OBJECTIVE: To investigate the effect of hyperbaric oxygen (HBO) on paroxysmal sympathetic hyperexcitation (PSH) after brain injury. METHODS: A multicenter retrospective study was conducted. Fifty-six patients with PSH who received HBO treatment from four hospitals in Henan Province from January 2021 to September 2023 were selected as the HBO group, and 36 patients with PSH who did not receive HBO treatment from Zhengzhou People's Hospital from May 2018 to December 2020 were selected as the control group. PSH assessment measure (PSH-AM) score [clinical feature scale (CFS) score+diagnostic likelihood tool (DLT) score] and Glasgow coma scale (GCS) were compared before and after HBO treatment, and between HBO group and control group to evaluate the effect of HBO treatment on prognosis of PSH patients. RESULTS: There were no statistically significant differences in age, gender, PSH etiology, GCS score, time from onset to occurrence of PSH, CFS score, CFS+DLT score and frequency of PSH episodes between the two groups, indicating comparability. The duration of HBO treatment ranged from 3 to 11 days for 56 patients receiving HBO treatment, and the duration of HBO treatment ranged from 3 to 5 courses. Compared with before treatment, after HBO treatment, PSH symptoms in HBO patients were significantly relieved (body temperature increase: 14.29% vs. 64.29%, heart rate increase: 25.00% vs. 98.21%, shortness of breath: 14.29% vs. 76.79%, blood pressure increase: 8.93% vs. 85.71%, sweating: 10.71% vs. 85.71%, muscle tone increased: 19.64% vs. 75.00%, all P < 0.05), CFS+DLT score decreased significantly (16.90±4.81 vs. 22.12±3.12, P < 0.01), GCS score improved (12.31±5.34 vs. 5.95±2.18, P < 0.01). After 30 days of hospitalization, compared with the control group, PSH symptoms in the HBO group were improved (body temperature increase: 14.29% vs. 19.44%, heart rate increase: 19.64% vs. 25.00%, shortness of breath: 10.71% vs. 27.78%, blood pressure increase: 7.14% vs. 22.22%, sweating: 8.93% vs. 25.00%, muscle tone increased: 19.64% vs. 38.89%, all P < 0.05 except body temperature increase), CFS+DLT score decreased (16.90±3.81 vs. 19.98±4.89, P < 0.05), GCS score increased (14.12±4.12 vs. 12.31±4.14, P < 0.01), the length of intensive care unit (ICU) stay was shortened (days: 18.01±5.67 vs. 24.93±8.33, P < 0.01). CONCLUSIONS HBO treatment can significantly relieve the symptoms of patients with PSH after brain injury and provide a new idea for the treatment of PSH patients.
Humans ; Hyperbaric Oxygenation/methods* ; Retrospective Studies ; Brain Injuries/therapy* ; Female ; Male ; Prognosis ; Glasgow Coma Scale ; Autonomic Nervous System Diseases/etiology*

Objective To investigate the proper anesthetic administration schemes in pediatric patients undergoing surgery of transcatheter ventricular septal defect closure .Methods A total of 120 pediatric patients with congenital heart diseases of ventricu-lar septal defect ,aged 3-9 years old with ASA physiological status Ⅰ or Ⅱ ,undergoing surgery of transcatheter ventricular septal defect closure were randomly divided into 4 groups with 30 each :ketamine group( K group) ,propofol group( P group) ,ketamine associate with propofol ( KP group) ,sevoflurane group( S group) .Spontaneous respiration were maintained in K ,P ,PK groups ,but mechanical ventilation was adopted after endotracheal tube intubation in S group .The values of MAP ,HR ,SpO2 ,RR were recorded at the following time points :before anesthesia ,incision immediate ,procedure in heart ,completion of operation ,and 30min after oper-ation .awaking time and adverse reactions were recorded .Results Anesthesia and operation were carried out successfully in all pa-tients .Awaking time in P group and KP group markedly shorter than K group (P<0 .01) .The incidence rate of adverse reactions such as cough ,asphyxia and body motion in pediatric patients by mechanical ventilation and sevoflurane inhaled markedly less than other groups(P<0 .01) .Conclusion It is safe that pediatric patients received mechanical ventilation and sevoflurane inhaled after endotracheal intubation undergoing surgery of transcatheter ventricular septal defect closure .

Objective To compare the appfication of rapid sequence induce nasotracheal intobation with awake nasotracheal intubation with fiberoptic bronchoscope (FOB) in patients with cervical vertebra injury.Methods Forty patients with cervical vertebra injury were randomly divided into group (rapid sequence induce nasotracheal intubation with FOB) and group II (awake nasotracheal intubation with FOB),20 patients in each group.Bp,HR,SpO2 before and during intubation,intubafion time and cases of re-intubation were observed.Results SpO2 maintained normal during intubation.Between group I and group II,there was no significance in intubation lime [(3.12±0.52)min and (3.34±0.65)mini and cases of re-intubafion (2 cases and 1 case) (P ＞ 0.05 ).During intubation,MAP and HR inceased significantly in group II than those in group I (P ＜ 0.05 ).Conclusion The application of rapid sequence induce nasotracheal intubation with FOB is better than awake nasotracheal intubation with FOB in patients with cervical vertebra injury,it is safe and valid.