Hyperbaric oxygen therapy for paroxysmal sympathetic hyperactivity syndrome after brain injury: a multicenter, retrospective cohort study

Hong Wang, Yujing Li, Songying Shen, Xin Li, Changhe Li, Yihao Li, Huimin Chen, Caihong Ren, Yinsen Song, Yao Tang, Huijun Dong, Meng Zhao, Sisen Zhang, Hongyu Wang

¹Department of Emergency Medicine, The Fifth Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, Henan Province, China²Department of Emergency Medicine, People’s Hospital of Henan University of Chinese Medicine/People’s Hospital of Zhengzhou, Zhengzhou, Henan Province, China³Department of Geriatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China⁴Department of Emergency Medicine, Huaxian People’s Hospital, Anyang, Henan Province, China⁵Department of Hyperbaric Oxygen, Zhengzhou Jinshui District General Hospital, Zhengzhou, Henan Province, China⁶Department of Emergency Medicine, Luohe Central Hospital, Luohe, Henan Province, China

Abstract

Hyperbaric oxygen has been used to treat many diseases. However, there are few reports on hyperbaric oxygen treatment for paroxysmal sympathetic hyperactivity at home and abroad, and the clinical experience is very limited. To understand the efficacy of hyperbaric oxygen treatment for paroxysmal sympathetic hyperactivity after brain injury, this retrospective study was conducted in the adult intensive care units of five medical centers in central China. Ninety-two patients with paroxysmal sympathetic hyperactivity syndrome after brain injury were selected from January 2021 to September 2023. Fifty-six patients treated with hyperbaric oxygen were included in the hyperbaric oxygen group, and 36 patients without hyperbaric oxygen treatment were included in the control group. Patients in the hyperbaric oxygen group received 3–5 courses of hyperbaric oxygen treatment, twice daily, once for 70 minutes, 10 days for 1 course of treatment. Compared with before hyperbaric oxygen treatment, the paroxysmal sympathetic hyperactivity symptoms of all patients were significantly relieved after three courses of hyperbaric oxygen treatment. Compared with those in the control group, patients in the hyperbaric oxygen group had higher Glasgow coma scale scores, lower paroxysmal sympathetic hyperactivity syndrome assessment measure scores, and shorter intensive care unit stays. In conclusion, the use of hyperbaric oxygen therapy as an assisted therapy can significantly alleviate the symptoms of patients with paroxysmal sympathetic hyperactivity, thereby providing new ideas for the treatment of paroxysmal sympathetic hyperactivity.

摘要：高压氧已被用于治疗许多疾病。然而，国内外关于高压氧治疗阵发性交感神经亢进的报道很少，临床经验也非常有限。为了解高压氧治疗脑损伤后阵发性交感神经亢进的疗效，本研究在华中地区五家医疗中心的成人重症监护室进行了回顾性研究。选择2021年1月至2023年9月脑损伤后阵发性交感神经多动综合征患者92例。接受高压氧治疗的患者56例为高压氧组，未接受高压氧治疗的患者36例为对照组。高压氧组患者给予高压氧治疗3-5个疗程，每日2次，每次70分钟，10天为1个疗程。与高压氧治疗前比较，高压氧治疗3个疗程后，所有患者阵发性交感神经多动症状均明显缓解。与对照组相比，高压氧组患者格拉斯哥昏迷评分较高，阵发性交感多动综合征评估评分较低，重症监护时间较短。综上所述，高压氧治疗作为辅助治疗可显著缓解阵发性交感神经亢进患者的症状，从而为阵发性交感神经亢进的治疗提供新的思路。