Hyperbaric Oxygen therapy helps toddler survive brain damage – case report

By Dr. Ananya Mandal, MDJul 20 2017

Eden Carlson, a two year old child had fallen into the family swimming pool. She was rushed to medical care but her heart had stopped beating for over two hours. A team of doctors used an innovative therapy with a combination of new oxygen therapies and the child was revived of the brain damage that she had suffered.

After the near drowning episode, the toddler suffered a deep injury to her grey matter of the brain. This led to cerebral atrophy which means that her brain matter was shrinking. An MRI on day 4 after the drowning showed the grey matter injury and on day 32 a repeat MRI of her brain revealed the atrophy of her brain.

She was drowned for nearly 15 minutes before she could be rescued. She had gotten through the baby gate while her mother was in a shower and had fallen into the pool. After the brain damage she was unable to speak, walk or respond to voices. She would only squirm with discomfort.

For her treatment the team of doctors used hyperbaric oxygen therapy (HBOT) to try to reverse the brain damage. The oxygen was administered at high pressure in a sealed chamber. This raised the oxygen in the child’s blood. She was given normobaric 100% oxygen treatment (2 L/minute for 45 minutes) using a nasal canula or tubes starting on day 56 after the drowning. Then from day 79 she received HBOT treatment at 1.3 atmosphere absolute (131.7 kPa) air/45 minutes, 5 days/week for a total of 40 sessions.

HBOT hyperbaric oxygen therapy chamber tank in hopsital medical center clinic. Image Credit: edwardolive / Shutterstock

With this treatment the child recovered from the brain damage and can now eat, speak and is alert and responsive to commands. She was soon laughing, moving her hands and feet increasingly, able to track objects with her eyes, grasping well with her hands, returning to her speech levels before drowning. Her vocabulary however seemed to have diminished a bit. The brain volume that was lost due to the drowning was also regained after the HBOT therapy, write the researchers. However she still has some residual impairment of finer movements of her fingers. But the overall development is visible.

After HBOT treatment the child underwent an MRI examination at 5 months after the incident and 27 days after the HBOT treatment was given. The ventricles or empty sac like spaces within the brain appeared to have normalized and further the cerebral atrophy of brain matter loss was seen to have been restored.

According to lead author of the case report and hyperbaric specialist Paul Harch from the LSU Health New Orleans School of Medicine, this treatment worked because the intervention was early and timely before the brain tissues could undergo degeneration and also because it was done on a growing child.

The case report was published this week in the journal Medical Gas Research. This was the first study where HBOT has been tried in a a pediatric drowning incident. Normobaric or normal oxygen therapy has been used in the past with moderate success. At present Eden is on physical therapy, speech therapy and occupational therapy.