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HBOT research

HBOT AND HEAD INJURY:
Hyperbaric oxygen therapy for traumatic brain injury: bench-to-bedside - Medical Gas Research 2016
Conclusion: Summary of the research results of HBOT in experimental and clinical TBI. Mild HBOT at 1.5ATA showed positive improvements in cranial blood flow, alleviation of post-concussion symptoms, and reduced mortality.

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“Hyperbaric Oxygen Therapy (HBOT) for Reduction of Secondary Brain Damage in Head Injury”
—Journal of Neurotrauma, 21:44-48. 2004 
Conclusion: Translational research of HBOT in a variety of Traumatic Brain Injuries (TBI) models has shown neuroprotective effects in the absence of increased oxygen toxicity. Recent clinical trials favour HBOT as promising safe therapeutic strategy for severe TBI patient. 

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“Role of Hyperbaric Oxygen Therapy in Severe Head Injury in Children” 
—Journal of Pediatric Neuroscience. 2012 Jan-April 7(1) 4-8 www.ncbi.nlm.nih.gov/pmc/articles/PMC3401652/
Conclusion: In children with traumatic brain injury, the addition of HBOT significantly improved outcome and quality of life and reduced risk of complications. Patients receiving HBOT were significantly better than the control group with decreased hospital stay, better Glasgow Coma Scale and drastic reduction in disability. 

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Hyperbaric Oxygen Therapy can improve Post Concussion Syndrome years after Mild Traumatic Brain Injury – Randomised Prospective Trial” www.ncbi.nlm.nih.gov/pubmed/24260334
—PLoS One November 2013 10.137/journal.pone 0079995
Conclusion: Convincing results based on a crossover study, demonstrating that HBOT can induce neuroplasticity and significant brain function improvement in mild TBI patients with prolonged Post-Concussion-Syndrome at late chronic stage, years after injury. The findings here bear the promises that HBOT can be effective in treating other brain impairments like PTSD or repairing radiation damage. It is reasonable to expect that HBOT can help slow down or even reverse metabolic disorders associated with neurodegenerative diseases.

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HBOT AND SPORTS INJURY: “Effects of Exposure to Hyperbaric Oxygen for the Treatment of Acute Soft Tissue Injury” —Clinical Journal of Sports Medicine 13 (3): 138-147. 2003.
Conclusion: In many cases of sports injury, surgery is often required. Treatments that can speed up the healing process are of greatest interest to the patient and the doctors. The advantages of HBOT are the known benefits in reducing swelling, decreased inflammation, improved collagen deposition in the skin and increasing the growth of new blood cells.

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“Hyperbaric Oxygen Therapy in Sports Injury” —Journal of Applied Physiology 106 (2): 711-728 2009.
Conclusion: By coupling the advances in sports medicine, physical treatments and Hyperbaric medicine, we will accelerate the time to recovery, complement surgical procedures and enhance the outcomes of physical therapy. As many professional sports teams have discovered, HBOT is a real tool to enhance their performance and reduce their down-time from injuries. 

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HBOT IN STROKE AND WOUND REPAIR:
“Hyperbaric Oxygen Induces Late Neuroplasticity in Post Stroke Patients – Randomised Prospective Trial”
—University of Muster, Germany. January 2013
Conclusion: The clinical results indicate that HBOT can lead to significant neurological improvements in post stroke patients, even at chronic late stage. The observed clinical improvements indicate that neuroplasticity can still be activated long after damage onset.

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“Oxygen in Wound Healing: nutrient, antibiotic, signalling molecule and therapeutic agent”
—Clinical Plastic Surgery July 2012 39(3) 293-310
Conclusion: There is strong scientific basis for oxygen treatment as prophylaxis against infection, to facilitate wound closure. This article reviews extensive data from human trials of hyperbaric oxygen and topical oxygen treatment. Oxygen supports biochemical metabolism and cellular function and has roles in combating infection and facilitating the wound healing cascade. 

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HBOT AND CANCER

“Hyperbaric Oxygen Therapy and Cancer – a review” —Target Oncology 2012 Dec; 7(4): 233-242
Conclusion: Two systematic reviews have concluded that the use of HBOT in patients with malignancies is considered safe. HBOT alone has a strong anti proliferative effect on different mammary cells in vivo and vitro. HBOT could be an effective therapy for breast cancer and this is supported by six studies over the last nine years. 

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HBOT AND ACUTE MYOCARDIAL INFARCTION (HEART ATTACK):

Hyperbaric Oxygen and Thrombolysis in Myocardial Infarction —The American Heart Journal, September 1998.
Conclusion: Hyperbaric Oxygen Treatment (HBOT) in combination with thrombolysis has been demonstrated to salvage myocardium in acute myocardial infarction (AMI). Treatment with HBOT appears to be a feasible and safe treatment for AMI and may result in an attenuated rise in creatine phosphokinase and a more rapid resolution of pain.

