significantly more improvement in absolute and relative hearingimprovement when HBOT was started in 2 days, compared to >2 days.Conclusion: Our analysis shows results in favor of early initiation ( 2 days) of the combination treatmentof HBOT and corticosteroids in patients with AAT.展开更多
In this study,we investigated the protective effect of hyperbaric oxygen(HBO)on PC12 and H9C2 cell damage caused by oxygen-glucose deprivation/reperfusion and its possible mechanism.PC12 and H9C2 cell oxygen-glucose d...In this study,we investigated the protective effect of hyperbaric oxygen(HBO)on PC12 and H9C2 cell damage caused by oxygen-glucose deprivation/reperfusion and its possible mechanism.PC12 and H9C2 cell oxygen-glucose deprivation/reperfusion model were established.Cells were divided into a control group,model group,hyperbaric air(HBA)group and HBO group.The cell viability was detected by the CCK8 assay.Hoechst 33342 and PI staining assays and mitochondrial membrane potential(MMP)assays were used to detect cell apoptosis.The ultrastructure of cells,including autophagosomes,lysosomes,and apoptosis,were examined using a transmission electron microscope.The expression of autophagy-related proteins was detected by cellular immunofluorescence and immunocytochemistry.Our results showed that HBO can significantly improve the vitality of damaged PC12 and H9C2 cells caused by oxygen–glucose deprivation/reperfusion.HBO can significantly inhibit apoptosis of PC12 and H9C2 cells caused by oxygenglucose deprivation/reperfusion.Importantly,we found that the protective mechanism of PC12 and H9C2 cell damage caused by oxygen-glucose deprivation/reperfusion may be related to the inhibition of the autophagy pathway.In this study,the results of cellular immunofluorescence and immunocytochemistry experiments showed that the 4E-BP1,p-AKt and mTOR levels of PC12 and H9C2 cells in the model group decreased,while the levels of LC3B,Atg5 and p53 increased.However,after HBO treatment,these autophagy-related indexes were reversed.In addition,observation of the cell ultrastructure with transmission electron microscopy found that in the model group,a significant increase in the number of autophagic vesicles was observed.In the HBO group,a decrease in autophagic vesicles was observed.The study demonstrated that hyperbaric oxygen protects against PC12 and H9C2 cell damage caused by oxygen-glucose deprivation/reperfusion via the inhibition of cell apoptosis and autophagy.展开更多
Background: Radiotherapy is one of the most popular treatments for pelvic malignancy, which causes patients suffering from the adverse effect such as cystitis, hematuria, proctitis, hematochezia and distal ureteric st...Background: Radiotherapy is one of the most popular treatments for pelvic malignancy, which causes patients suffering from the adverse effect such as cystitis, hematuria, proctitis, hematochezia and distal ureteric stricture. The hematuria condition from radiation-induced hemorrhagic cystitis is the most common adverse event suffering the patients, losing properties, wasting time, and deteriorating quality of life. One of the most effective treatments for radiation-induced hemorrhagic cystitis is the hyperbaric oxygen therapy with no necessity for patients to be hospitalized, no need of anesthesia use, and also non-invasion. However, it requires that patients spend 90 - 120 minutes a day for 40 days administered out-patient treatment session. The transportation cost as well as the accommodation one will greatly burden the self-pay health care patients. In addition, there is still no definite standardized number of HBOT treatment session assignment at present. Objectives: To compare the treatment outcome (bladder mucosal characteristics, red blood cells in urine) between 30 and 40 sessions of HBOT for treatment of radiation-induced hemorrhagic cystitis. Methods: Prospective cohort observational study of patients (n = 15) who were diagnosed with radiation-induced hemorrhagic cystitis that were treated with hyperbaric oxygen therapy in Somdechprapinklao Hospital between October 2020 and September 2021. We compared the parameter about hemoglobin concentration, red blood cell number in urine during the course of HBOT treatment every 10 sessions and cystoscopic finding severity as EORTC/RTOG classification for radiation-induced hemorrhagic cystitis in Table 1 before treatment, and after 30 and 40 sessions of treatment. Results: From 15 of treated patients, 93.3% of patients had evidence of posterior wall lesion. The mean duration from radiotherapy (radiation and brachytherapy) to the first episode gross hematuria is 112 months. This study shows no statistically different cystoscopic findings as EORTC/RTOG classification for radiation-induced hemorrhagic cystitis after 30 and 40 sessions of HBOT (p = 0.653) and statistically significant improvement after the treatment of more than 30 sessions (p = 0.008). No relationship was found with the hemoglobin concentration and red blood cell number in urine during the course of HBOT. Conclusions: Radiation-induced hemorrhagic cystitis can be treated with HBOT. There is no different treatment outcome between 30 and 40 sessions of HBOT.展开更多
