[On the opportunity of treating with hyperbaric oxygenation (hyperbaric oxygen) for the prevention of post-interventional anoxic encephalopathy (delayed neurologic sequelae)].
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Results for “Hyperbaric Oxygenation”
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Treatment of radiation-induced tissue injury by hyperbaric oxygen.
Hyperbaric oxygen therapy appears to be a beneficial adjunctive treatment modality in the management of radionecrosis of bone and soft tissue in the head and neck. The mechanism of such wound healing enhancement appears to be related to oxygen stimulation of fibroblastic activity and neovasculation. In this pilot study, involving 13 cases of refractory mandibular radionecrosis treated with hyperbaric oxygen, complete healing of soft tissue disease with covering of exposed bone has been noted in seven cases 11 to 27 months posttreatment; transient healing was seen in three cases; moderate to marked improvement in soft tissue disease has been noted in three cases. Pain relief was marked in six cases, moderate in four cases, and slight in one case of the 11 patients with significant pretreatment pain. Radiographic improvement was slight to moderate in ten cases. Four of the five patients with pathologic fractures developed a firm fibrous union of the mandibular segments during or shortly after treatment. Three additional cases of head and neck radionecrosis of other sites have noted significant improvement in their lesions during treatment. Three other patients with radionecrosis of the foot, hip, and vagina have also been treated with good results only in the vaginal case. None of the 19 patients treated with hyperbaric oxygen developed persistent or significant complications.
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[Microcirculation in patients with systemic scleroderma during treatment using hyperbaric oxygenation].
Hyperbaric oxygenation treatment of systemic scleroderma has a favourable effect on microcirculatory changes whose positive dynamics can be demonstrated by conjunctival biomicroscopy. These changes include accelerated blood flow and decrease in the degree of erythrocyte aggregation. The method can be used for the objective assessment and for prognosis of the effectiveness of hyperbaric oxygenation treatment in patients with systemic scleroderma.
Adult↗
Recovery of the hypoxic ventilatory drive of rats from the toxic effect of hyperbaric oxygen.
Hyperbaric oxygen (HBO) exposure reduces the hypoxic ventilatory drive (HVD), probably by damaging the carotid bodies. The recovery of the HVD from HBO exposure was studied. The HVD was calculated from whole body plethysmographic recordings of the ventilatory response to greater than 85% and 2% O2 in N2 mixtures. Five groups of rats were exposed to HBO for 9 h at pressures of 1.9, 2.0, 2.1, 2.2, and 2.4 ATA, respectively. Each rat underwent three control measurements on different days prior to HBO exposures and then at various intervals following the exposure. Postexposure HVD was reduced to 28% of control values in the high PO2s. Ninety percent recovery of pre-exposure HVD was evident by 12-48 h although in some animals exposed to relatively low PO2s (1.9 and 2.0 ATA) HVD stabilized at a level lower than 100%. The recovery of the HVD in percent during the first 4 d following exposure can be expressed as an exponential function of the time from the termination of HBO: HVD = 28 + 72(1 - exp-0.053t) (t in hours). This information may be of importance in cases of repeated exposures to HBO where one tries to avoid cumulative damage to the carotid bodies, and in the care of the poorly oxygenated patient after HBO treatment.
Air Pressure↗
[Reproducibility of somatosensory evoked potentials and EEG in normal humans under hyperbaric oxygenation].
Hyperbaric oxygenation (HBO) was reported to have a favorable influence on ischemic brain dysfunction, and also appeared to be useful in improving brain edema. Somatosensory evoked potentials (SEP) and EEG would be available as indicators of brain function. The purpose of this paper is to study reproducibility of the N1-amplitude of SEP and EEG under HBO. Materials were 10 normal volunteers, from 21 to 31 (mean age: 26) years old. Two stimulating needle electrodes were inserted into the skin at the wrist and somatosensory stimulations were applied to the median nerve with 1 msec duration square pulses. Stimulation pulses were generated regularly every 1 sec., and stimulus intensity was adjusted just above the thumb twitch threshold. Monopolar EEGs were recorded from 16 silver-cup electrodes on the scalp, and SEPs were recorded by averaging 250 responses in those EEGs using computer technique. N1-amplitude was determined by the vertical distance between peaks of the P1 and N1 components. EEGs were analyzed by Fast Fourier Transform and the square root of the averaged power of each frequency band (delta, theta, alpha 1, alpha 2, beta) was obtained and evaluated as the equivalent potential. EEGs under the influence of sleeping or artifacts, such as electromyograms, eye lid movements and wandering of the base line, were excluded in evaluating the EEGs. SEPs and EEGs recorded consecutively. The first record was taken before HBO under air breathing at 1ATA, the second during HBO under pure oxygen breathing at 2ATA, and the third after HBO under air breathing at 1ATA once again.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Indicators of the sympathetico-adrenal system in patients with peritonitis after hyperbaric oxygenation].
