HBO Preconditioning for TBI and Stroke Patients

Chapter
Part of the Springer Series in Translational Stroke Research book series (SSTSR)

Abstract

Cerebrovascular disease is one of the top killers of mankind, which led to a great waste of medical resources. Although many innovative strategies were introduced to treat such a disease recently, the hyperbaric oxygen (HBO) may be the most potential one. Since a line of evidence has demonstrated the beneficial effects of HBO against cerebral ischemia and reperfusion injury, HBO is increasingly used in ischemic events such as stroke and traumatic brain injury nowadays. However, there is considerable controversy about HBO due to absence of standard procedure, potential adverse effects, and its narrow time window. It is no doubt that protection is definitely superior to treatment on diseases in clinic setting. Preconditioning, as a new stimulator of endogenous protection, has opened up new avenues and new ideas for the prevention of organ ischemia and reperfusion injury. In the past decade, ischemic tolerance induced by HBO preconditioning is getting more attention. Although HBO preconditioning is confirmed to be effective protection against cerebral ischemic injury both in animal models and several clinical trials, the primary endpoints used to assess its efficacy in the trials that gained positive outcomes were most often biomarkers such as S100β protein and neuron-specific enolase (NSE). Existing trials seem to be encouraging and promising, but maybe not convincible enough. Thus, an optimal HBO-preconditioning protocol, including exact preconditioning dosing and timing, is still not clearly addressed. We expect further well-designed multicenter randomized controlled trials to promote HBO preconditioning against cerebral ischemia injury from bench to bedside.

Keywords

Fatigue Toxicity Glycerol Ischemia Urea 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Anesthesiology, Xijing HospitalFourth Military Medical UniversityXi’anChina

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