Objective:We launched the fourth national hyperbaric oxygen(HBO)medicine week publicity campaign in China to increase patients’and medical professionals’understanding of HBO medicine and expand the influence of HBO....Objective:We launched the fourth national hyperbaric oxygen(HBO)medicine week publicity campaign in China to increase patients’and medical professionals’understanding of HBO medicine and expand the influence of HBO.Methods:The theme of 2019 was“Oxygen protects life,healthy China”.The main components of the campaign were free medical consultation,free HBO experience,and telemedicine lectures.At least one component was required for each participating hospital.Results:(1)In total,195 hospitals in 26 provinces,autonomous regions,and municipalities directly under the central government participated in the campaign.Shandong province of China had the highest number of hospitals in a single area(48 hospitals);(2)The free medical consultation was organized by the HBO department.In some hospitals,other medical professionals were also invited.Among all hospitals,up to 13 different HBO-related departments participated;(3)The free HBO experiences were held in some hospitals,and the number of experiences ranged from one to three per person;(4)Three telemedicine lectures involving a total of 8 live interactions were held in 55 different hospitals.Lecture videos were provided to play locally in hospitals without the setting necessary for live interactions.Conclusion:Our campaigns created a brand effect beginning in 2016.In the herein-described 2019 study,we considered the previous three campaigns and explored different methods of publicizing HBO medicine in China,including telemedicine.展开更多
<strong>Aim:</strong> Diabetes Mellitus is a global public health challenge with major and potentially devastating complications, and concomitant complications include retinopathy and neuropathy due to hyp...<strong>Aim:</strong> Diabetes Mellitus is a global public health challenge with major and potentially devastating complications, and concomitant complications include retinopathy and neuropathy due to hypoxia and microvascular dysfunction. In this study, we investigated the effect of hyperbaric oxygen therapy as a method to transiently improve tissue oxygenation on diabetic retinopathy and neuropathy in a streptozotocin induced type-1 diabetic rat model (Wistar). <strong>Methods:</strong> Streptozotocin induced type-1 diabetic rats received 10 sessions of 2-h hyperbaric oxygen exposures (pO<sub>2</sub> = 309 kPa) over 2 weeks. Animals were exposed to light stimuli to produce light evoked potentials to estimate the effect of oxygen treatment on diabetic retinopathy. Sciatic nerves were exposed and stimulated to produce muscle evoked potential, which were recorded in the muscles of the foot and subsequently used to evaluate the effect of oxygen treatment on diabetic neuropathy. <strong>Results:</strong> We found significantly shorter light evoked potential latency and increased amplitude in hyperbaric oxygen treated animals. No change was found in nerve conduction. <strong>Conclusions:</strong> This study showed that hyperbaric oxygen therapy is a potentially effective treatment for diabetic retinopathy, improving both latency and amplitude of light evoked potentials.展开更多
Purpose: The study aimed to investigate, using a photoplethysmographic (PPG) technique, how pulsatile blood flow within the patellar bone and skin over the patella reacts to normobaric (NBO) and hyperbaric oxygen brea...Purpose: The study aimed to investigate, using a photoplethysmographic (PPG) technique, how pulsatile blood flow within the patellar bone and skin over the patella reacts to normobaric (NBO) and hyperbaric oxygen breathing (HBO). Methods: Eleven healthy volunteers, breathed air or oxygen. Subjects were blinded to breathing gas. A range of partial pressures of oxygen were administered in 10 minute intervals: 21 kPa, 101 kPa (NBO), 21 kPa, (compression to 280 kPa), 59 kPa, 280 kPa (HBO), 59 kPa, (decompression), and 21 kPa. Changes were measured continuously for each individual. Results: Hyperoxia decreased pulsatile patellar blood flow ~32 resp. 38% and skin blood flow ~36 resp. 42% during the first 2 - 3 minutes of NBO resp. HBO. This decrease was normalized within 5 minutes after exposure. The results were similar when switching from air to NBO (101 kPa) and from air at pressure (59 kPa) to HBO (280 kPa). Conclusions: The study shows that pulsatile patellar skin and bone blood flow, decreases significantly as a reaction to oxygen breathing in healthy subjects. The results suggest that a non-invasive PPG technique could be used to monitor blood flow changes in bone during oxygen treatment.展开更多
Objective:To observe the efficacy and significance of hyperbaric oxygen at different pressures in the treatment of diffuse axonal injury(DAI).Methods:Sixty patients with DAI were randomly divided into 1.8 ATA group(30...Objective:To observe the efficacy and significance of hyperbaric oxygen at different pressures in the treatment of diffuse axonal injury(DAI).Methods:Sixty patients with DAI were randomly divided into 1.8 ATA group(30 cases)and 2.2 ATA group(30 cases).The routine treatment for each group was the same.The 1.8 ATA.group received hyperbaric oxygen therapy under 1.8 ATA on the basis of routine treatment,whereas the 2.2 ATA group received hyperbaric oxygen therapy under 2.2 ATA.on the basis of routine treatment.The therapy was given once a day over 3 consecutive courses,with each course having 10 sessions.The Glasgow Coma Scale(GCS)on day 10,day 20,and day 30 after treatment,as well as the Glasgow Outcome Scale(GOS)after 6 months were compared between the two groups.Results:The mean GCS on day 10,day 20,and day 30 after treatment,as well as the mean GOS after 6 months of treatment in the 2.2 ATA group were significantly higher than those in the 1.8 ATA group(p<0.05).Conclusion:For patients with dififtise axonal injury,hyperbaric oxygen therapy is more effective with 2.2 ATA.compared with 1.8 ATA.展开更多