Hyperbaric oxygenation was used in 32 patients with acute peritonitis and terminal phases of the disease. Changes in the sympatho-adrenal system indices in the blood and excretion of catecholamines with urine during HBO course were investigated. The general pool of adrenaline and noradrenaline in the blood was shown to decrease, their excretion with urine to increase. Normalization of biosynthesis of precursors under the influence of HBO sessions was found.
Acute Disease↗
Osteoradionecrosis of the mandible. Treatment with hyperbaric oxygen.
Hyperbaric oxygen used in the treatment of 14 patients with intractable osteonecrosis of the mandible produced a favorable response in relief of pain, elimination of extraoral draining sinus tracts, the return of osseous union in areas of the abnormal fracture, and the rapid dissolution of sequestrum without suppuration, so that further loss of hard and soft tissue was minimized. This treatment is a more conservative approach in the management of osteoradionecrosis.
Adult↗
Management of chronic staphylococcal osteomyelitis of the temporal bone: the use of hyperbaric oxygen.
Hyperbaric oxygen (HBO) is an effective adjunct in the management of selected otolaryngologic problems including radiation-induced necrosis of the temporal bone, malignant external otitis, mandibular osteoradionecrosis and refractory osteomyelitis, soft tissue head and necrotizing fasciitis, compromised skin flaps and grafts, acute air or gas embolism, and otologic barotrauma. We describe the management of a patient with insidious Staphylococcus aureus osteomyelitis of the temporal bone by the use of HBO preoperatively and postoperatively in conjunction with surgical debridement. The possible application of angiogenic agents and tetracycline bone-labeling in combination with HBO therapy in the management of refractory neurotologic disease is discussed.
Chronic Disease↗
[Hyperbaric oxygenation in the overall therapy of chronic ischemic heart disease].
Seventy-seven patients with chronic ischemic heart disease were treated in single-seater oxygen hyperbaric chambers; 52 patients had angina pectoris of effort or angina of effort and at rest while 25 patients with macrofocal postinfarction cardiosclerosis had insufficiency of pulmonary or systemic circulation. Treatment consisted of 12--15 procedures. The use of hyperbaric oxygenation in a complex with drug therapy makes it possible to alleviate or arrest the attack of angina pectoris and relieve considerably the symptoms of cardiac decompensation. The initial condition of central hemodynamics affects greatly the results of barotherapy. Normal parameters of hemodynamics hardly change after treatment. At the same time, in patients with markedly reduced myocardial contractility hyperbaric oxygenation causes evident positive changes in hemodynamics. The combination of hyperbaric oxygenation with drug therapy improves the effect of treatment significantly.
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Hyperbaric oxygen therapy.
Hyperbaric oxygen therapy involves intermittent inhalation of 100% oxygen under a pressure greater than 1 atm. Despite over a century of use in medical settings, hyperbaric oxygen remains a controversial therapy. The last 20 years have seen a clarification of the mechanism of action of hyperbaric therapy and a greater understanding of its potential benefit. However, despite the substantial evidence that hyperbaric oxygen may have a therapeutic effect in certain carefully defined disease states, many practitioners remain unaware of these findings or are concerned about using hyperbaric therapy because of the controversy it has engendered. This review examines the indications currently considered appropriate for hyperbaric oxygen and briefly evaluates animal and clinical data substantiating these indications. Areas in which the mechanism of action of hyperbaric oxygen is still not well understood, as well as possible new areas of applications, are discussed.
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Post-traumatic limb ischemia: prediction of final outcome by transcutaneous oxygen measurements in hyperbaric oxygen.
