Administration Of Hyperbaric Oxygen Therapy Research Articles

Penerapan Terapi Hiperbarik Oksigen Terhadap Penyembuhan Luka Pada Pasien Ulkus Kaki Diabetik: Studi Literatur

Background: Diabetic foot ulcers are advanced complications experienced by people with diabetes mellitus that have a negative impact and must be treated immediately. One method that can be done to overcome the incidence of diabetic foot ulcers is hyperbaric oxygen therapy. This therapy is known to facilitate wound healing by improving wound tissue perfusion, increasing fibroblast replication and collagen production and increasing phagocytic ability. Purpose: The purpose of this study was to determine the application of hyperbaric oxygen therapy to wound healing in diabetic foot ulcer patients. Methods: The method used in this writing is literature review, with secondary data obtained from previous research with empirical studies of the last 10 years, data sources are accessed through the google scholar database, by taking journals that are relevant to the research topic. Results: This study shows that the results that have been carried out on the administration of hyperbaric oxygen therapy to diabetic foot ulcers, show the ability to heal wounds in a fast time and more effective results. Conclusion: Based on the results of literature review research by collecting several journals, it is concluded that the management of hyperbaric oxygen therapy in diabetic foot ulcer patients is more effective, cost-effective, and increases the prevalence of wound healing.

Acute Coronary Syndrome Induced by Carbon Monoxide Intoxication: A Case Report

Carbon monoxide (CO) intoxication is the most frequent etiology of toxicological morbidity and mortality in the world. If the neurological manifestations are in the foreground, then cardiovascular signs of myocardial damage by necrosis are possible, which can result in angina, an acute coronary syndrome followed by myocardial stupor, collapse or even cardiac arrest.
 We report a case of CO intoxication inducing an acute coronary syndrome without ST elevation in an elderly diabetic patient with no coronary artery disease history.
 Diagnosis: This patient presented a CO intoxication after an accidental exposure; the electrocardiogram showed a depressed ST segment of the inferior and apico-lateral leads; cardiac enzyme troponins gradually increased. Echocardiography showed a preserved systolic function with a disorder of the heart wall motions. Coronary angiography revealed significant lesions of the proximal left anterior descending artery (LAD) and the first marginal evoking a diagnosis of acute coronary syndrome induced by CO intoxication.
 Interventions: His management consisted of the administration of hyperbaric oxygen therapy, a platelet aggregation inhibitor (aspirin plus clopidogrel), an anticoagulant (low molecular weight heparin) and myocardial support (Bisoprolol). Coronary angiography and the placement of two active stents were performed after 24hrs onset diagnosis.
 Results: The patient had a good clinical outcome under hyperbaric oxygen therapy, complete revascularization of the angiographic lesions which showed improvement in cardiac function and a slight improvement of heart wall motion on echocardiography performed on the 5th day. After 6 days, the patient had recovered well and was discharged from the hospital without chest discomfort, dizziness or headache.
 Lecture: This case suggests that the symptoms of carbon monoxide intoxication are complex and diverse. This can manifest as a primary hypoxic symptom or cause an exacerbation of underlying diseases due to hypoxia. Therefore, patients with carbon monoxide intoxication should actively seek a comprehensive cardiac examination to ensure early diagnosis. Whenever necessary, coronary angiography and stent implantation should be performed to improve the patient's chances of survival.

Simultaneous Administration of Hyperbaric Oxygen Therapy and Antioxidant Supplementation with Filipendula ulmaria Extract in the Treatment of Thermal Skin Injuries Alters Nociceptive Signalling and Wound Healing.

Background and Objectives: Thermal skin injuries are a prevalent cause of skin damage, potentially leading to severe morbidity and significant mortality. In this study, we intended to estimate the effects of HBO (hyperbaric oxygen treatment) and antioxidant supplementation with Filipendula ulmaria extract, individually and simultaneously, in the treatment of thermal skin injuries. Materials and Methods: As a thermal skin injury experimental model, we used two-month-old male Wistar albino rats. Thermal injuries were made with a solid aluminium bar at a constant temperature of 75 °C for 15 s. Hyperbaric oxygen treatment was performed in a specially constructed hyperbaric chamber for rats (HYB-C 300) for seven consecutive days (100% O2 at 2.5 ATA for 60 min). Antioxidant supplementation was performed with oral administration of Filipendula ulmaria extract dissolved in tap water to reach a final concentration of 100 mg/kg b.w. for seven consecutive days. Results: Simultaneous administration of hyperbaric oxygen therapy and antioxidant supplementation with Filipendula ulmaria extract significantly ameliorated the macroscopic and histopathological characteristics of the wound area and healing. Also, this therapeutic approach decreased the local expression of genes for proinflammatory mediators and increased the expression of the μ-opioid receptor and the MT1 and MT2 receptors in the wound area and spinal cord, with a consequent increase in reaction times in behavioural testing. Conclusions: In conclusion, the presented results of our study allow evidence for the advantages of the simultaneous employment of HBO and antioxidant supplementation in the treatment of thermal skin injuries, with special reference to the attenuation of painful sensations accompanied by this type of trauma.