Objective:To analyze the efficacy of hyperbaric oxygen at different pressures in the treatment of sudden deafness.Methods:Eighty-two patients with sudden deafness treated in the Affiliated Hospital of Hebei University...Objective:To analyze the efficacy of hyperbaric oxygen at different pressures in the treatment of sudden deafness.Methods:Eighty-two patients with sudden deafness treated in the Affiliated Hospital of Hebei University from September 2019 to September 2021 were selected as the research subjects.The patients were randomly divided into study group 1 and study group 2,and they were treated with hyperbaric oxygen on the basis of routine treatment,in which the pressure used was 1.8 ATA and 2.2 ATA,respectively.Oxygen was delivered via the pressure stabilizing mask for 60 minutes.The patients received two courses of treatment,each lasting 10 days.The changes in hearing(pure tone audiometry)and the clinical efficacy of both the groups were compared before and after treatment.The data obtained were statistically analyzed using SPSS 19.0.Results:The total effective rate of study group 1 was 90.00%,while that of study group 2 was 76.19%.The differences between the two groups were statistically significant(p<0.05).Conclusion:For patients with sudden deafness treated with hyperbaric oxygen,the clinical efficacy of 1.8 ATA is more significant than that of 2.2 ATA.展开更多
Objective:To investigate the efficacy and mechanism of ultra-early hyperbaric oxygen intervention in the treatment of diffuse axonal injury(DAI).Methods:Eighty-six patients with diffuse axonal injury were selected and...Objective:To investigate the efficacy and mechanism of ultra-early hyperbaric oxygen intervention in the treatment of diffuse axonal injury(DAI).Methods:Eighty-six patients with diffuse axonal injury were selected and then divided into an ultra-early hyperbaric oxygen treatment group and a conventional treatment group with 43 patients in each group.The Glasgow Coma Scale(GCS)on the 10h day(10d),20h day(20d),and 30h day(30d)after treatment and the Glasgow Outcome Score(GOS)6 months later were observed and compared between both the groups.Results:The average score of the GCS at 10d,20d,and 30d as welll as the GOS 6 months later in the ultra-early hyperbaric oxygen treatment group were higher than those in the conventional treatment group(P<0.05).Conclusion:Hyperbaric oxygen therapy is one of the unique and effective methods in clinical treatment especially for the treatment of DAI patients and it is worthy of promotion.展开更多
Objective:To observe the clinical effect of hyperbaric oxygen in the treatment of sudden deafness.Methods:Ninety-six patients with sudden deafness diagnosed by the otolaryngology department were divided into 2 groups ...Objective:To observe the clinical effect of hyperbaric oxygen in the treatment of sudden deafness.Methods:Ninety-six patients with sudden deafness diagnosed by the otolaryngology department were divided into 2 groups which comprised of 48 patients in the conventional treatment group and the other 48 patients in the hyperbaric oxygen treatment group.Both groups were treated with methylcobalamin,vitamin B1,and ginkgo biloba extract.The patients in the hyperbaric oxygen treatment group were given hyperbaric oxygen therapy of 2.0 ATA once a day.Each course of treatment lasted 10 days and after two courses of treatment,the clinical efficacies of the two groups were compared.Results:After two courses of treatment,the effect of treatment in the hyperbaric oxygen treatment group was significantly better than that of the conventional treatment group.Conclusion:Hyperbaric oxygen therapy can effectively improve the hearing level of patients with sudden deafness and the overall effective rate of treatment.展开更多
Objective To evaluate the effects of hyperbaric oxygen therapy (HBOT) on Glasgow Coma Scale (GCC) after traumatic brain injury (TBI) in patients. Methods One hundred and thirty-eight patients with traumatic brain inju...Objective To evaluate the effects of hyperbaric oxygen therapy (HBOT) on Glasgow Coma Scale (GCC) after traumatic brain injury (TBI) in patients. Methods One hundred and thirty-eight patients with traumatic brain injury were treated by routine therapy combined with HBOT and 29 patients by routine therapy.展开更多
