Hyperbaric oxygen preconditioning improves postoperative cognitive dysfunction by reducing oxidant stress and inflammation

Abstract

Postoperative cognitive dysfunction is a crucial public health issue that has been increasingly studied in efforts to reduce symptoms or prevent its occurrence. However, effective advances remain lacking. Hyperbaric oxygen preconditioning has proved to protect vital organs, such as the heart, liver, and brain. Recently, it has been introduced and widely studied in the prevention of postoperative cognitive dysfunction, with promising results. However, the neuroprotective mechanisms underlying this phenomenon remain controversial. This review summarizes and highlights the definition and application of hyperbaric oxygen preconditioning, the perniciousness and pathogenetic mechanism underlying postoperative cognitive dysfunction, and the effects that hyperbaric oxygen preconditioning has on postoperative cognitive dysfunction. Finally, we conclude that hyperbaric oxygen preconditioning is an effective and feasible method to prevent, alleviate, and improve postoperative cognitive dysfunction, and that its mechanism of action is very complex, involving the stimulation of endogenous antioxidant and anti-inflammation defense systems.

Hyperbaric Oxygen Therapy Improves the Osteogenic and Vasculogenic Properties of Mesenchymal Stem Cells in the Presence of Inflammation In Vitro

“…Several studies have demonstrated that, since exposure to hyperoxia in clinical HBO therapy is rather brief, cellular antioxidant defenses are adequate and biochemical stress related to increased ROS is reversible [43,44]. More interestingly, it has been reported that the initial oxidative stress induced by HBO therapy acts as a trigger mechanism stimulating antioxidative and anti-inflammatory responses in cells [45].…”

Hyperbaric Oxygen Preconditioning Can Reduce Postabdominoplasty Complications: A Retrospective Cohort Study

“…Several studies have demonstrated the efficacy of HBOT preconditioning in expected ischemia–reperfusion injury to the skin, spinal cord, brain, liver, kidney, and heart in various animal models. 9–13,16–19 In addition, some clinical studies in humans reported that HBOT preconditioning in patients with coronary artery disease before coronary artery graft bypass demonstrated decreased myocardial injury, decreased duration of postoperative stay in the cardiac intensive care unit, decreased blood loss, fewer postoperative complications, and lesser financial burden. 14,19 The results of this study support the use of HBOT as an effective preconditioning treatment before abdominoplasty.…”

An Extra Breath of Fresh Air: Hyperbaric Oxygenation as a Stroke Therapeutic

“…Additionally, HBOT serves a vital role in enhancing BBB stability through MMP regulation [ 23 ], and can also decrease intracranial pressure and relieve cerebral edema [ 31 ]. Secondary effects of HBOT in the ischemic brain may be prevalent, due to the reduction of extracellular glutamate levels, causing neural dysfunction and excitotoxic death [ 44 ].…”

“…Alongside protecting BBB integrity and minimizing edema, HBOT may also protect energy metabolism and tissue perfusion by stabilizing glucose levels, preventing glutamate levels from increasing, lowering lactate/pyruvate ratios, and increasing Ang-2 activity. Protecting energy metabolism gave therapeutic effects, including increased microvessel density, reduced brain injury, and alleviated post-ischemic neurological deficits [ 44 , 134 ].…”