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01-07-2016 | Clinical Article - Neurosurgical Techniques

Hyperbaric oxygen therapy in spontaneous brain abscess patients: a population-based comparative cohort study

Authors: Jiri Bartek Jr, Asgeir S. Jakola, Simon Skyrman, Petter Förander, Peter Alpkvist, Gaston Schechtmann, Martin Glimåker, Agneta Larsson, Folke Lind, Tiit Mathiesen

Published in: Acta Neurochirurgica | Issue 7/2016

Abstract

Background

There is a need to improve outcome in patients with brain abscesses and hyperbaric oxygen therapy (HBOT) is a promising treatment modality. The objective of this study was to evaluate HBOT in the treatment of intracranial abscesses.

Method

This population-based, comparative cohort study included 40 consecutive adult patients with spontaneous brain abscess treated surgically between January 2003 and May 2014 at our institution. Twenty patients received standard therapy with surgery and antibiotics (non-HBOT group), while the remaining 20 patients also received adjuvant HBOT (HBOT group).

Results

Resolution of brain abscesses and infection was seen in all patients. Two patients had reoperations after HBOT initiation (10 %), while nine patients (45 %) in the non-HBOT group underwent reoperations (p = 0.03). Of the 26 patients who did not receive HBOT after the first surgery, 15 (58 %) had one or several recurrences that lead to a new treatment: surgery (n = 11), surgery + HBO (n = 5) or just HBO (n = 1). In contrast, recurrences occurred in only 2 of 14 (14 %) who did receive HBOT after the first surgery (p < 0.01). A good outcome (Glasgow Outcome Score [GOS] of 5) was achieved in 16 patients (80 %) in the HBOT cohort versus 9 patients (45 %) in the non-HBOT group (p = 0.04).

Conclusions

HBOT was associated with less treatment failures and need for reoperation and seemingly with improved long-term outcome. Further, HBOT was well tolerated and safe. Prospective studies are warranted to establish the role of HBOT in the treatment of brain abscesses.

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Title: Hyperbaric oxygen therapy in spontaneous brain abscess patients: a population-based comparative cohort study
Authors: Jiri Bartek Jr
Asgeir S. Jakola
Simon Skyrman
Petter Förander
Peter Alpkvist
Gaston Schechtmann
Martin Glimåker
Agneta Larsson
Folke Lind
Tiit Mathiesen
Publication date: 01-07-2016
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 7/2016
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-016-2809-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Hyperbaric oxygen therapy in spontaneous brain abscess patients: a population-based comparative cohort study

Abstract

Background

Method

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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