BACKGROUND Whether hyperbaric oxygen therapy(HBOT)can cause paradoxical herniation is still unclear.CASE SUMMARY A 65-year-old patient who was comatose due to brain trauma underwent decompressive craniotomy and gradua...BACKGROUND Whether hyperbaric oxygen therapy(HBOT)can cause paradoxical herniation is still unclear.CASE SUMMARY A 65-year-old patient who was comatose due to brain trauma underwent decompressive craniotomy and gradually regained consciousness after surgery.HBOT was administered 22 d after surgery due to speech impairment.Paradoxical herniation appeared on the second day after treatment,and the patient’s condition worsened after receiving mannitol treatment at the rehabilitation hospital.After timely skull repair,the paradoxical herniation was resolved,and the patient regained consciousness and had a good recovery as observed at the follow-up visit.CONCLUSION Paradoxical herniation is rare and may be caused by HBOT.However,the underlying mechanism is unknown,and the understanding of this phenomenon is insufficient.The use of mannitol may worsen this condition.Timely skull repair can treat paradoxical herniation and prevent serious complications.展开更多
文摘Long COVID symptoms typically occur within 3 months of an initial COVID-19 infection,last for more than 2 months,and cannot be explained by other diagnoses.The most common symptoms include fatigue,dyspnea,coughing,and cognitive impairment.The mechanisms of long COVID are not fully understood,but several hypotheses have been put forth.These include coagulation and fibrosis pathway activation,inflammatory and autoimmune manifestations,persistent virus presence,and Epstein-Barr virus reactivation.Hyperbaric oxygen therapy(HBOT)is a therapeutic method in which a person inhales 100%oxygen under pressure greater than that of the atmosphere.HBOT has some therapeutic effects,including improvement of microcirculation,inhibition of cytokine release leading to a reduction in inflammatory responses,inhibition of autoimmune responses,and promotion of neurological repair.Several clinical trials have been carried out using HBOT to treat long COVID.The results suggest that HBOT helps to improve symptom severity,reduce symptom duration,and enhance patients’quality of life.It is believed that HBOT is an effective option for patients with long COVID,which is worth actively promoting.
文摘Radiotherapy(RT)is the backbone of multimodality treatment of more than half of cancer cases.Despite new modern RT techniques,late complications may occur such as radiation proctitis(RP).The natural history of RP is unpredictable.Minor symptoms may resolve spontaneously or require conservative treatment.On the other hand,for similar and uncomplicated clinical contexts,symptoms may persist and can even be refractory to the progressive increase in treatment measures.Over the last decades,an enormous therapeutic armamentarium has been considered in RP,including hyperbaric oxygen therapy(HBOT).Currently,the evidence regarding the impact of HBOT on RP and its benefits is conflicting.Additional prospective and randomised studies are necessary to validate HBOT’s effectiveness in the‘real world’clinical practice.This article reviewed the relevant literature on pathophysiology,clinical presentation,different classifications and discuss RP management including a proposal for a therapeutic algorithm with a focus on HBOT.
基金supported by a grant from Suzhou Key Medicine Project Fund of China,No.Szxk201504
文摘Although hyperbaric oxygen(HBO) therapy can promote the recovery of neural function in patients who have suffered traumatic brain injury(TBI),the underlying mechanism is unclear.We hypothesized that hyperbaric oxygen treatment plays a neuroprotective role in TBI by increasing regional transcranial oxygen saturation(rSO_2) and oxygen partial pressure(PaO_2).To test this idea,we compared two groups: a control group with 20 healthy people and a treatment group with 40 TBI patients.The 40 patients were given 100% oxygen of HBO for 90 minutes.Changes in rSO_2 were measured.The controls were also examined for rSO_2 and PaO_2,but received no treatment.rSO_2 levels in the patients did not differ significantly after treatment,but levels before and after treatment were significantly lower than those in the control group.PaO_2 levels were significantly decreased after the 30-minute HBO treatment.Our findings suggest that there is a disorder of oxygen metabolism in patients with sub-acute TBI.HBO does not immediately affect cerebral oxygen metabolism,and the underlying mechanism still needs to be studied in depth.
基金supported by Beijing Science and Technology Special Fund[grants number 2161100000116067]。
文摘Objective Hyperbaric oxygen treatment(HBOT)has demonstrated efficacy in improving hearing levels of patients with idiopathic sudden sensorineural hearing loss(ISSHL);however,the underlying mechanisms are not well understood.HBOT alleviates the inflammatory response,which is mediated by Toll-like receptor(TLR)4 and nuclear factor(NF)-κB.In this study we investigated whether HBOT attenuates inflammation in ISHHL patients via alteration of TLR4 and NF-κB expression.Methods ISHHL patients(n=120)and healthy control subjects(n=20)were enrolled in this study.Patients were randomly divided into medicine group treated with medicine only(n=60)and HBO group receiving both HBOT and medicine(n=60).Audiometric testing was performed pre-and posttreatment.TLR4,NF-кB,and TNF-αexpression in peripheral blood of ISSHL patients and healthy control subjects was assessed by ELISA before and after treatment.Results TLR4,NF-κB,and TNF-αlevels were upregulated in ISSHL patients relative to healthy control subjects;the levels were decreased following treatment and were lower in the HBO group than that in the medicine group post-treatment(P<0.05 and P<0.01).Conclusion HBOT alleviates hearing loss in ISSHL patients by suppressing the inflammatory response induced by TLR4 and NF-κB signaling.
