Transcript Presentation from WFNR SIG Chair Meeting, Abu Dhabi, March 2015

Report of the SIG
HBOT and Neurorehabilitation
Chair Meeting, Abu Dhabi 5th-8th March, 2015
Chair: F.Gerstenbrand, Vienna
Co-Chair: T.Sieber, Piestany
Main Aims of the SIG
HBOT and Neurorehabilitation
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Application of HBOT method in the rehabilitation of TBI,
stroke, paediatric neurology, vegetative state/apallic
syndrome. Clinical trials in cooperation with competent
SIG’s
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Working basis: HBO Department of Adeli Medical
Center, Piestany, Slovakia.
Oxymed Department, HBOT Chamber
Adeli Medical Center, Piestany, Slovakia
Special Treatment Program Adeli Center Piestany
for Cerebral Palsy
History of Hyperbaric Oxygenation Chamber
Oxymed Department Adeli Center Piestany
“The Domicilium” from 1662
Cunningham's hyperbaric chamber
In Cleveland - 1928
Fontaine’s mobile hyperbaric operating room - 1879
12-seat hyperbaric chamber
HAUX STARMED 2200 / 5.5 / XL –
2014 Oxymed Center, Piestany
Hyperbaric Oxygenation Therapy
use of 100% Oxygen higher than
atmospheric pressure
Under HBOT O2 Increased in:
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Bone
Urine
Plasma
Lymph
And Most Importantly the
Cerebrospinal Fluid
Under pressure free molecular
oxygen is delivered directly to
the cell for immediate metabolic
use without energy exchange.
Edward Teller
Effects of Pressurized Oxygen
Chronic Brain Damage
• Restores the integrity of the blood
brain barrier and cell membranes
• Improves cell respiration, Reduces
cell byproducts – cytokines
• Promotes Neovascularization
• Promotes Epithelization
Effects of Pressurized Oxygen
Chronic Brain Damage
• Reactivates idling neurons
• Enhances plasticity
• Efficiently elevates diffusional driving
force for O2 thereby increasing tissue
oxygen availability
• Promotes phagocytosis (internal
debridement)
• Ameliorates multiple biochemical
changes
HBOT and hypoxic damage of the
brain
• Early form of HBOT (within 24 hours)
• Deferred form of HBOT (months to years
• Treatment
structure:
 1,2 - 1,5 bar
 75-90min
 10-40x
Hyperbaric Oxygen Therapy
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Complex effect
Stimulates DNA in each cell
Promotes growth of new tissue
Affects perfusion (NO)
Produces oxygen free radicals
Inhibits acute inflammation
Attenuates the apoptosis of cells
Reactivates “sleeping” (idling) neurons
Results – Cochrane review
• Traumatic Brain Injury – Artru (1976), Holbach (1974),
Rockswold (1992), Ren (2001)
• Neonatal hypoxic encephalopathy – Hutchinson
(1966), Liu (2006)
• Cerebral Palsy – Machado (1989), Montgomery (1999),
Packard (2000), Collet (2001), Mathai (2005)
Presentation of patients treated in the Adeli Medical Center Piestany
2011-2013
Possibilities of cooperation with other SIG‘s
- Paediatric neurorehabilitation
- Early rehabilitation
- Severe brain injury
- Spinal cord injury
- Neurological rehabilitation
- Autonomic rehabilitation
- Neurosurgical, reconstructive and restaurative
rehabilitation