Evaluation of the 2023 Kahramanmaras earthquake from the perspective of Plastic Surgery Department: A single-center experience.

The aim of this study was to evaluate the treatment management and demographic data of earthquake victims admitted to Plastic Surgery Department of our center after the 2023 Kahramanmaras earthquake. Between February 6th, 2023 and February 15th, 2023, a total of 120 patients (65 males, 55 females; mean age: 36.3±17.3 years; range, 85 to 88 years) who were consulted to the Plastic Surgery Department of our center were included. Demographic data of the patients, time to admission to the emergency room, removal time under the rubble, type of injury, emergency operation requirement, fasciotomy requirement, hyperbaric oxygen therapy administration, and length of stay in the intensive care unit were evaluated. After the first intervention, patients with compartment syndrome underwent emergency fasciotomy immediately. Perioperative laboratory values of the patients were followed closely to prevent the development of crush syndrome. Due to stay under the rubble, upper extremity soft tissue injury was seen in 46.2% of the patients. The pelvic and abdominal region were the least affected soft tissues in 1.7% patients. Fasciotomy was performed in 75 patients who stayed under the rubble. Hyperbaric oxygen therapy was applied to 21 of 75 patients who underwent fasciotomy. Amputation was performed in four patients, three of which were in the upper extremity and one in the lower extremity, during follow-up after fasciotomy. A total of 10.83% of the patients were treated conservatively and 11.67% of them were reconstructed with free flaps. Totally 7.5% of the patients who stayed under the rubble were hospitalized in our clinic for maxillofacial injuries. A total of 66.6% of these patients were treated surgically, while 33.3% of them were further treated conservatively. Proper triage, proper fasciotomy, and appropriate surgical interventions reduce the amputation rate, yielding clinically satisfactory results.

Recovery from the damage of cranial radiation modulated by memantine, an NMDA receptor antagonist, combined with hyperbaric oxygen therapy.

Radiotherapy is an important treatment option for central nervous system malignancies. However, cranial radiation induces hippocampal dysfunction and white matter injury; this leads to cognitive dysfunction, and results in a reduced quality of life in patients. Excitatory glutamate signaling through N-methyl-d-aspartate receptors (NMDARs) plays a central role both in hippocampal neurogenesis and in the myelination of oligodendrocytes in the cerebrum. We provide a method for quantifying neurogenesis in human subjects in live brain during cancer therapy. Neuroimaging using originally created behavioral tasks was employed to examine human hippocampal memory pathway in patients with brain disorders. Treatment with memantine, a non-competitive NMDAR antagonist, reversed impairment in hippocampal pattern separation networks as detected by functional magnetic resonance imaging. Hyperbaric preconditioning of the patients just before radiotherapy with memantine mostly reversed white matter injury as detected by whole brain analysis with Tract-Based Spatial Statics. Neuromodulation combined with the administration of hyperbaric oxygen therapy and memantine during radiotherapy facilitated the restoration of hippocampal function and white matter integrity, and improved higher cognitive function in patients receiving cranial radiation. The method described herein, for diagnosis of hippocampal dysfunction, and therapeutic intervention can be utilized to restore some of the cognitive decline experienced by patients who have received cranial radiation. The underlying mechanism of restoration is the production of new neurons, which enhances functionality in pattern separation networks in the hippocampi, resulting in an increase in cognitive score, and restoration of microstructural integrity of white matter tracts revealed by Tract-Based Spatial Statics Analysis.

