Is there a role for hyperoxia in the management of severe traumatic brain injury?

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The pathophysiological features of neurotrauma, including traumatic brain injury (TBI) and spinal cord injury, involve a primary mechanical injury that reflects the complex interplay of contusion, compression, and shear and rotational forces as well as a series of vascular, metabolic, molecular, and inflammatory processes that synergistically culminate in a process termed secondary injury.2,5,8,9

Although improved outcomes after TBI have occurred due to the use of restraint systems in automobiles, protocol-driven critical care management, and judicious use of decompressive surgery, no significant attenuation of secondary injury mechanisms has yet occurred in the clinical setting,

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