Watching TV dramas and movies to talk about hyperbaric oxygen therapy for traumatic brain injury

Author: Zhang Yi Beijing Chaoyang Hospital, Capital Medical University

Reviewer: Yang Jing, Chief Physician, Beijing Chaoyang Hospital, Capital Medical University

In 2020, there was a hit TV series, "Trident", which tells the story of three old policemen who once dominated the world and innovated their detection methods, and finally worked together to defeat the financial crime group in one fell swoop. There is such a plot in the play: "Stick", one of the three old policemen, was unfortunately injured in the head while fighting with the gangsters, causing coma and was sent to the hospital for emergency surgery. After the operation, the doctor told the family: Although he is not in danger of life for the time being, due to the long period of cerebral ischemia and hypoxia, there is a possibility of becoming a vegetative state. Therefore, the doctor suggested that he receive hyperbaric oxygen therapy to promote the recovery of brain nerves. Coincidentally, there is also such a scene in the TV series "Emergency Physician": Lawyer Mei, who was unconscious due to a car accident, received hyperbaric oxygen therapy.

What is hyperbaric oxygen therapy mentioned in both TV series? Why can hyperbaric oxygen be used to treat traumatic brain injury?

What is Hyperbaric Oxygen Therapy?

In the plains, we live in an environment with 1 atmosphere of pressure. Hyperbaric oxygen therapy refers to the method of treating diseases by inhaling pure oxygen or high-concentration oxygen in a hyperbaric oxygen chamber with a pressure higher than 1 atmosphere. With the discovery of oxygen, people gradually realized the importance of oxygen and thought of combining oxygen with high pressure to form hyperbaric oxygen therapy. Hyperbaric oxygen medicine has been clinically applied since 1887 and has a history of more than 100 years. my country's first medical hyperbaric oxygen chamber was built in 1964, which means that the development of hyperbaric oxygen in China has a history of nearly 60 years.

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Many people may have heard that hyperbaric oxygen can treat carbon monoxide poisoning. In fact, hyperbaric oxygen can treat hundreds of diseases, and has become a routine treatment for carbon monoxide poisoning, decompression sickness (mostly occurring during diving, flying, and similar high-altitude climbing), sudden deafness, various nervous system injuries, radiation damage, and wound healing. In recent years, hyperbaric oxygen medicine has been constantly intersecting with multiple disciplines, and can not only be used as a treatment method, but also has health care and preventive effects.

Application of hyperbaric oxygen in traumatic brain injury

With the continuous development of transportation and construction industries, traumatic brain injury has become a major disease that endangers human health, accounting for 17% to 23% of all trauma. The damage caused by traumatic brain injury can be divided into primary injury and secondary injury. Primary injury can be understood as brain damage directly caused by violent blows. Secondary brain injury is based on primary brain injury, because secondary lesions aggravate the damage to brain tissue, such as cerebral edema, neuroinflammation, etc., leading to worsening of the disease.

Severe traumatic brain injury has a mortality rate of more than 20% and a severe disability rate of about 50%, making it the main cause of death and long-term disability. It is estimated that the number of patients with chronic disorders caused by traumatic brain injury in my country increases by 50,000 to 100,000 cases each year.

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In addition to the performances in film and television dramas, there are also many examples of hyperbaric oxygen treatment for traumatic brain injuries in real life.

In 2002, Phoenix TV anchor Liu Hairuo encountered a train derailment accident while traveling in the UK. Although her primary brain injury was not serious, it caused serious secondary brain injury. Epidural hematoma caused long-term brain herniation, brain tissue was squeezed and ischemic, and severe hypotension shock after the injury caused severe ischemia of brain tissue. These factors caused her to fall into a coma; she was taken back to her motherland one month after the injury. On the third day of treatment at Xuanwu Hospital, she began hyperbaric oxygen therapy; by the 10th treatment, her EEG had improved greatly; by the 30th treatment, she was conscious; after more than 50 treatments, she could eat and her condition improved significantly.

The application of hyperbaric oxygen in traumatic brain injury has a history of nearly 60 years. In 1964, foreign scholars reported it for the first time. The clinical report of Chinese scholars on the application of hyperbaric oxygen in traumatic brain injury can be traced back to 1987. At present, it is believed that hyperbaric oxygen therapy can be used in acute traumatic brain injury to reduce intracranial pressure, improve cerebral edema, reduce secondary injuries, and promote awakening of comatose patients; it can also be used in the chronic stage of traumatic brain injury to promote the recovery of persistent vegetative state, improve cognitive function, promote improvement of neurological function, and reduce sequelae.

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In summary, patients with traumatic brain injury can use hyperbaric oxygen therapy, and treatment should be started as soon as possible if vital signs are stable and there are no contraindications.