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Mild TBI Diagnosis and Management Strategies

Hyperbaric Oxygen (HBO2) for Symptomatic mTBI: The VA-DoD Experience


by David Cifu, MD
Seminar date: 10/31/2013

Description: The nearly 10% incidence of OEF-OIF-OND Veterans with Persistent Post-Concussion Symptoms (PPCS) has prompted a comprehensive program of rigorous clinical research into the efficacy of complementary interventions. In 2008, the VA-DoD developed a series of three major clinical trials utilizing randomized, sham-controlled, double blind methodology to study the efficacy of hyperbaric oxygen (HBO2). HBO2 administration involves breathing high levels of oxygen, usually 100%, at an increased pressure at least 1.4 times greater than the atmospheric absolute pressure at sea level (1 atmospheres absolute or ATA, which is equivalent to 760 mmHg partial pressure of oxygen).8 The partial pressure of oxygen will increase proportionally with an increase in the hyperbaric chamber compression pressure, consequently the intent of HBO2 is to increase the oxygenation of the patient’s blood and tissues to supraphysiologic levels as a stimulus to cellular growth and repair. This seminar will focus on the integrated DoD-VA clinical trials program studying the effect of hyperbaric oxygen on persistent symptoms after combat-related mild TBI. At the end of this seminar, participants will be able to; 1) Outline the DoD-VA integrated research program in HBO2 for PPCS. 2) Analyze the results of the two completed trials. 3) Discuss the appropriate approach to the management of PPCS, including the role of HBO2. The intended audience for this session is Clinicians providing care for Veterans with mTBI, Researchers.

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