脑损伤的高压氧治疗—越早越好 HBOT for brain injury - the earlier, the better
首先，脑细胞的代谢，只有一种方式——有氧代谢方式。也就是说氧和葡萄糖时刻都不能中断。氧供不足，脑细胞有氧代谢受到影响，产生的能量物质ATP减少，导致各种泵和通道失活，细胞死亡。
脑损伤患者的脑组织经常有水肿，水肿组织压迫动脉可以使脑组织灌注不良脑组织进一步缺氧；压迫静脉使组织回流不畅，脑组织水肿加剧；水肿还使毛细血管之间的距离拉大，而氧的弥散距离有限，使得离血管比较远的细胞不能得到足够的氧来进行有效的有氧代谢，进一步损伤脑细胞，甚至导致脑细胞死亡。
临床研究还发现，正常情况下人脑灰质毛细血管氧的弥散距离的有效半径约30微米，如果是在3.0ATA标准大气压下吸氧，人脑灰质毛细血管氧的弥散距离的有效半径可以达到100微米。及时的氧供可以减轻脑损伤，减少脑细胞死亡数量。
另外，高压下吸氧可以激活脑干网状上行激活系统，有助于唤醒大脑。
心跳呼吸骤停的患者，在高压氧舱里抢救，疗效更佳。视频中有一个深昏迷的危重病人，没有呼吸，血压维持需大剂量升压药泵入。生理反射、病理反射，全部消失，每天还要血透。这一天高压氧治疗的时候，病人一转运到氧舱大厅，血压就测不出了，随之心跳停止。此时工作人员立即将病人转移到高压氧舱内，迅速加压、给氧，胸外按压，注射肾上腺素......很快患者就出现了心跳，并渐渐转为窦性。血氧饱和度也由原先的测不出，提高到89%（拍摄视频时）。您可能会问，怎么没有之前抢救时胸外按压的照片或视频？当时大家都在紧张的抢救病人......在病人心跳出现以后，才松了一口气，想起来拍摄一下短视频，留点资料。所以您看到的只是抢救病人接近尾声的一小段场景。
The Earlier Accepting Hyperbaric Oxygen Therapy，the Better Result for the Patient with Brain Injury
First, brain cells metabolize in only one way -- aerobic. That means that oxygen and glucose can't be interrupted at any time. If oxygen supply is insufficient, the aerobic metabolism of brain cells is affected, and the energy substance ATP is reduced, that will lead to the inactivation of various pumps and channels, and cell death.
Patients with brain injury often have edema in brain tissue. Edema tissue compression of the artery can make brain tissue perfusion poor, brain tissue further hypoxia. Compression of the vein makes the tissue flow is not free, brain tissue edema is aggravated. Edema also makes the distance between capillaties is longger, and the diffusion distance of oxygen is liminted, so make the cell that leaves blood vessel relatively far cannot get enough oxygen to undertake effective AEROBIC METABOLISM. Further brain cell can be damaged, even bring about brain cell death.
Clinical studies have also found that under normal conditions the effective radius of the diffusion distance of capillary oxygen in human brain gray matter is about 30 microns. If oxygen is inhaled at 3.0ATA (standard atmospheric pressure), the effective radius of the diffusion distance of capillary oxygen in human brain gray matter can reach 100 microns. Timely oxygen supply can reduce brain damage and reduce the number of brain cells dying.
In addition, oxygen exposure at high pressure activates the brain stem reticular ascending activation system, which helps to wake up the patient in coma condition.
For patients with cardiac and respiratory arrest, it is better to rescue them in hyperbaric oxygen chamber. This video shows a critically ill patient in a deep coma, no breathing, whose blood pressure needs to be maintained by pumping high doses of pressor. Both physiological reflexes and pathological reflexes all disappeared, and daily hemodialysis. On this way of hyperbaric oxygen therapy, as soon as the patient was transferred to the hall of oxygen chamber, blood pressure could not be measured, followed by cardiac arrest. At this time, the staff immediately transferred the patient to the hyperbaric oxygen chamber, rapid pressure, oxygen, chest compressions, injection of epinephrine...... Soon the patient began to have a heartbeat, which gradually became sinus. Oxygen saturation also increased from undetectable to 89% (when the video was taken). Why, you may ask, are there no photos or videos of chest compressions from previous rescues? At that time, we were nervous to rescue the patient...... After the patient's heartbeat appeared, I was relieved and thought of shooting a short video to save some information. So what you're seeing is just a little bit of the end of the patient's rescue.
