Hyperbaric Oxygen Therapy in Acute Stroke: is It Time for Justitia to Open Her Eyes?

Overview

Journal Neurol Sci

Specialty Neurology

Date 2020 Jan 12

PMID 31925614

Citations 7

Authors

Milija D Mijajlovic

Vuk Aleksic

Nenad Milosevic

Natan M Bornstein

Affiliations

Soon will be listed here.

Abstract

Hypoxia is a critical component of neuronal death in patients with stroke. Therefore increasing oxygenation of brain tissue seems to be a logical therapy against cerebral ischemia. Oxygen therapy exists in two modalities: normobaric hyperoxia therapy and hyperbaric oxygen therapy (HBO). HBO is a therapeutic procedure in which pure (100%) oxygen is administered at greater than atmospheric pressure in HBO therapy chambers. In this review article, we aimed to summarize the current knowledge regarding the therapeutic use of HBO in acute stroke patients. Literature review and electronic search were performed using PubMed, Medscape, and UpToDate with the keywords stroke, acute stroke, hyperbaric oxygen therapy, and hyperoxia. According to the reviewed literature, the use of HBO as routine stroke therapy cannot be justified in acute stage of stroke. More randomized, controlled studies are needed regarding safety and especially effectives of HBO in stroke patients. Also, standardized definitionof HBO should be proposed and used in all future studies.

Citing Articles

Integrated multi-biomarker panel of CXCL13, HS-CRP, and WBC counts predicts outcomes in stroke neurosyphilis patients treated with HBO and TUS-NMES.

He W, Chen S, Chen R, Zhang J, Zhang X, Wu M Front Neurol. 2025; 16:1530447.

PMID: 40070668 PMC: 11894733. DOI: 10.3389/fneur.2025.1530447.

Research progress on high-concentration oxygen therapy after cerebral hemorrhage.

Zeng H, Zeng D, Yin X, Zhang W, Wu M, Chen Z Front Neurol. 2024; 15:1410525.

PMID: 39139771 PMC: 11320605. DOI: 10.3389/fneur.2024.1410525.

Dey A, Khandelwal A Med J Armed Forces India. 2024; 80(1):10-15.

PMID: 38239601 PMC: 10793228. DOI: 10.1016/j.mjafi.2022.11.008.

Adverse effects of hyperbaric oxygen therapy: a systematic review and meta-analysis.

Zhang Y, Zhou Y, Jia Y, Wang T, Meng D Front Med (Lausanne). 2023; 10:1160774.

PMID: 37275378 PMC: 10232961. DOI: 10.3389/fmed.2023.1160774.

The application and perspective of hyperbaric oxygen therapy in acute ischemic stroke: From the bench to a starter?.

Yan Y, Zhang X, An X, Fan W, Liang J, Luo B Front Neurol. 2022; 13:928802.

PMID: 35989933 PMC: 9389005. DOI: 10.3389/fneur.2022.928802.

References

Jauch E, Saver J, Adams Jr H, Bruno A, Connors J, Demaerschalk B . Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013; 44(3):870-947. DOI: 10.1161/STR.0b013e318284056a. View

Liu W, Khatibi N, Sridharan A, Zhang J . Application of medical gases in the field of neurobiology. Med Gas Res. 2011; 1(1):13. PMC: 3231869. DOI: 10.1186/2045-9912-1-13. View

Hawkins B, Egleton R . Pathophysiology of the blood-brain barrier: animal models and methods. Curr Top Dev Biol. 2007; 80:277-309. DOI: 10.1016/S0070-2153(07)80007-X. View

Singhal A, Lo E, Dalkara T, Moskowitz M . Advances in stroke neuroprotection: hyperoxia and beyond. Neuroimaging Clin N Am. 2005; 15(3):697-720, xii-xiii. DOI: 10.1016/j.nic.2005.08.014. View

Shin H, Dunn A, Jones P, Boas D, Lo E, Moskowitz M . Normobaric hyperoxia improves cerebral blood flow and oxygenation, and inhibits peri-infarct depolarizations in experimental focal ischaemia. Brain. 2007; 130(Pt 6):1631-42. PMC: 3023418. DOI: 10.1093/brain/awm071. View