In limb injuries (amputation, laceration injuries, or compartment syndrome), a circulatory insufficiency with a total or subtotal ischemia may occur and jeopardize the result of reconstructive surgery. Transcutaneous oxygen monitoring has been shown to reflect tissue perfusion and has been advocated to predict the final outcome of major vascular trauma of the limb. Unfortunately, in normal atmospheric conditions, this test is not sufficiently discriminative; we evaluate the effect of hyperbaric oxygen on the efficiency of this test. 23 patients with major vascular trauma of the limbs were evaluated by clinical examination and transcutaneous oxygen pressure (PTCO2) measurements. Sixteen had arterial repair and seven had clinical evidence of peripheral ischemia without an arterial lesion. In normal air, the transcutaneous oxygen values in the traumatized limb, of these 23 patients, were significantly lower than in the nontraumatized limb. But neither the absolute PTCO2 value nor the ratio between the traumatized limb's PTCO2 and that of the nontraumatized one can predict the final outcome (amputation). In hyperbaric oxygen (2.5 ATA), this ratio is significantly higher in the group where the surgery will succeed than in the group where final amputation will be needed (81.2 +/- 26.0 vs. 15.2 +/- 13.1; p less than 0.01). The overall sensitivity and specificity of prediction of the limb's final outcome when the bilateral PTCO2 ratio in 2.5 ATA pure oxygen is less than 0.40, are 100% and 94%, respectively. But what is perhaps more interesting is that, when considering a ratio value of less than 0.20, amputation can be predicted with a 100% true predictive value.(ABSTRACT TRUNCATED AT 250 WORDS)
Acute Disease↗
Hyperbaric oxygenation for experimental bladder tumor. II. Hyperbaric oxygenation in combination with chemotherapy in N-butyl-N-(4-hydroxybutyl)nitrosamine-induced bladder tumors.
Two series of experiments were conducted to ascertain whether hyperbaric oxygenation (HBO) treatment with or without antineoplastic chemotherapy can really suppress tumor development in N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN)-induced bladder tumor in rats. HBO treatment of 2 ATA of air saturating with 30-35% of oxygen for 90 min daily plus 0.5 mg/100 g body weight of 1-(4-amino-2-methyl-5-pyrimidinyl)methyl-3-(2-chloroethyl)-3-nitrosourea hydrochloride (ACNU) administration for 5 times suppressed the neoplastic spread of the bladder for 9 weeks and reduced the bladder weight in BBN-treated rats. Similar effects were also obtained in ACNU-treated rats, but to a lesser extent. HBO treatment associated with or without doxorubicin failed to suppress tumor growth in BBN-treated animals. Based on these findings combined with the previous study (part I), HBO treatment associated with ACNU might be available for the treatment of some cases of bladder tumors.
Animals↗
Hyperbaric oxygenation for experimental bladder tumor. I. Tissue oxygen tension of the rabbit bladder during hyperbaric oxygenation.
Although considerable advances have been made in the application of hyperbaric oxygenation (HBO) on tumor treatment in the recent past, many difficulties persist due to conflicting results and the understanding of its mechanism. We tested whether HBO treatment in clinical use could really influence the tissue concentration of oxygen in bladder or circulatory condition in animals. Eleven rabbits were treated with 1-3 atmospheric absolute pressures under an environment of air saturating 30-35% of oxygen for 90 min. Ten control animals were placed in the same chamber without providing HBO treatment. The tissue oxygen pressure in trigone or dome of the in HBO-treated group was significantly higher than that of the control group. A similar tendency was also noted in the arterial oxygen concentration to a greater extent, while regional blood flow in the bladder, mean arterial blood pressure and plasma volume were not significantly changed following HBO treatment. The use of HBO appears to offer some possibilities for the treatment of bladder tumor in the future.
Animals↗
Hyperbaric oxygen and stellate ganglion blocks for idiopathic sudden hearing loss.
Ninety-one patients suffering from idiopathic sudden hearing loss are presented. Twenty-two patients were given medical treatment (vasodilators, steroid hormones and vitamins) alone (group 1). Forty-nine patients were treated with stellate ganglion block (SGB) plus oxygen hyperbaric therapy (OHP) (group 2) and 20 patients were treated with SGB plus OHP along with medical treatment (group 3). The SGB plus OHP treated patients were given bupivacaine, which induced Moor's anterior approach of SGB and then exposed to oxygen at a pressure of 2.4 ATA for 90 min. In group 1, 69% of the patients treated within one week after onset exhibited over 10 dB pure tone average improvement, with only 33% patients treated one to two weeks after onset experiencing over 10 dB. However, 74% of the patients in group 2 and 100% of the patients in group 3 who were treated within two weeks after onset exhibited over 10 dB improvement. More significantly, of the patients which experienced complete loss of hearing, 83% in group 2 and 100% in group 3, exhibited over 10 dB improvement, compared to only 33% in group 1. Moreover, 8 (40%) patients in group 3 recovered to within 20 dB of their normal hearing levels. In group 2, 17 patients were treated two to six weeks after onset and 12 (71%) patients had over 10 dB improvement. SGB plus OHP therapy was shown effective in the treatment of sudden idiopathic hearing loss even when patients were treated more than two weeks after onset.
