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home : columns : ask the doctors June 24, 2018

   
6/12/2018 8:05:00 AM
Toddler's remarkable story highlights hyperbaric oxygen therapy

Dear Doctor: How did oxygen therapy help the brain of that toddler who almost drowned a few years ago? Has the child completely recovered from her near-death experience?

Dear Reader: The incident you're referring to happened in Arkansas in 2016, when a toddler who had just learned to walk managed to slip through a latched baby gate in her home. The little girl, who was 23 months old at the time, then entered her backyard, where she fell into the family's swimming pool. Although it isn't known exactly how long the child was in the water, news reports say it was at least five minutes and perhaps as long as 15 minutes. When her family found her, she wasn't breathing.

Despite nonstop CPR administered first by her mother and then by paramedics, it would be more than 1 1/2 hours before the child's heart began to beat on its own. At the hospital, MRI scans revealed extensive brain damage. When she returned home five weeks later, her profound brain injury was clearly apparent. The child had no motor control. She was unable to sit up or speak and had to take all nourishment through a feeding tube. Due to the brain injury, the toddler's body sometimes would "forget" to breathe while she was asleep. Alerted by a monitor, her parents would rush to resuscitate her.

Research into brain injuries and their treatment led the family to an expert in hyperbaric medicine at LSU Health New Orleans School of Medicine. Hyperbaric oxygen therapy is perhaps best known as the treatment used for decompression sickness, a complication that occurs when scuba divers resurface too quickly. It is also used to treat serious infections and wounds that won't heal. (Although some non-medical practitioners make claims that it can treat conditions like Alzheimer's disease, depression and spinal cord injury, there is no evidence of that at this time.)

In this type of therapy, the patient is provided with a higher percentage of oxygen than is available in the air we breathe. Most commonly, this involves a pressure-controlled chamber filled with pure oxygen. When the pressure of the chamber is raised -- it can be up to three times normal air pressure -- the lungs are able to deliver significantly increased amounts of oxygen to the tissues of the body.

In this case, oxygen delivered first via a tank and a mask, followed by several months of treatment in the hyperbaric chamber at the New Orleans clinic, had remarkable results on the child. She went from being profoundly injured to what her parents now say is a normal 3-year-old. Brain scans taken five months after the near-drowning reveal only mild injury to the brain. The shrinkage that accompanies serious brain injuries was also reversed.

It's not known exactly how hyperbaric oxygen therapy heals tissues at the cellular level. In this particular case, there is some speculation by researchers that the child's age, at which tissues are already rapidly growing, played a role in her recovery. The toddler's experience is unique enough that a case study was published last year in the journal Medical Gas Research.

Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.





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