Hyperbaric oxygen in the treatment of asphyxia in two newborn infants.

Hypoxic-ischaemic encephalopathy (HIE) is a common cause of brain damage in the neonatal period. Approximately 10% of births involve some degree of asphyxia, and 1% of these are severe. Current treatment has been limited to supportive measures and the recent use of hypothermia. Beneficial effects of hyperbaric oxygen treatment (HBOT) in neonatal asphyxia have been reported in the Chinese literature. We report the use of HBOT to treat two term neonates with moderate HIE according to Sarnat's classification. Clinical improvement occurred following HBOT. A 50% decrease in the total creatine phosphokinase (CPK) level and a 40% decrease in the CPK myocardial fraction were observed within 24 hours of the first treatment. The decline in CPK levels may be related to a reduction in the overall systemic inflammatory process and cannot be attributed solely to a reduction in brain damage. HBOT may have a role in HIE.