Adjunctive Therapy Application of Hyperbaric Oxygen Therapy in Children Already Treated with Mild Hypothermia for Disturbance of Consciousness

Abstract

Hypothermia is potentially useful for treating a variety of diseases, but in some cases its results remain unsatisfactory. We report three children who were treated with hyperbaric oxygen therapy (HBOT) because they had exhibited poor recovery after hypothermia. Between 1999 and 2002 in Kagoshima University Hospital, three children with hypoxic encephalopathy were treated with HBOT after previously undergoing mild hypothermia. They exhibited various degrees disturbance even several days after completion of hypothermia. Case 1 was a 10-year-old boy [Japan Coma Scale (JCS)-3], Case 2 was a 4-year-old boy (JCS-30), and Case 3 was a 1-year-old girl (JCS-200). Each had suffered cardiac arrest. They received HBOT once a day. The number of sessions of HBOT ranged from 10 to 29. Two patients, Cases 1(10 HBOT sessions) and 3 (29 HBOT sessions), left our hospital without neurological disturbance, but the other (16 HBOT sessions) exhibited continued disturbance. Although the mechanism underlying such HBOT-induced improvement is still not clear, this procedure appears to be useful for patients who do not exhibit full recovery from disturbance. In conclusion, HBOT may be capable of further improving neurological disturbances that remain after hypothermia. Employed in combination with hypothermia, HBOT may improve recovery from neurological disturbance, and delayed HBOT appears to be one clinical option for treating any neurological disturbance remaining after hypothermia.