[Efficacy of hyperbaric oxygen therapy under different pressures on neonatal hypoxic-ischemic encephalopathy].
OBJECTIVE
Some research has shown that hyperbaric oxygen (HBO) can decrease the rate of mortality and disability caused by hypoxic-ischemic encephalopathy (HIE) in neonates. However, the HBO pressure used in the clinical reports and the efficacy of HBO are different. This study was designed to investigate the efficacy of HBO therapy under different pressures by observing the changes of peroxidation, antioxidant levels and brain vasomotor regulation factors as well as the score of neonatal behavioral neurological assessment (NBNA) in neonates with HIE after HBO therapy.


METHODS
Sixty neonates with HIE were randomly administered with 1.4, 1.5 or 1.6 atmosphere absolute (ATA) of HBO, once daily for seven days. Serum levels of malondialdehyde (MDA), superoxide dismutase (SOD), nitric oxide (NO) and nitric oxide synthase (NOS) were measured before and after HBO therapy. Meanwhile, NBNA and eye ground examination were performed.


RESULTS
Serum SOD level increased and serum levels of MDA, NO and NOS decreased significantly after HBO therapy in the three HBO therapy groups (P<0.01). Serum SOD level was significantly higher and serum levels of MDA, NO and NOS were significantly lower in the 1.6 ATA HBO group than those in the 1.4 ATA group after therapy (P<0.05). The 1.6 ATA HBO group also showed increased SOD and decreased MDA levels compared with the 1.5 ATA HBO group after therapy (P<0.05). NBNA scores in the three groups increased significantly after HBO therapy (P<0.05). None of the three HBO therapy group patients showed abnormal eye grounds after therapy.


CONCLUSIONS
HBO therapy with 1.4, 1.5 or 1.6 ATA is safe and effective for neonatal HIE. The antioxidant capacity increases with the increasing HBO pressure in neonates with HIE.
Zhou
Bei-Yan
BY
Department of Neonatology, Bao'an Maternal and Child Health Care Hospital of Shenzhen, Shenzhen, Guangdong 518103, China.
Lu
Guang-Jin
GJ
Huang
Yan-Qing
YQ
Ye
Zhen-Zhi
ZZ
Han
Yu-Kun
YK
D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D020925:Hypoxia-Ischemia, Brain / Q000188:drug therapy* / Q000503:physiopathology; D007231:Infant, Newborn; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D009569:Nitric Oxide / Q000097:blood; D019001:Nitric Oxide Synthase / Q000097:blood; D011312:Pressure; D013482:Superoxide Dismutase / Q000097:blood
D009569:Nitric Oxide; D008315:Malondialdehyde; D019001:Nitric Oxide Synthase; D013482:Superoxide Dismutase