A prospective, randomized Phase II clinical trial to evaluate the effect of combined hyperbaric and normobaric hyperoxia on cerebral metabolism, intracranial pressure, oxygen toxicity, and clinical outcome in severe traumatic brain injury

Rockswold et al.

Journal of Neurosurgery n = 42 1.5 ATA 6 sessions

Plain English

This trial focused on the acute, intensive-care-unit phase of severe traumatic brain injury — a very different population from chronic TBI. Even in this critically ill cohort, HBOT at 1.5 ATA reduced mortality and improved markers of brain metabolism. The protocol was deliberately conservative: 1.5 ATA, applied once daily. The fact that even this gentle protocol moved the needle in severe TBI is one reason 1.5 ATA has emerged as a safe, well-tolerated default for both clinical and home use.

Key findings

What the trial documented.

HBOT reduced mortality and improved outcomes in severe TBI
Improved cerebral metabolism on microdialysis monitoring
No oxygen toxicity at the protocol used

Most HBOT brain research looks at chronic injury; this trial is different — it studied the acute, intensive-care phase of severe traumatic brain injury, a critically ill population.

What the study looked at

A prospective, randomized Phase II clinical trial enrolled 42 patients with severe TBI (mean Glasgow Coma Scale 5.7) within 24 hours of injury. One arm received a combined treatment of hyperbaric oxygen (60 minutes at 1.5 ATA) followed by normobaric hyperoxia (3 hours of 100% oxygen). The trial evaluated cerebral metabolism, intracranial pressure, oxygen-toxicity markers, and clinical outcome.

What it found

The authors reported that the combined HBO2/NBH treatment improved markers of cerebral metabolism and was associated with favorable effects on intracranial pressure and outcome, even at the conservative 1.5 ATA pressure.

How strong is the evidence?

A single-center Phase II randomized trial — designed to test feasibility and signal, not to be definitive. Its relevance here is partly that benefit appeared at a gentle 1.5 ATA pressure.

Related on Saturate

See our evidence overview of HBOT for TBI and concussion.

Source

Rockswold SB, et al. (2013). Phase II trial: combined hyperbaric and normobaric hyperoxia in severe traumatic brain injury. Journal of Neurosurgery. doi.org/10.3171/2013.2.JNS121468 · PubMed

This content is for educational purposes only and is not medical advice. Hyperbaric oxygen therapy carries genuine clinical risks; consult a qualified clinician. Read our full medical disclaimer.

Protocol used

1.5 ATA, 100% oxygen, 60-minute sessions, every 24 hours for up to 6 sessions

Full citation

Rockswold et al.. A prospective, randomized Phase II clinical trial to evaluate the effect of combined hyperbaric and normobaric hyperoxia on cerebral metabolism, intracranial pressure, oxygen toxicity, and clinical outcome in severe traumatic brain injury. Journal of Neurosurgery. 2013.

DOI →

Medical disclaimer

This content is for educational purposes only and is not medical advice. Hyperbaric oxygen therapy carries genuine clinical risks; consult a qualified clinician before starting any protocol. Full disclaimer →