Background: Persistent neurocognitive deficits associated with Post-Intensive Care Syndrome (PICS) impair functional capacity. HBOT increases oxygen availability under hyperbaric conditions and is discussed as a potential trigger for neuroplastic processes; consequently, valid measurements of cognitive domains are essential within the context of rehabilitation. Objective: To apply an assessment and evaluation framework for the quantitative measurement of neurocognitive deficits during HBOT, with a focus on domain-specific changes, rehabilitation-relevant linkages to functional outcome measures, and the methodological control of confounders and test artifacts. Methods: Neuropsychological assessments are conducted within a prospective study design. The test battery operationalizes defined cognitive domains. Concurrently, clinical parameters are collected to model non-specific influences on test performance. Primary endpoints are changes in domain-specific scores as well as aggregated performance indices. Intervention: HBOT is administered according to a standardized pressure and dosage protocol as an adjunct to structured neurological rehabilitation; adherence, the time interval relative to diagnostic assessments, and concomitant therapies are prospectively documented. A dosage rationale aligned with published RCT protocols facilitates the comparability of cognitive efficacy assessments. Results: The hypothesis posits that HBOT leads to significant improvements in relevant cognitive domains, thereby measurably reducing neurocognitive deficits to a degree relevant for rehabilitation. Conclusion: The proposed framework enables a structured, reproducible, and rehabilitation-relevant assessment of neurocognitive deficits during HBOT. It supports the evidence-based attribution of potential therapeutic effects to specific cognitive mechanisms and enhances comparability across studies and clinical settings.

Prof. Dr. med. Olaf Schedler is a specialist in anesthesiology with a clinical focus on emergency and intensive care medicine, as well as the specialized fields of aerospace and maritime medicine; he currently serves as Chief Physician of Hyperbaric Medicine at the Klinik Bavaria Kreischa. Furthermore, he is a prominent speaker and expert within the contexts of maritime, expedition, and extreme medicine.