Henninger N, Bratane B, Bastan B, Bouley J, Fisher M . Normobaric hyperoxia and delayed tPA treatment in a rat embolic stroke model. J Cereb Blood Flow Metab. 2008; 29(1):119-29. DOI: 10.1038/jcbfm.2008.104. View

Kim H, Singhal A, Lo E . Normobaric hyperoxia extends the reperfusion window in focal cerebral ischemia. Ann Neurol. 2005; 57(4):571-5. DOI: 10.1002/ana.20430. View

Wu O, Lu J, Mandeville J, Murata Y, Egi Y, Dai G . Dynamic functional cerebral blood volume responses to normobaric hyperoxia in acute ischemic stroke. J Cereb Blood Flow Metab. 2012; 32(9):1800-9. PMC: 3434635. DOI: 10.1038/jcbfm.2012.87. View

Singhal A . Oxygen therapy in stroke: past, present, and future. Int J Stroke. 2008; 1(4):191-200. DOI: 10.1111/j.1747-4949.2006.00058.x. View

10.

Singhal A, Benner T, Roccatagliata L, Koroshetz W, Schaefer P, Lo E . A pilot study of normobaric oxygen therapy in acute ischemic stroke. Stroke. 2005; 36(4):797-802. DOI: 10.1161/01.STR.0000158914.66827.2e. View

11.

Singhal A, Ratai E, Benner T, Vangel M, Lee V, Koroshetz W . Magnetic resonance spectroscopy study of oxygen therapy in ischemic stroke. Stroke. 2007; 38(10):2851-4. DOI: 10.1161/STROKEAHA.107.487280. View

12.

Ronning O, Guldvog B . Should stroke victims routinely receive supplemental oxygen? A quasi-randomized controlled trial. Stroke. 1999; 30(10):2033-7. DOI: 10.1161/01.str.30.10.2033. View

13.

Chan Y, Katz M, Moskowitz A, Levine S, Richardson L, Tuhrim S . Supplemental oxygen delivery to suspected stroke patients in pre hospital and emergency department settings. Med Gas Res. 2015; 4:16. PMC: 4582959. DOI: 10.1186/2045-9912-4-16. View

14.

Al-Waili N, Butler G, Beale J, Abdullah M, Hamilton R, Lee B . Hyperbaric oxygen in the treatment of patients with cerebral stroke, brain trauma, and neurologic disease. Adv Ther. 2006; 22(6):659-78. DOI: 10.1007/BF02849960. View

15.

Plafki C, Peters P, Almeling M, Welslau W, Busch R . Complications and side effects of hyperbaric oxygen therapy. Aviat Space Environ Med. 2000; 71(2):119-24. View

16.

Mader J, Brown G, Guckian J, Wells C, REINARZ J . A mechanism for the amelioration by hyperbaric oxygen of experimental staphylococcal osteomyelitis in rabbits. J Infect Dis. 1980; 142(6):915-22. DOI: 10.1093/infdis/142.6.915. View

17.

Nylander G, Lewis D, Nordstrom H, Larsson J . Reduction of postischemic edema with hyperbaric oxygen. Plast Reconstr Surg. 1985; 76(4):596-603. DOI: 10.1097/00006534-198510000-00021. View

18.

Sukoff M, Ragatz R . Hyperbaric oxygenation for the treatment of acute cerebral edema. Neurosurgery. 1982; 10(1):29-38. View

19.

Singhal A, Dijkhuizen R, Rosen B, Lo E . Normobaric hyperoxia reduces MRI diffusion abnormalities and infarct size in experimental stroke. Neurology. 2002; 58(6):945-52. DOI: 10.1212/wnl.58.6.945. View

20.

Nakajima S, Meyer J, Amano T, Shaw T, Okabe T, Mortel K . Cerebral vasomotor responsiveness during 100% oxygen inhalation in cerebral ischemia. Arch Neurol. 1983; 40(5):271-6. DOI: 10.1001/archneur.1983.04050050039004. View