文摘BACKGROUND:Hyperbaric oxygen(HBO)is an effective adjuvant therapy for ischemiareperfusion(I/R)injury of the brain,small intestine and testis in addition to crushing injury.Studies have shown that HBO increases the activity of villi of the ileum 30 minutes after I/R injury.The present study aimed to observe the effect of HBO on apoptosis of epithelial cells in the small intestine during different periods of I/R and to elucidate the potential mechanisms.METHODS:Rats were subjected to 60-minute ischemia by clamping the superior mesenteric artery and 60-minute reperfusion by removal of clamping.The rats were randomly divided into four groups:I/R group,HBO precondition or HBO treatment before ischemia(HBO-P),HBO treatment during ischemia period(HBO-I),and HBO treatment during reperfusion(HBO-R).After 60-minute reperfusion,samples of the small intestine were prepared to measure the level of ATP by using the colorimetric method and immunochemical expression of caspase-3.The levels of TNF-αin intestinal tissue were measured using the enzyme-linked immunosorbent assay method(Elisa).RESULTS:TNF-αlevels were significantly lower in the HBO-I group than in the HBO-P(P<0.05),HBO-R and I/R groups;there was no significant difference between the HBO-R and I/R groups(P>0.05).The expression of caspas-3 was significantly lower in the HBO-I group than in the HBO-P group(P<0.05);it was also significantly lower in the HBO-P group than in the I/R and HBO-R groups(P<0.05).ATP level was significantly lower in the HBO-I group than in the HBO-P group(P<0.05),and also it was significantly lower in the HBO-P group than in the I/R and HBO-R groups(P<0.05).CONCLUSIONS:There is an association between HBO,small intestinal I/R injury,and mucosa apoptosis.HBO maintains ATP and aerobic metabolism,inhibites TNF-αproduction,and thus prevents intestinal mucosa from apoptosis.Best results can be obtained when HBO is administered to patients in the period of ischemia,and no side effects are produced when HBO is given during the Period of Reperfusion.
文摘Non-healing wounds impart serious medical problems to people with diabetes.Amongst 15%of diabetic patients,the incidence of foot ulcer is the most prevailing,which confers a significant risk of limb amputation,mainly due to hypoxia and impairment in cell signaling.Alteration in the expression of chemokines and the related factors in diabetic conditions delays the recruitment of different cell types,including fibroblasts,keratinocytes,and immune cells such as macrophages to the site of injury,further impairing neovasculogenesis,reepithelialization,and extracellular matrix formation.Thus,proper activation of effector cells through an accurate signal pathway is necessary for better therapeutic application.Hyperbaric oxygen therapy(HBOT)is the current treatment prescribed by medical practitioners,shown to have increased the wound healing rate by reducing the need for significant amputation among the diabetic population.However,the risk of morbidity associated with HBOT needs complete attention through rigorous research to avoid adverse outcomes.Altering the level of pro-angiogenic chemokines may regulate the inflammatory response,further promote vascularization,and enhance the complete healing of wounds in diabetic patients.Thus,a combination of better therapeutic approaches could pave the way for developing a successful treatment for diabetic foot and wound healing.
基金supported by the Natural Science Foundation of Beijing, No.7202055(to XHL)
文摘Accumulating studies have demonstrated that hyperbaric oxygen(HBO)treatment alleviates spinal cord injury(SCI).However,the underlying mechanism by which HBO alleviates SCI remains to be elucidated.In this study,we performed genome-wide transcriptional profiling of the spinal cord between SCI mice and mice that received HBO treatment by high-throughput RNA sequencing at 1 week after SCI.We also compared genome-wide transcriptional profiles from SCI mice and sham-operated mice.We found 76 differentially co-expressed genes in sham-operated mice,SCI mice,and HBO-treated SCI mice.Using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis,we identified the biological characteristics of these differentially expressed genes from the perspectives of cell component,biological process,and molecular function.We also found enriched functional pathways including ferroptosis,calcium signaling pathway,serotonergic synapse,hypoxia-inducible factor-1 signaling pathway,cholinergic synapse,and neuroactive ligand-receptor interaction.We performed quantitative reverse transcription-polymerase chain reaction and validated that HBO treatment decreased the expression of Hspb1(heat shock protein beta 1),Hmox1(heme oxygenase 1),Ftl1(ferritin light polypeptide 1),Tnc(tenascin C)and Igfbp3(insulin-like growth factor binding protein 3)and increased the expression of Slc5a7(solute carrier family 5 choline transporter member 7)after SCI.These results revealed the genome-wide transcriptional profile of the injured spinal cord after HBO treatment.Our findings contribute to a better understanding of the mechanism by which HBO treats SCI and may provide new targets for SCI intervention.
