Friends and colleagues please post a comment in support of DR HARCH’S pilot trial. Also please thank Congressman Jones for his support. Write whatever is appropriate for you individually. We would like Congressman Walter Jones to know there is a lot of energy surrounding and supporting this.

Here is the video below:

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FOR IMMEDIATE RELEASE
CONTACT: LESLIE CAPO
(504) 568-4806; CELL (504) 452-9166

New Orleans, LA — Dr. Paul Harch, LSUHC Clinical Associate Professor of Emergency Medicine, is the principal investigator of a pilot study to determine the effectiveness of one or two courses of hyperbaric oxygen therapy in treating chronic traumatic brain injury (TBI) and TBI with post traumatic stress disorder (PTSD).  The study grew out of previous experience in treating TBI with hyperbaric oxygen therapy with improvement in symptoms and function.

Thirty participants will be recruited — half will have traumatic brain injury and half will have both traumatic brain injury and post traumatic stress disorder.  The participants will undergo oral, written, and computer tests, ass well as an MRI (if the participant has not had one since injury) and SPECT brain imaging.  Participants will have 40 hyperbaric oxygen therapy treatments and can request up to 40 more if not improved to his/her satisfaction.

Certain conditions preclude participation including pregnancy and increased risk for rare HBOT complications.

Possible benefits include improvement in thinking ability, quality of life, and reduction of PTSD symptoms: however there may be no benefits.

Results will be measured by brain blood flow imaging, written tests for memory and thinking, and questionnaires about quality of life and health.

According to the Centers for Disease Control and Prevention, a traumatic brain injury (TBI) is caused by a blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.  The severity of a TBI my range from “mild,” i.e., a brief change in mental status or consciousness to “severe,” i.e., an extended period of unconsciousness or amnesia after the injury.  TBIs contribute to a substantial number of deaths and cases of permanent disability annually.  CDC estimates that at least 5.3 million Americans, about 2% of the U.S. population, currently have a long-term or lifelong need for help to perform activities of daily living as a result of a TBI.

TBI has been called the signature wound of the Wars in Iraq and Afghanistan.  A RAND Corporation study released in April “estimates that about 320,000 service members may have experienced a traumatic brain injury during deployment — the term used to describe a range of injuries from mild concussions to severe penetrating head wounds.  Just 43 percent reported ever being evaluated by a physician for that injury.  One-year estimates of the societal cost associated with treated cases of mild traumantic brain injury range up to $32,000 per case, while estimated for treated moderate to severe cases range from $268,000 to more than $408,000.  Estimates of the total one-year societal cost of the roughly 2,700 cases of traumatic brain injury identified to date  range from $591 million to $910 million.”

A 2005 article in the New England Journal of Medicine, Traumatic Brain Injury in the War Zone, by Susan Okie, MD, says “among surviving soldiers wounded in combat in Iraq and Afghanistan, TBI appears to account for a larger proportion of casualties than it has in other recent U.S. wars.  According to the Joint Theater Trauma Registry, compiled by the U.S. Army Institute of Surgical Research, 22 percent of the wounded soldiers from these conflicts who have passed through the military’s Landstuhl Regional Medical Center in Germany had injuries to the head, face, or neck.  This percentage can serve as a rough estimate of the fraction who have TBI, according to Deborah L. Warden, a neurologist and psychiatrist at Walter Reed Army Medical Center who is the national director of the Defense and Veterans Brain Injury Center (DVBIC).  Warden said the true proportion is probably higher, since some cases of closed brain injury are not diagnosed promptly.”

For more information or to find out if you qualify, call 504-309-4948.

Continuation  of  Previous Entry —

veterans-new

HBOT also has beneficial effects on vasospasm and cellular reperfusion injury.  Multiple studies have shown that HBOT reduces cerebral edema and decreases intracranial pressure (ICP).   A summary of the HBOT/cerebral edema studies in animals is that HBOT has two differenct effects: one reducing brain edema (injured brain), and another producing brain edema (normal brain).  This toxic effect on normal brain causes a breakdown in the protective vasoconstriction of arterioles, resulting in a rapid rise in brain blood flow and deterioration in EEG.

Rockswold in 1992 reported the most exhaustive, rigorous, and important study to date in acute TBI (traumatic brain injury) in an attempt to refute or affirm all of the above animal and human data.  Conducted from 1983 to 1989 the study enrolled 168 patients with GCS or 9 or less in a RPCT design and stratified the patients by age and GCS.  Patients were treated at 1.5 ATA/60 every 8 hours for a maximum of two weeks immediately post TBI or until awake or deceased during these two weeks.  The average patient entered treatment 26 hours post TBI and received 21 treatments.  Overall mortality was significantly reduced 50% in the HBOT group and as high as 56% and 60% in the elevated ICP and GCS 4-6 subgroups.

This reduction in mortality has never been equaled by any therapy in the medical armamentarium except possibly the ambulance, or in the case of the military, the helicopter.  Adding HBOT to helicopter evacuation of casualties should further decrease morbidity and mortality of injured soldiers.  This is the foundation of the DoD-BIRR Project.