A challenging journey of maxillofacial implants placement and rehabilitation in an irradiated exenterated socket

Rehabilitation of a post-exenterated orbital defect is a necessity, to restore a patient's esthetic appearance and help overcome the associated psychosocial stigma. An implant supported prosthesis enjoys a better patient acceptance due to its superior retention and stability. This clinical report highlights the challenges faced in planning, designing and placement of maxillofacial implants in the supra-orbital rim of an exenterated socket post-radiotherapy along with the management of the unexpected complications which developed subsequently. Administration of hyperbaric oxygen therapy, fabrication of a digitally designed surgical guide to ensure predictable implant placement, selection of surface treated implants for better biomechanical anchorage, and a gentler surgical technique for recovery of irradiated hard and soft tissues were measures undertaken during the treatment phase. An effort has been made to point-out the fact that despite the various approaches adopted in an irradiated patient, success of implant placement in such a situation remains a challenge.

Hyperbaric Oxygen Therapy and Vascular Complications in Diabetes Mellitus.

Vascular complications in patients with diabetes mellitus (DM) are common. Since impaired oxygen balance in plasma plays an important role in the pathogenesis of chronic DM-associated complications, the administration of hyperbaric oxygen therapy (HBOT) has been recommended to influence development of vascular complications. Hyperbaric oxygen therapy involves inhalation of 100% oxygen under elevated pressure from 1.6 to 2.8 absolute atmospheres in hyperbaric chambers. Hyperbaric oxygen therapy increases plasma oxygen solubility, contributing to better oxygen diffusion to distant tissues and preservation of the viability of tissues reversibly damaged by atherosclerosis-induced ischemia, along with microcirculation restoration. Hyperbaric oxygen therapy exerts antiatherogenic, antioxidant, and cardioprotective effects by altering the level and composition of plasma fatty acids and also by promoting signal transduction through membranes, which are impaired by hyperglycemia and hypoxia. In addition, HBOT affects molecules involved in the regulation of nitric oxide synthesis and in that way exerts anti-inflammatory and angiogenic effects in patients with DM. In this review, we explore the recent literature related to the effects of HBOT on DM-related vascular complications.

The influence of hyperbaric oxygen therapy (HBOT) to intercausal relationship between blood vessels, osteoblast, and new bone formation during maxillary suture expansion

Introduction: Expansion appliance that can imply tooth movement and opening maxilla suture might affect the blood vessels, bone cells, and formation of the new bone. HBOT accelerated the rate of osteoblast differentiation leading to an increase in bone formation during osteonecrosis. Research about HBOT during maxillary suture expansion has never been investigated. The purpose of this research was to correlate the blood vessels number, osteoblast by administered 2.4 ATA HBOT from day 8-14 to imply new bone formation during maxillary suture expansion. Methods: Eighteen male guinea pigs with randomised post-test only control group design divided into 3 groups. Negative control group K(-), positive control with expansion appliance K(+), expansion appliance and HBOT (P). After 14 days guinea pigs were decapitated. Histological slide of the blood vessels number, osteoblast, and new bone formation were examined under a light microscope then were analysed by regression test. Results: Descriptive test showed increasing blood vessels number, osteoblast, and new bone formation on the administration of HBOT during maxillary suture expansion. Regression test showed that there was a strong correlation between the blood vessels number and osteoblast to the new bone formation with R=6.95 during maxillary suture expansion. Conclusion: 2.4 ATA HBOT influences the intercausal relationship between increasing blood vessels number, increasing osteoblast, and new bone formation during maxillary suture expansion.

Effect of hyperbaric oxygen therapy to IFNγ and TNFα expression in pregnant Rattus novergicus infected with Tachyzoite of Toxoplasma gondii