文摘Background: Acute acoustic trauma (AAT) is an acute hearing impairment caused by intense noiseimpact. The current management strategy for AAT with substantial hearing loss in the Dutch militaryis the combination therapy with corticosteroids and hyperbaric oxygen therapy (HBOT). In a previousstudy, early initiation of the combination therapy was associated with better outcomes. Therefore, weperformed a new analysis to assess the difference in hearing outcome between patients in whomcombination therapy was started within two days, versus after more than two days.Methods: A retrospective analysis was performed on military patients diagnosed with AAT with substantial hearing loss who presented between February 2018 and March 2020. Absolute and relativehearing improvement between first and last audiograms were calculated for all affected frequencies(defined as loss of 20 dB on initial audiogram). We also determined the amount of patients whorecovered to the level of Dutch military requirement, and performed speech discrimination tests.Results: In this analysis, 30 male patients (49 ears) with AAT were included. The median age was 24.5years (IQR 23e29). The median time to initiation of therapy with corticosteroids and HBOT were one andtwo days, respectively. HBOT was started within two days in 31 ears, and after more than two days in 18ears. The mean absolute and relative hearing gains were 18.8 dB (SD 14.6) and 46.8% (SD 31.3) on allaffected frequencies. The 100% discrimination/speech perception level improved from 64.0 dB to 51.7 dB(gain 12.3 dB ± 14.1). There was significantly more improvement in absolute and relative hearingimprovement when HBOT was started in 2 days, compared to >2 days.Conclusion: Our analysis shows results in favor of early initiation ( 2 days) of the combination treatmentof HBOT and corticosteroids in patients with AAT.
基金supported by the National Natural Science Foundation of China(81960246,81701089,81560044 and 30860113)the Guangxi Natural Science Foundation(2020GXNSFAA238003 and 2017GXNSFBA198010)+1 种基金the Guangxi Medical and Health Appropriate Technology Research and Development Project(S2020076,S201422-01 and S2019087)the Shanxi Health Research Project(2019165).
文摘In this study,we investigated the protective effect of hyperbaric oxygen(HBO)on PC12 and H9C2 cell damage caused by oxygen-glucose deprivation/reperfusion and its possible mechanism.PC12 and H9C2 cell oxygen-glucose deprivation/reperfusion model were established.Cells were divided into a control group,model group,hyperbaric air(HBA)group and HBO group.The cell viability was detected by the CCK8 assay.Hoechst 33342 and PI staining assays and mitochondrial membrane potential(MMP)assays were used to detect cell apoptosis.The ultrastructure of cells,including autophagosomes,lysosomes,and apoptosis,were examined using a transmission electron microscope.The expression of autophagy-related proteins was detected by cellular immunofluorescence and immunocytochemistry.Our results showed that HBO can significantly improve the vitality of damaged PC12 and H9C2 cells caused by oxygen–glucose deprivation/reperfusion.HBO can significantly inhibit apoptosis of PC12 and H9C2 cells caused by oxygenglucose deprivation/reperfusion.Importantly,we found that the protective mechanism of PC12 and H9C2 cell damage caused by oxygen-glucose deprivation/reperfusion may be related to the inhibition of the autophagy pathway.In this study,the results of cellular immunofluorescence and immunocytochemistry experiments showed that the 4E-BP1,p-AKt and mTOR levels of PC12 and H9C2 cells in the model group decreased,while the levels of LC3B,Atg5 and p53 increased.However,after HBO treatment,these autophagy-related indexes were reversed.In addition,observation of the cell ultrastructure with transmission electron microscopy found that in the model group,a significant increase in the number of autophagic vesicles was observed.In the HBO group,a decrease in autophagic vesicles was observed.The study demonstrated that hyperbaric oxygen protects against PC12 and H9C2 cell damage caused by oxygen-glucose deprivation/reperfusion via the inhibition of cell apoptosis and autophagy.
文摘Background: Radiotherapy is one of the most popular treatments for pelvic malignancy, which causes patients suffering from the adverse effect such as cystitis, hematuria, proctitis, hematochezia and distal ureteric stricture. The hematuria condition from radiation-induced hemorrhagic cystitis is the most common adverse event suffering the patients, losing properties, wasting time, and deteriorating quality of life. One of the most effective treatments for radiation-induced hemorrhagic cystitis is the hyperbaric oxygen therapy with no necessity for patients to be hospitalized, no need of anesthesia use, and also non-invasion. However, it requires that patients spend 90 - 120 minutes a day for 40 days administered out-patient treatment session. The transportation cost as well as the accommodation one will greatly burden the self-pay health care patients. In addition, there is still no definite standardized number of HBOT treatment session assignment at present. Objectives: To compare the treatment outcome (bladder mucosal characteristics, red blood cells in urine) between 30 and 40 sessions of HBOT for treatment of radiation-induced hemorrhagic cystitis. Methods: Prospective cohort observational study of patients (n = 15) who were diagnosed with radiation-induced hemorrhagic cystitis that were treated with hyperbaric oxygen therapy in Somdechprapinklao Hospital between October 2020 and September 2021. We compared the parameter about hemoglobin concentration, red blood cell number in urine during the course of HBOT treatment every 10 sessions and cystoscopic finding severity as EORTC/RTOG classification for radiation-induced hemorrhagic cystitis in Table 1 before treatment, and after 30 and 40 sessions of treatment. Results: From 15 of treated patients, 93.3% of patients had evidence of posterior wall lesion. The mean duration from radiotherapy (radiation and brachytherapy) to the first episode gross hematuria is 112 months. This study shows no statistically different cystoscopic findings as EORTC/RTOG classification for radiation-induced hemorrhagic cystitis after 30 and 40 sessions of HBOT (p = 0.653) and statistically significant improvement after the treatment of more than 30 sessions (p = 0.008). No relationship was found with the hemoglobin concentration and red blood cell number in urine during the course of HBOT. Conclusions: Radiation-induced hemorrhagic cystitis can be treated with HBOT. There is no different treatment outcome between 30 and 40 sessions of HBOT.
