Use of normobaric and hyperbaric oxygen in acute focal cerebral ischemia – a preclinical and clinical review

@article{Michalski2011UseON,
  title={Use of normobaric and hyperbaric oxygen in acute focal cerebral ischemia – a preclinical and clinical review},
  author={Dominik Michalski and Wolfgang H{\"a}rtig and Dietmar Schneider and Carsten Hobohm},
  journal={Acta Neurologica Scandinavica},
  year={2011},
  volume={123}
}
Michalski D, Härtig W, Schneider D, Hobohm C. Use of normobaric and hyperbaric oxygen in acute focal cerebral ischemia – a preclinical and clinical review.
Acta Neurol Scand: 2011: 123: 85–97.
© 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard. 
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ncbi.nlm.nih.gov
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TLDR
The long-term consequences of simultaneously applied tPA and both NBO and HBO need to be addressed by further studies to identify therapeutic potencies in acute stroke, and to avoid unfavorable courses following combined treatment.
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TLDR
Previous human studies in stroke patients indicating that 100% oxygen at pressure of 1.5 atm absolute (ATA) is better tolerated than higher pressures by the brain injured by acute ischemia are considered.
Hyperbaric Oxygenation as an Adjunct Therapy in Strokes Due to Thrombosis: A Review of 122 Patients
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HBO is used as adjunctive treatment and there appears to be justification for a controlled study to delineate the treatment further, and it is essential to treat patients with stroke at 1.5 to 2 atmospheres absolute (ATA).
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The literature regarding the effects of HBO on brain oxygenation, cerebral blood flow and intracranial pressure in both the healthy and injured brains are summarized, as well as how changes in these three factors can impart protection.
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HBO is highly efficient in reducing infarct volume and improving neurobehavioral outcome in transient MCAO within the first 6 hours, while HBO at later time points (≥12 hours) is harmful by increasing infarCT volume.
Hyperbaric oxygen decreases infarct size and behavioral deficit after transient focal cerebral ischemia in rats
Delayed hyperbaric oxygenation is more effective than early prolonged normobaric hyperoxia in experimental focal cerebral ischemia
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The study was interrupted when it noticed what appeared to be a trend favoring the air-treated patients, whose neurological deficits were less severe and whose infarcts were smaller, and was probably an artifact of the randomization process.
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An acute ischemia lesion of the bra in implies a rapid fall to zero of the oxygen tension within central par t s of t h e lesion, and measures which tend to ameliorate circulation anti oxygenation may diminish the final consequences of thc lesion.
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