| |
Hyperbaric oxygen therapy (HBOT) involves the breathing of pure oxygen while in a sealed chamber that has been pressurized at 1.5 to 3 times normal atmospheric pressure. There is no scientific evidence to support these claims. Monoplace chambers house one individual placed in the supine position. Current chambers have an acrylic shell, which allows the patient to observe his or her surroundings. Oxygen is essential in a variety of enzymatic, biochemical, and physiologic interactions that promote normal cellular respiration and tissue function. Angiogenesis and epithelization also are oxygen dependent.
The remaining 2.5% is dissolved in plasma. The effects of Hyperbaric Treatments on the cardiovascular system include decreased heart rate, decreased cardiac output, possible slight increase in blood pressure and arterial vasoconstriction after load increases. Hyperoxygenation results in greater oxygen carrying capacity by the blood and increased oxygen defusion in tissue fluid. Fibroblast proliferation helps heal chronic wounds and treat radiation-induced injury.
As a primary therapy, Hyperbaric Oxygen is useful for treating:- Carbon monoxide poisoning
- Cerebral arterial gas embolus
- Decompression sickness
- Osteoradionecrosis
- Clostridial gas gangrene.
As a secondary therapy, Hyperbaric Oxygen assists with:- Radiation tissue damage
- Osteoradionecrosis prophylaxis
- Acute ischemia and/or crush injuries
- Necrotizing infections
- Acute exceptional blood loss
- Acute thermal burns
- Compromised skin grafts or flaps
- Selected problem wounds
- Refractory osteomyelitis.
HBO treatment increases the relative dose of oxygen; thus susceptible patients need to be recognized and modifications made to prevent the manifestations of oxygen toxicity. The most common barotrauma is middle ear injury. Do not use Hyperbaric Oxygen Therapy on patients with the following conditions, for the following reasons:- Claustrophobia - Anxiety
- Pneumothorax - Gas emboli, pneumomediastinum, pneumoperitoneum tension (pneumothorax), subcutaneous emphysema
- A history of spontaneous pneumothorax - Increased lung bleb incidence (pneumothorax)
- Chronic obstructive pulmonary disease (COPD) - Increased oxygen intolerance, increased risk of seizures
- Pneumocystic carinii pneumonia - Questionable fetal teratogen
- Seizure disorders - Barotrauma to sinus/ear/lung
- Pregnancy - Decreased threshold for oxygen-induced seizures (although HBO therapy may be required in pregnancy in situations of carbon monoxide poisoning, cerebral gas embolus, decompression sickness, or clostridial myonecrosis.)
- Upper respiratory infection - Increased hemolysis
- Hyperthermia
- Hereditary spherocytosis
- Optic neuritis - Possible increased optic nerve pathology
- Malignant tumors - possible increased vascularity for tumors
- Acidosis - Decreased threshold for oxygen seizures
- Steroid use - Decreased threshold for oxygen seizure
- Alcohol use - Dehydration (increased risk of decompression sickness)
- Nicotine use - Decreased seizure threshold.
|
|
|
