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 HBOT
and Near-Drowning
Near-drowning is a form of global ischemia/hypoxia
that is similar to cardiac arrest and has
equivalent devastating consequences. Unfortunately,
the data for HBOT in this setting is scant,
but was included by Drs. Harch and Neubauer
in some of the studies mentioned in Chapter
18 of the K.K. Jain Textbook, 1999 (4).
The earliest cases of HBOT in chronic near-drowning
were treated and presented by Drs. Harch
and Neubauer in the early 1990's. Dr. Harch
has now treated a steadily increasing number
of these chronic severe patients with modest
results. While the patients show improvements
in awareness and a reduction in seizures
their progress is slower than nearly every
other chronic neuropathology treated with
HBOT. In the acute setting, however, HBOT
has great potential. Dr. Harch had the opportunity
to treat such a patient in 1997 within 2
hours of the event. The child made a total
recovery and returned to school after a
single treatment. He was featured in the
Methodist Hospital national magazine that
same year and presented at the 5/1998 Congress
on Cerebral Ischemia, Vascular Aging, and
Dementia in Washington, D.C., along with
a case of HBOT in acute cardiac arrest who
subsequently returned to work (31).
Two of Dr. Harch's chronic cases were presented
in 1994 at the UHMS meeting (3)
and subsequently published in the 1999 K.K.
Jain Textbook. One of them is featured below.
Case Presentation:
The patient is a 4 year old boy who presented
16 months after a 5 minute submersion which
required 45 minutes of CPR to regain a pulse.
He was subsequently wheelchair-bound with
diffuse spasticity, motor impairment, and
cognitive problems. He underwent SPECT imaging
before and after a single (Figures
1 and 2) and 80 (Figure
3) HBOT's which demonstrated global
improvement in brain blood flow (more yellow)
that paralleled clinical improvements in
cognition, tone, and motor abilities. Figures
4, 5, and 6 are three dimensional surface
reconstructions of Figures 1, 2, and 3.
Click Image to Enlarge
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Figure 1
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Figure 2
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Figure 3
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Figure 4
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Figure 5
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Figure 6
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3. Harch PG, et al. HMPAO SPECT brain
imaging and low pressure HBOT in the diagnosis
and treatment of chronic traumatic, ischemic,
hypoxic and anoxic encephalopathies. Undersea
and Hyperbaric Medicine, 1994;21(Suppl):30.
4. Harch PG and Neubauer RA. Hyperbaric
oxygen therapy in global cerebral ischemia/anoxia
and coma, Chapter 18. Textbook of Hyperbaric
Medicine, 3rd Edition. Editor: K.K. Jain.
Hogrefe and Huber Publishers, Seattle, 1999.
31. Harch PG. Hyperbaric oxygen therapy:
Pharmacology and effects on pathophysiology
in acute central nervous system ischemia
and anoxia. Congress on Cerebral Ischemia,
Vascular Dementia, Epilepsy and CNS Injury,
Washington Marriott Wardman Park Hotel,
Washington, DC, May 9-13, 1998, SP-12. Copies
available from the National Stroke Research
Center, Winston-Salem, N.C., and the office
of Dr. Harch.
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