文摘Objective:We launched the fourth national hyperbaric oxygen(HBO)medicine week publicity campaign in China to increase patients’and medical professionals’understanding of HBO medicine and expand the influence of HBO.Methods:The theme of 2019 was“Oxygen protects life,healthy China”.The main components of the campaign were free medical consultation,free HBO experience,and telemedicine lectures.At least one component was required for each participating hospital.Results:(1)In total,195 hospitals in 26 provinces,autonomous regions,and municipalities directly under the central government participated in the campaign.Shandong province of China had the highest number of hospitals in a single area(48 hospitals);(2)The free medical consultation was organized by the HBO department.In some hospitals,other medical professionals were also invited.Among all hospitals,up to 13 different HBO-related departments participated;(3)The free HBO experiences were held in some hospitals,and the number of experiences ranged from one to three per person;(4)Three telemedicine lectures involving a total of 8 live interactions were held in 55 different hospitals.Lecture videos were provided to play locally in hospitals without the setting necessary for live interactions.Conclusion:Our campaigns created a brand effect beginning in 2016.In the herein-described 2019 study,we considered the previous three campaigns and explored different methods of publicizing HBO medicine in China,including telemedicine.
文摘<strong>Aim:</strong> Diabetes Mellitus is a global public health challenge with major and potentially devastating complications, and concomitant complications include retinopathy and neuropathy due to hypoxia and microvascular dysfunction. In this study, we investigated the effect of hyperbaric oxygen therapy as a method to transiently improve tissue oxygenation on diabetic retinopathy and neuropathy in a streptozotocin induced type-1 diabetic rat model (Wistar). <strong>Methods:</strong> Streptozotocin induced type-1 diabetic rats received 10 sessions of 2-h hyperbaric oxygen exposures (pO<sub>2</sub> = 309 kPa) over 2 weeks. Animals were exposed to light stimuli to produce light evoked potentials to estimate the effect of oxygen treatment on diabetic retinopathy. Sciatic nerves were exposed and stimulated to produce muscle evoked potential, which were recorded in the muscles of the foot and subsequently used to evaluate the effect of oxygen treatment on diabetic neuropathy. <strong>Results:</strong> We found significantly shorter light evoked potential latency and increased amplitude in hyperbaric oxygen treated animals. No change was found in nerve conduction. <strong>Conclusions:</strong> This study showed that hyperbaric oxygen therapy is a potentially effective treatment for diabetic retinopathy, improving both latency and amplitude of light evoked potentials.
文摘Purpose: The study aimed to investigate, using a photoplethysmographic (PPG) technique, how pulsatile blood flow within the patellar bone and skin over the patella reacts to normobaric (NBO) and hyperbaric oxygen breathing (HBO). Methods: Eleven healthy volunteers, breathed air or oxygen. Subjects were blinded to breathing gas. A range of partial pressures of oxygen were administered in 10 minute intervals: 21 kPa, 101 kPa (NBO), 21 kPa, (compression to 280 kPa), 59 kPa, 280 kPa (HBO), 59 kPa, (decompression), and 21 kPa. Changes were measured continuously for each individual. Results: Hyperoxia decreased pulsatile patellar blood flow ~32 resp. 38% and skin blood flow ~36 resp. 42% during the first 2 - 3 minutes of NBO resp. HBO. This decrease was normalized within 5 minutes after exposure. The results were similar when switching from air to NBO (101 kPa) and from air at pressure (59 kPa) to HBO (280 kPa). Conclusions: The study shows that pulsatile patellar skin and bone blood flow, decreases significantly as a reaction to oxygen breathing in healthy subjects. The results suggest that a non-invasive PPG technique could be used to monitor blood flow changes in bone during oxygen treatment.
