Examples of Enhancing Treatment & Care with Hyperbaric Oxygen Therapy (HBOT): Baclofen Toxicity Resulting in Respiratory Arrest and Complete Global Ischemia in a Canine

A one year old, intact female Miniature Pinscher was reported to have ingested 2 to 3 (10mg) tablets of baclofen, a drug with effects similar to GABA. This drug is widely used in the management of multiple sclerosis. Neurologic signs ensued, including seizures, followed by coma. A respiratory arrest occurred, which required intubation and support on a mechanical ventilator for several hours. 

Intralipid and cyproheptadine were given, along with intensive supportive care.  Spontaneous respirations resumed, allowing removal from the ventilator. Several hours after spontaneous respirations resumed, pupillary light reflexes and doll’s eye responses remained absent.

A single HBOT session at 1.5 ATA for one hour was performed. Following the session, the patient’s neurologic function rapidly improved, and within 4 hours she was bright, alert, and able to exercise vigorously with normal strength and coordination.

Left: Pre-HBOT. Right: Four hours after one HBOT session.

Hyperbaric Oxygen Therapy has been shown to have beneficial effects in several models of Complete Global Ischemia in animals. HBOT results in reduced neuronal cell death, a reduction in neuroinflammation, and more rapid improvement in neurologic function recovery scores.

In 1996 Kondo et al demonstrated that HBOT given 6 hours after a 10 minute episode of complete global ischemia resulted in preservation of hippocampal neurons, and prevented delayed neuronal death (in the journal of Neuropathology and Applied Neurobiology, 22, pages 350-360)

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