Adult↗
Fundamentals of hyperbaric oxygen therapy.
Hyperbaric oxygen therapy (HBO) is an adjunctive treatment used for wound healing. HBO treatments are given by increasing the atmospheric pressure in a chamber while the patient is breathing 100% oxygen. Many orthopaedic disease entities can benefit from HBO therapy. For the orthopaedic nurse to recognize potential HBO patients, a basic understanding of HBO therapy is necessary. Knowledge of diseases that can be treated with HBO, the side effects of HBO, and educating a patient for HBO therapy are all important aspects of hyperbaric therapy.
Humans↗
Reduction of rattlesnake-venom-induced myonecrosis in mice by hyperbaric oxygen therapy.
Hyperbaric oxygen therapy (HBOT) at 1, 2, and 2.75 atmospheres absolute (ATA) was used to treat rattlesnake (Crotalus atrox) venom-induced tissue damage and edema in thigh muscles of mice. Tissue damage was evaluated by double-blind histopathologic examination: tissue edema was determined by measuring tissue water content. A total of 10 intermittent exposures to oxygen over a period of 4 days at 2 and 2.75 ATA did not influence the resolution of venom-induced tissue edema, whereas tissue damage was significantly ameliorated as compared to air-treated envenomated controls. HBOT also promoted healing in the venom-injected mice as evidenced by the presence of regenerating muscle cells. It is concluded that HBOT may limit rattlesnake venom-induced myonecrosis and promote healing in a dose-response relationship without reducing venom-induced edema.
Animals↗
Efficient oxygen mask for patients undergoing hyperbaric oxygen therapy.
Hyperbaric oxygen (HBO) is established therapy for various disorders, but its effectiveness depends on the efficiency of the oxygen delivery system. A mask oxygen delivery system, consisting of the standard USAF aviator's A-14 regulator and the MBU-5/P oxygen mask, is installed in all USAF hyperbaric chambers. The efficiency of the mask oxygen delivery system at the USAF Hyperbaric Center, Brooks AFB, Tx, was evaluated breath-by-breath at sea level and 2.4 ATA via two different measuring techniques. Three groups of subjects were evaluated. Four subjects in Group I and seven subjects in Group II were randomly selected to use a single instrumented mask which was improperly fitted. The result was variable inspired oxygen levels from 64% to 100%. Six subjects in Group III wore properly fitted masks and achieved end-inspired oxygen levels ranging from 96% to 99%, for a mean of 97.8 +/- 0.5 (S.E.)%. A mean end-inspired oxygen level of 88,5 +/- 3,5 (S.E.)% was achieved within 5 min of mask donning. Inspiratory gas analyses indicate that the USAF aviator MBU-5/P mask and the A-14 regulator as used at the USAF Hyperbaric Center constitute a highly efficient oxygen delivery system for HBO therapy. This view has been refleced in arterial blood gas measurements and in preliminary data from tissue oxygen measurements in a gas gangrene patient. Future improvements in patient therapy masks are recommended.
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[Changes in gas metabolism and tissue oxygen balance during the hyperbaric oxygenation of patients with chronic thrombotic obliterating diseases of the extremities].
The study of some indices of external respiration through spirography, studies of acid-base status and oxygenation parameters of arterialized capillary blood, evaluation of tissue oxygen tension by means of polarography in 44 cases of chronic thromboobliterating disease of the extremities before and after therapy with 1.7--2.0 ata at 40 to 60 minutes exposure in single oxygen barochambers were carried out with the aim of investigation of alterations of gas exchange and tissue oxygen balance. It was found that in hyperbaric oxygenation the normalization of metabolic processes in an ischemic tissue takes place together with the elimination of oxygen deficit and deviations in acid-base status.
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