文摘Objective:To observe the efficacy and significance of hyperbaric oxygen at different pressures in the treatment of diffuse axonal injury(DAI).Methods:Sixty patients with DAI were randomly divided into 1.8 ATA group(30 cases)and 2.2 ATA group(30 cases).The routine treatment for each group was the same.The 1.8 ATA.group received hyperbaric oxygen therapy under 1.8 ATA on the basis of routine treatment,whereas the 2.2 ATA group received hyperbaric oxygen therapy under 2.2 ATA.on the basis of routine treatment.The therapy was given once a day over 3 consecutive courses,with each course having 10 sessions.The Glasgow Coma Scale(GCS)on day 10,day 20,and day 30 after treatment,as well as the Glasgow Outcome Scale(GOS)after 6 months were compared between the two groups.Results:The mean GCS on day 10,day 20,and day 30 after treatment,as well as the mean GOS after 6 months of treatment in the 2.2 ATA group were significantly higher than those in the 1.8 ATA group(p<0.05).Conclusion:For patients with dififtise axonal injury,hyperbaric oxygen therapy is more effective with 2.2 ATA.compared with 1.8 ATA.
基金The Youth Scientific Research Fund of the Affiliated Hospital of Hebei University“Observation on the Efficacy of Different Pressure Hyperbaric Oxygen in the Treatment of Sudden Deafness”(Grant Number:2021Q040).
文摘Objective:To analyze the efficacy of hyperbaric oxygen at different pressures in the treatment of sudden deafness.Methods:Eighty-two patients with sudden deafness treated in the Affiliated Hospital of Hebei University from September 2019 to September 2021 were selected as the research subjects.The patients were randomly divided into study group 1 and study group 2,and they were treated with hyperbaric oxygen on the basis of routine treatment,in which the pressure used was 1.8 ATA and 2.2 ATA,respectively.Oxygen was delivered via the pressure stabilizing mask for 60 minutes.The patients received two courses of treatment,each lasting 10 days.The changes in hearing(pure tone audiometry)and the clinical efficacy of both the groups were compared before and after treatment.The data obtained were statistically analyzed using SPSS 19.0.Results:The total effective rate of study group 1 was 90.00%,while that of study group 2 was 76.19%.The differences between the two groups were statistically significant(p<0.05).Conclusion:For patients with sudden deafness treated with hyperbaric oxygen,the clinical efficacy of 1.8 ATA is more significant than that of 2.2 ATA.
文摘Objective:To investigate the efficacy and mechanism of ultra-early hyperbaric oxygen intervention in the treatment of diffuse axonal injury(DAI).Methods:Eighty-six patients with diffuse axonal injury were selected and then divided into an ultra-early hyperbaric oxygen treatment group and a conventional treatment group with 43 patients in each group.The Glasgow Coma Scale(GCS)on the 10h day(10d),20h day(20d),and 30h day(30d)after treatment and the Glasgow Outcome Score(GOS)6 months later were observed and compared between both the groups.Results:The average score of the GCS at 10d,20d,and 30d as welll as the GOS 6 months later in the ultra-early hyperbaric oxygen treatment group were higher than those in the conventional treatment group(P<0.05).Conclusion:Hyperbaric oxygen therapy is one of the unique and effective methods in clinical treatment especially for the treatment of DAI patients and it is worthy of promotion.
文摘Objective:To observe the clinical effect of hyperbaric oxygen in the treatment of sudden deafness.Methods:Ninety-six patients with sudden deafness diagnosed by the otolaryngology department were divided into 2 groups which comprised of 48 patients in the conventional treatment group and the other 48 patients in the hyperbaric oxygen treatment group.Both groups were treated with methylcobalamin,vitamin B1,and ginkgo biloba extract.The patients in the hyperbaric oxygen treatment group were given hyperbaric oxygen therapy of 2.0 ATA once a day.Each course of treatment lasted 10 days and after two courses of treatment,the clinical efficacies of the two groups were compared.Results:After two courses of treatment,the effect of treatment in the hyperbaric oxygen treatment group was significantly better than that of the conventional treatment group.Conclusion:Hyperbaric oxygen therapy can effectively improve the hearing level of patients with sudden deafness and the overall effective rate of treatment.
文摘Objective To evaluate the effects of hyperbaric oxygen therapy (HBOT) on Glasgow Coma Scale (GCC) after traumatic brain injury (TBI) in patients. Methods One hundred and thirty-eight patients with traumatic brain injury were treated by routine therapy combined with HBOT and 29 patients by routine therapy.
文摘BACKGROUND Whether hyperbaric oxygen therapy(HBOT)can cause paradoxical herniation is still unclear.CASE SUMMARY A 65-year-old patient who was comatose due to brain trauma underwent decompressive craniotomy and gradually regained consciousness after surgery.HBOT was administered 22 d after surgery due to speech impairment.Paradoxical herniation appeared on the second day after treatment,and the patient’s condition worsened after receiving mannitol treatment at the rehabilitation hospital.After timely skull repair,the paradoxical herniation was resolved,and the patient regained consciousness and had a good recovery as observed at the follow-up visit.CONCLUSION Paradoxical herniation is rare and may be caused by HBOT.However,the underlying mechanism is unknown,and the understanding of this phenomenon is insufficient.The use of mannitol may worsen this condition.Timely skull repair can treat paradoxical herniation and prevent serious complications.
