Hyperbaric oxygen therapy of cerebral ischemia.
BACKGROUND
Hyperbaric oxygen (HBO) therapy of cerebral ischemia has been evaluated in a number of human and animal studies; however, there is presently no consensus on its efficacy.


METHODS
We present a review of animal and human studies on HBO therapy of cerebral ischemia as well as present potential mechanisms of action of HBO.


RESULTS
Animal studies of HBO have shown promise by reducing infarct size and improving neurologic outcome. HBO has also been shown to inhibit inflammation and apoptosis after cerebral ischemia. Early reports in humans also suggested benefit in stroke patients treated with HBO. Recent randomized, controlled human studies, however, have not shown benefit, although all were limited by small sample size. Important differences between animal and human studies suggest HBO might be more effective in stroke within the first few hours and at a pressure of 2-3 ATA.


CONCLUSIONS
The clinical usefulness of HBO in the treatment of cerebral ischemia is not yet certain. Attention to emerging pathophysiologic data should be taken into consideration in design of any future clinical trials of HBO in acute ischemic stroke.
Helms
Ann K
AK
Medical College of Wisconsin, Milwaukee, Wisc. 53226, USA.
Whelan
Harry T
HT
Torbey
Michel T
MT
D000818:Animals; D002545:Brain Ischemia / Q000628:therapy*; D002986:Clinical Trials as Topic; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000009:adverse effects / Q000639:trends; D020521:Stroke / Q000628:therapy