References:

Harch, Paul, M.D., “FEB Scientific Background and Overview,” 2005 (81 scientific references)

Harch, Paul, M.D., “Evidence for Use of Hyperbaric Oxygen Therapy for Acute Traumatic Brain Injury,” 2001

I had the opportunity to visit with Teri Rich, the founder of Advanced Wound Care Systems, Inc. located in Taylorsville, Utah located inside the Salt Lake City metropolitan area.

Teri Rich and Dr. Sherman Johnson informed me that Advanced Wound Care Systems has been selected as one of approximately 90 installations around the U.S. for providing a Hyperbaric Oxygen therapy program for veterans.   

For more detailed information, you will need to contact Teri Rich directly at 801-964-2008.  Be sure to mention that you found her through the Hyperbaric Discovery blog.

veterans-new

 Here is the beginning of the overview for this program.  It will be completed in subsequent entries:

Department of Defense Brain Injury Rescue and Rehabilitation Project (DoD-BIRR) Rescue for Blunt Trauma, Crush & Acute Traumatic Brain Injury
Summary of Scientific Backgrounds & Overview
 
 Oxygen delivered under pressure, Hyperbaric Oxygen Therapy (HBOT) is one of the most powerful drugs known to man.  Simultaneously, HBOT delivers the substrate of life, oxygen, for which there is no substitute.  HBOT has profound beneficial effects on injury pathophysiologic processes that are common in military casualties.  Moreover, it has been shown to positively impact traumatic brain injury, compartment syndrome, burns, hemorrhage, and reperfusion injury.  These injuries and injury processes comprise the bulk of battlefield caualties.  With timely intervention of HBOT the morbidity and mortality of injured soldiers should substantially improve as they have in their civilian counterparts.  Past foreign military experience strongly suggests this benefit in extremity wounds and it is our conviction that United States soldiers deserve nothing less.  This is the goal of the Brain Injury Rescue and Rehabilitation Project (Dod-BIRR).

HBOT has both acute and chronic drug effects.  HBOT exerts these effects by obeying the Universal Gas Laws, the most important of which is Henry’s Law (2).  Henry’s Law states that the concentration of a gas in solution is proportional to the pressure of that gas interfacing with the solution.

At the point of three atmospheres absolute of pure oxygen (3 ATA), just slightly more than the amount the U.S. Navy has used for 50 years in the treatment of divers with decompression sickness, we can dissolve enough oxygen in the plasma to render red blood cells useless.  Under these conditions as blood passes through the tiniest blood vessels tissue cells will extract all of the dissolved oxygen in the blood without touching the oxygen bound to hemoglobin.  This amount of dissolved oxygen alone can exceed the amount necessary for the tissue to sustain life.  In other words, you don’t need red blood cells for life at 3 ATA of 100% oxygen.  This ability to maintain life without blood has obvious potential to battlefield casualties awaiting transfusion.

As a result of Henry’s Law HBOT is able to exert a variety of drug effects on acute pathyophysiologic processes.  These have been well documented over the past 50 years and include reduction of hypoxia (lack of oxygen), inhibition of reperfusion injury (immune response to injury), reduction of edema (swelling), blunting of systemic inflammatory responses, and a multitude of others.  In addition, repetitive HBOT in wound models acts as a DNA stimulating drug to effect tissue growth.    HBOT has been shown to interact with the DNA of cells in damaged areas to begin the production of repair hormones, proteins, and cell surface receptors that are stimulated by the repair hormones.  The resultant repair processes include replication of the cells responsible for tissure strength (fibroblasts), new blood vessel growth, bone healing and strengthening, and new skin growth.

In the past 12 years scientific research has unequivocally shown that the only drug to completely or nearly completely reverse the reperfusion injury process is hyperbaric oxygen.  This  physiological reaction of the body to trauma is  is a major  source of injury that battlefield casualties experience.  In multiple experiments with different models, different organ systems, different types of blood flow reduction or absence (e.g., heart attack, stroke, cardiac arrest, carbon monoxide, tourniqueting of an extremity, etc.) timely HBOT within hours of reperfusion injury has been shown to completely or nearly completely reverse reperfusion injury.

Simultaneously, due to HBOT’s ability to dissolve large amounts of oxygen in the liquid portion of the blood, oxygen-enriched plasma is able to reach damaged areas of tissue not accessible by normal blood flow and restore oxdative function to those areas.  The net result is a dramatic reduction in the secondary injury process, improved viability of tissue that would otherwise die.

In addition, twenty percent of the wounded in Iraqi experience traumatic brain injury (TBI) a diffuse cerebral insult characterized by primary mechanical disruption of tissue and secondary injury from ischemia, hypoxia, edema, vasospasm, neurochemicals and reperfusion injury.  A review of the medical literature shows that there is substantial data proving a beneficial effect of HBOT on the secondary injury processes of acute TBI.  HBOT has been shown indirectly to improve ischemia and hypoxia in acute TBI by its effect on aerobic metabolism and EEG.  The neurosurgeon authors of the Rockswold study conclude that  “HBOT should be initiated as soon as possible after acute severe traumatic brain injury.”

— TO BE CONTINUED in PART 2