Subacute normobaric oxygen and hyperbaric oxygen therapy in drowning, reversal of brain volume loss: a case report
Subacute normobaric oxygen and hyperbaric oxygen therapy in drowning, reversal of brain volume loss: a case report
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DOI：
10.4103/2045-9912.208521
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发表时间：
2017-04-01
影响因子：
2.9
通讯作者：
Fogarty, Edward F.
中科院分区：
文献类型：
--
作者：
Harch, Paul G.;Fogarty, Edward F.
一名2岁女孩在冷水溺水后心脏骤停。磁共振成像(MRI)显示第4天深部灰质损伤，第32天脑萎缩，灰质和白质丢失。在出院的第48天，患者没有言语、步态或对命令的反应。她从第56天开始接受常压100%氧气治疗(2 L/分钟，经鼻插管45分钟，2次/天)，然后从第79天开始接受高压氧治疗(HBOT)，治疗时间为1.3大气压绝对空气(131.7 kpa)/45分钟，每周5天，共40次；在开始治疗时，视觉明显和/或体检记录的神经功能改善。HBOT治疗后，患者言语和认知功能正常，步态辅助，残留精细运动和气质缺陷。伤后5个月和高压氧治疗后27天的MRI显示脑室接近正常，萎缩逆转。亚急性常压氧和高压氧能够恢复溺水所致的皮质灰质和白质丢失，如序列MRI所证明的那样，以及同时神经功能的恢复，如视频和体检所记录的。
A 2-year-old girl experienced cardiac arrest after cold water drowning. Magnetic resonance imaging (MRI) showed deep gray matter injury on day 4 and cerebral atrophy with gray and white matter loss on day 32. Patient had no speech, gait, or responsiveness to commands on day 48 at hospital discharge. She received normobaric 100% oxygen treatment (2 L/minute for 45 minutes by nasal cannula, twice/day) since day 56 and then hyperbaric oxygen treatment (HBOT) at 1.3 atmosphere absolute (131.7 kPa) air/45 minutes, 5 days/week for 40 sessions since day 79; visually apparent and/or physical examination-documented neurological improvement occurred upon initiating each therapy. After HBOT, the patient had normal speech and cognition, assisted gait, residual fine motor and temperament deficits. MRI at 5 months after injury and 27 days after HBOT showed near-normalization of ventricles and reversal of atrophy. Subacute normobaric oxygen and HBOT were able to restore drowning-induced cortical gray matter and white matter loss, as documented by sequential MRI, and simultaneous neurological function, as documented by video and physical examinations.