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HBOT AND INFLAMMATORY BOWEL DISEASE:
Hyperbaric Oxygen Treatment for Inflammatory Bowel Disease: a Systematic Review and Analysis —Journal of Medical Gastroenterology. March 2013.
Conclusion: In patients with Crohn’s Disease, 78% had clinical improvements, while all 39 patients with ulcerative colitis improved. HBOT lowered markers of inflammation and oxidative stress and ameliorated inflammatory bowel disease in both human and animal studies

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HBOT AND FIBROMYALGIA:

Hyperbaric Oxygen can diminish fibromyalgia syndrome – prospective clinical trial
—PLoS One.2015;10(5)e0127012. PubMed

Conclusion: The study provides evidence that HBOT can improve the symptoms and life quality of FMS patients. Moreover it shows that HBOT can induce neuroplasticity and significantly rectify abnormal brain activity in pain related areas of FMS patients.

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HBOT FOR DIABETES AND OBESITY:

Effects of Hyperbaric Oxygen on metabolic capacity of the skeletal muscle in Type II diabetic rats with obesity
—Scientific World Journal 2012.

Conclusion: Hyperbaric Oxygen enhances glucose and lipid metabolism in the skeletal muscle, indicating that HBOT can prevent elevation of glucose and adipocyte hypertrophy. 

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HBOT AND RECOVERY FROM SURGERY

Applications of Hyperbaric Oxygen Therapy and Surgery
—Division of Surgery, University of Nevada School of Medicine, Nevada, USA. 1992.
Conclusion: Many factors can delay wound healing such as oedema, infection, anaemia, poor perfusion and poor oxygen supply. The consequences of these factors is low oxygen tension, which adversely affects neutrophil, macrophages, collagen synthesis and fibroblast function during inflammation and repair. Hyperbaric Oxygen Therapy successfully negates these problems.

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HBOT AND INFERTILITY

Hyperbaric Oxygenation as a possible therapy of choice for infertility treatment
—Bosn Journal Basic Medical Science 2006 May: 6(2):21-4.PubMed
Conclusion: The oxygen used under pressure, the oxygen as a drug may have extraordinary significance for better outcome of pregnancy implantation by improving endometrial receptivity. If endometrial receptivity is conditioned by adequate vascularisation and oxygenation, then hyperbaric oxygen is the treatment of choice.

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HBOT FOR CHILDREN
How mild Hyperbaric Oxygen Therapy (mHBOT) worked and why it’s good for our children”
—Medicinal Veritas, 2 647. 2005.
Conclusion: Children on the autistic spectrum experience improvement in a wide range of their symptoms with mHBOT treatments, including increased language ability, better socialisation, less aggression, improved bowel function and better cognition, to name a few. 

The effects of hyperbaric oxygen therapy on oxidative stress, inflammation, and symptoms in children with autism: an open-label pilot study"
Daniel A Rossignol. BMC Pediatrics 20077:36 Published: 16 November 2007
Conclusion: In this prospective pilot study of children with autism, HBOT at a maximum pressure of 1.5 atm with up to 100% oxygen was safe and well tolerated. HBOT did not appreciably worsen oxidative stress and significantly decreased inflammation as measured by C-Reactive Protein levels. Pre- and post-parental observations indicated statistically significant improvements in both groups, including motivation, speech, and cognitive awareness.

 

RECENT RESEARCH INTO MHBOT AND POST CONCUSSION SYNDROME1) Hyperbaric oxygen therapy for mild traumatic brain injury persistent postconcussion syndrome: a randomised controlled trial (Link: https://pubmed.ncbi.nlm.nih.gov/32189664/)
40 HBOTs at 150 kPa/60 minutes demonstrated statistically significant improvements in postconcussion and Post-Traumatic Stress Disorder symptoms, memory, cognitive functions, depression, anxiety, sleep, and quality of life in civilian and military subjects with mTBI/PPCS compared to controls. Using a randomised controlled crossover design with 2-month follow-up

2)  The National Brain Injury, Rescue and Rehabilitation Study – a multicenter observational study of hyperbaric oxygen for mild traumatic brain injury with post-concussive symptoms.  2019.  (Link: https://pubmed.ncbi.nlm.nih.gov/30950414/)
Subjects received 40–82 one-hour treatments at 1.5 atmospheres absolute 100% oxygen. Outcome measures included repeated self-assessment measures and automated neurocognitive tests. The subjects demonstrated improvement in 21 of 25 neurocognitive test measures observed. The objective neurocognitive test components showed improvement in 13 of 17 measures. Earlier administration of hyperbaric oxygen post injury, younger age at the time of injury and hyperbaric oxygen administration, military status, and increased number of hyperbaric oxygen administrations were characteristics associated with improved outcomes. There were no adverse events. Hyperbaric oxygen was found to be safe, inexpensive and worthy of clinical application in the 21st Century model of facile data collection provided by recent research regulatory shifts in medicine.

