Saturday, April 03, 2010

Military plans to test brain-injury therapy

DENVER -- The U.S. military plans clinical trials next year to see whether breathing pure oxygen in a pressurized chamber might help thousands of Iraq and Afghanistan war veterans suffering from traumatic brain injuries.

About 300 service members with mild to moderate damage will participate in the trials of hyperbaric oxygen therapy to help determine whether it can help them heal, or at least ease the headaches, mood swings or other symptoms linked to brain injury.

Some will spend a total of 40 hours over 10 weeks breathing pure oxygen in a hyperbaric chamber, where the atmospheric pressure is increased to a level similar to what they would experience about 20 feet under water.

A control group will breathe room air in a hyperbaric chamber under conditions that will approximate the pressure the test group will feel.

Col. Richard Ricciardi, of Washington, D.C., with the Defense Center of Excellence, said Thursday the therapy is unproven but the clinical trials are warranted.

"There is sufficient evidence to say, 'You know what, we ought to take a look at it,'" said Ricciardi, research director for the Center of Excellence for Psychological Health and Traumatic Brain Injury.

The hypothesis is that oxygen dissolves more readily in the blood when the body is under pressure, and that if the blood delivers more oxygen to the body, it can help damaged tissue heal, Ricciardi said.

Dr. Mark Helfand of Portland, Ore., said the military trials are welcome news because some previous studies were not well done.

Helfand is a staff physician at the Portland Veterans Affairs Medical Center and director of the Oregon Evidence-based Practice Center, which does reviews for the federal Agency for Healthcare Research and Quality. He conducted a 2003 review of studies on using hyperbaric oxygen therapy for brain injuries.

"Most of the research didn't help us one way or the other. It was just too poorly done," Helfand said.

He said he's not familiar with any studies done since then.

The military is faced with a rising number of traumatic brain injuries because improved combat protection and medical care have allowed more service members to survive explosions and other traumas that would have been fatal in previous wars.

The Defense Department said more than 134,000 service men and women suffered traumatic brain injuries from 2003 through 2009.

The tests are expected to get under way in January or February at Fort Carson, Colo., Camp Pendleton, Calif., Brooks City-Base, Texas, and Camp Lejeune, N.C.. A fifth site will be designated later.

Before the trials, all the participants will undergo a four-day evaluation at Fort Carson and in Colorado Springs, adjacent to the post.

A preliminary trial involving 50 to 100 service members is planned this summer at Camp Pendleton to check the test methods.

The military trials are limited to mild to moderate brain injuries. Ricciardi said some civilian trials are under way on therapies for more severe injuries.

WaPo

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