Advance in hyperbaric oxygen therapy in spinal cord injury  

作　　者：Antonio Siglioccolo Renato Gammaldi Veronica Vicinanza Alessio Galardo Vittorio Caterino Salvatore Palmese Carmine Ferraiuoli Alessandro Calicchio Antonio Romanelli 

机构地区：[1]Department of Anaesthesia and Intensive Care Unit,Azienda Ospedaliero Universitaria"San Giovanni Di Dio e Ruggi D'Aragona",Via San Leonardo,84125,Salerno,Campania,Italy [2]Department of Diving and Hyperbaric Medicine,Azienda Ospedaliero Universitaria"San Giovanni Di Dio e Ruggi D'Aragona",Via San Leonardo,84125,Salerno,Campania,Italy [3]Resident in Anaesthesia and Intensive Care,"Federico II"University,Via Sergio Pansini,80131,Naples,Campania,Italy

出　　处：《Chinese Journal of Traumatology》2024年第6期348-353,共6页中华创伤杂志（英文版）

摘　　要：Spinal cord injury(SCI)is a severe lesion comporting various motor,sensory and sphincter dysfunctions,abnormal muscle tone and pathological reflex,resulting in a severe and permanent lifetime disability.The primary injury is the immediate effect of trauma and includes compression,contusion,and shear injury to the spinal cord.A secondary and progressive injury usually follows,beginning within minutes and evolving over several hours after the first ones.Because ischemia is one of the most important mechanisms involved in secondary injury,a treatment to increase the oxygen tension of the injured site,such as hyperbaric oxygen therapy,should theoretically help recovery.Although a meta-analysis concluded that hyperbaric oxygen therapy might be helpful for clinical treatment as a safe,promising and effective choice to limit secondary injury when appropriately started,useful and well-defined protocols/guidelines still need to be created,and its application is influenced by local/national practice.The topic is not a secondary issue because a well-designed randomized controlled trial requires a proper sample size to demonstrate the clinical efficacy of a treatment,and the absence of a common practice guideline represents a limit for results generalization.This narrative review aims to reassemble the evidence on hyperbaric oxygen therapy to treat SCI,focusing on adopted protocols in the studies and underlining the critical issues.Furthermore,we tried to elaborate on a protocol with a flowchart for an evidence-based hyperbaric oxygen therapy treatment.In conclusion,a rationale and shared protocol to standardize as much as possible is needed for the population to be studied,the treatment to be adopted,and the outcomes to be evaluated.Further studies,above all,well-designed randomized controlled trials,are needed to clarify the role of hyperbaric oxygen therapy as a strategic tool to prevent/reduce secondary injury in SCI and evaluate its effectiveness based on an evidence-based treatment protocol.We hope that adopting the pr

关 键 词：Spinal cord injury Hyperbaric oxygen therapy Randomised controlled trial PROTOCOL 

分 类 号：R651.2[医药卫生—外科学]