3) Hyperbaric Oxygen Therapy Can Improve Post Concussion Syndrome Years after Mild Traumatic Brain Injury - Randomized Prospective Trial (Link: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0079995)
‘A prospective, randomised and controlled cross over study of the effect of HBOT with 100% oxygen at 1.5Atm on mTBI patients at late chronic stage. The results clearly demonstrate that HBOT can induce neuroplasticity and significant brain function improvement in mild TBI patients with prolonged Post-Concussion-Syndrome at late chronic stage, years after brain injury. '

4) Hyperbaric oxygen therapy for post concussion symptoms: issues may affect the results 

(Link: https://medicalgasresearch.biomedcentral.com/articles/10.1186/s13618-015-0033-3)
'HBOT has showed great potential in neuroprotection and neurogenesis'

5) A Phase I Study of Low-Pressure Hyperbaric Oxygen Therapy for Blast-Induced Post-Concussion Syndrome and Post-Traumatic Stress Disorder (Link: https://www.liebertpub.com/doi/full/10.1089/neu.2011.1895)
‘...subjects achieved a 30% reduction in PTSD scores in a 30-day period’

6) Hyperbaric oxygen therapy ameliorates the symptoms of post-concussion syndrome by inhibiting MMP-9 activity: a randomized controlled trial in Indonesia [version 1; peer review: 2 not approved] (Link: https://f1000research.com/articles/10-501#article-comments)
‘Conclusion: HBOT effectively relieves the symptoms associated with post-concussion syndrome through a mechanism that involves repressing MMP-9 activity’.

7) Hyperbaric oxygen may induce angiogenesis in patients suffering from prolonged post-concussion syndrome due to traumatic brain injury (Link: https://content.iospress.com/articles/restorative-neurology-and-neuroscience/rnn150585)
Conclusion: HBOT may induce cerebral angiogenesis, which improves perfusion to the chronic damaged brain tissue even months to years after the injury.

8) Case control study: hyperbaric oxygen treatment of mild traumatic brain injury persistent post-concussion syndrome and post-traumatic stress disorder (Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674654/)
'Subjects experienced significant improvements in PPCS and PTSD symptoms, physical exam abnormalities, cognition, depression, anxiety, quality of life, and brain blood flow that cannot be explained with non-treatment effects; they are more consistent with the known wound-healing effects of HBOT on the diffuse cerebral microscopic wounds of TBI. Moreover, symptomatic improvements increased further during the 6-month post-treatment period. Compared to the matched Controls, TBI/PTSD subjects' brain blood flow was abnormal, but became visually more normal and statistically near-indistinguishable from Controls after 1 and 40 HBOTs. The main blood flow abnormalities and changes in blood flow after HBOT were in the white matter, the primary site of injury in mTBI. Simultaneously and most importantly, subjects experienced a significant reduction in suicidal ideation and anxiety...'

9) Hyperbaric oxygen therapy for the treatment of traumatic brain injury: a meta-analysis
(Link: https://link.springer.com/article/10.1007/s10072-015-2460-2)
Meta analysis: The results of eight studies (average age of patients, 23–41 years) reveal a higher post-treatment GCS score in the HBOT group (pooled difference in means = 3.13, 95 % CI 2.34–3.92, P < 0.001), in addition to greater improvement in GOS and lower mortality, as compared to the control group

10) Impact of Hyperbaric Oxygen Therapy on Cognitive Functions: a Systematic Review
(Link: https://link.springer.com/article/10.1007/s11065-021-09500-9#Sec10)
'HBOT is believed to diminish neuroinflammatory responses, blood–brain barrier permeability and apoptosis while positively impacting neurogenesis, neuronal and axonal integrity and synaptogenesis (reviewed by Daly et al., 2018; Fischer et al., 2010). All of these effects may potentially influence patients’ cognitive functioning.'

11) All the right moves: the need for the timely use of hyperbaric oxygen therapy for treating TBI/CTE/PTSD
(Link: https://link.springer.com/article/10.1186/s13618-015-0028-0)

14) Hyperbaric oxygen therapy as a potential treatment for post-traumatic stress disorder associated with traumatic brain injury.
(Link: https://psycnet.apa.org/record/2016-51984-001)
'HBOT has been shown to reduce apoptosis, upregulate growth factors, promote antioxidant levels, and inhibit inflammatory cytokines in animal models, and hence, it is likely that HBOT could be advantageous in treating at least the secondary phase of TBI and PTSD.’

13) Evidence Brief: Hyperbaric Oxygen Therapy (HBOT) for Traumatic Brain Injury and/or Post-traumatic Stress Disorder
(Link: https://www.ncbi.nlm.nih.gov/books/NBK499535/)
'In case series of TBI and/or PTSD populations, HBOT, mostly at 1.5 ATA, has statistically significantly improved cerebral blood flow and mean scores on post-concussion symptoms (PCS), PTSD, depression, and anxiety symptom checklists, as well as cognitive functioning and quality of life.'

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