Background: Hyperbaric Oxygen Therapy (HBOT) is a method of increasing oxygen delivery to tissues. The therapy improves tissue oxygenation and stimulates the formation of H2O2 as a secondary messenger for tumor necrosis factor alpha (TNFα), interferon gamma (IFNγ) and nuclear factor kappa beta phosphorylation (NF-kB) which play an important role in the rapid transcription of a wide variety of genes in response to extracellular stimuli. Aim: This study aims to determine the effects of Hyperbaric Oxygen therapy in enhancing the expressions of IFNγ and TNFα in pregnant rats infected with Toxoplasma gondii. Methods: This study is an animal study with a ‘randomized control group of post-test only design’ on 34 Rattus novergicus Sprague Dawley rats. Randomly, the rats were divided into four groups. The HBOT treatment group A is pregnant rats infected with tachyzoite received 10 sessions of HBOT 2.4 ATA in 3x30 minutes. B is Pregnant only and received 10 sessions of HBOT 2.4 ATA in 3x30 minutes. C ispregnant and infected with tachyzoite but not received HBOT. And the last, D is pregnant rats only without infection and not received HBOT. Each infected pregnant rats were given a 103 Tachyzoite of Toxoplasma gondii via intraperitoneal injection. Examinations of IFNγ and TNFα expressions were performed on day-5 after HBOT (HBOT twice a day). Rats that die or experience abortion will be eliminated while rats that still survive will be taken the blood by intracardiac technique. IFNγ and TNFα levels were measured by serum ELISA examination. Results: The results showed that the HBOT could improve IFNγ (p=0.000), TNF-α (p= 0.02) significantly in the provision of HBOT 2.4 ATA for 3x30 minutes in 10 sessions over five days of therapy. Conclusion: HBOT can improve the expressions of IFNγ and TNFα, in the provision of HBOT 2.4 ATA for 3x30 minutes, 10 times in 5 days and HBOT administration can prevent abortion in pregnant rats infected with tachyzoite T. gondii. Keywords: Toxoplasma gondii, Tachyzoite, Hyperbaric Oxygen Therapy, IFNγ, TNFα

Predictors for delayed encephalopathy following acute carbon monoxide poisoning

BackgroundIn Japan, many carbon monoxide (CO) poisoning cases are transported to emergency settings, making treatment and prognostic assessment an urgent task. However, there is currently no reliable means to predict whether “delayed neuropsychiatric sequelae (DNS)” will develop after acute CO poisoning. This study is intended to find out risk factors for the development of DNS and to characterize the clinical course following the development of DNS in acute CO poisoning cases.MethodsThis is a retrospective cohort study of 79 consecutive patients treated at a single institution for CO poisoning. This study included 79 cases of acute CO poisoning admitted to our emergency department after attempted suicide, who were divided into two groups consisting of 13 cases who developed DNS and 66 cases who did not. The two groups were compared and analyzed in terms of clinical symptoms, laboratory findings, etc.ResultsPredictors for the development of DNS following acute CO poisoning included: serious consciousness disturbance at emergency admission; head CT findings indicating hypoxic encephalopathy; hematology findings including high creatine kinase, creatine kinase-MB and lactate dehydrogenase levels; and low Global Assessment Scale scores. The clinical course of the DNS-developing cases was characterized by prolonged hospital stay and a larger number of hyperbaric oxygen (HBO) therapy sessions.ConclusionIn patients with the characteristics identified in this study, administration of HBO therapy should be proactively considered after informing their family, at initial stage, of the risk of developing DNS, and at least 5 weeks’ follow-up to watch for the development of DNS is considered necessary.

Delayed hyperbaric oxygen therapy induces cell proliferation through stabilization of cAMP responsive element binding protein in the rat model of MCAo-induced ischemic brain injury

Treatments that could extend the therapeutic window of opportunity for stroke patients are urgently needed. Early administration of hyperbaric oxygen therapy (HBOT) has been proven neuroprotective in the middle cerebral artery occlusion (MCAo) in rodents. Our aim was to determine: 1) whether delayed HBOT after permanent MCAo (pMCAo) can still convey neuroprotection and restorative cell proliferation, and 2) whether these beneficial effects rely on HBO-induced activation of protein phosphatase-1γ (PP1-γ) leading to a decreased phosphorylation and ubiquitination of CREB and hence its stabilization.The experiments were performed in one hundred thirty-two male Sprague–Dawley rats with the body weight ranging from 240 to 270g. Permanent MCAo was induced with the intraluminal filament occluding the right middle cerebral artery (MCA). In the first experiment, HBOT (2.5 ATA, 1h daily for 10days) was started 48h after pMCAo. Neurobehavioral deficits and infarct size as well as cyclic AMP response element-binding protein (CREB) expression and BrdU-DAB staining in the hippocampus and the peri-infarct region were evaluated on day 14 and day 28 post-MCAo. In the second experiment, HBOT (2.5 ATA, 1h) was started 3h after pMCAo. The effects of CREB siRNA or PP1-γ siRNA on HBO-induced infarct size alterations and target protein expression were studied. HBOT started with 48h delay reduced infarct size, ameliorated neurobehavioral deficits and increased protein expression of CREB, resulting in increased cell proliferations in the hippocampus and peri-infarct region, on day 14 and day 28 post-MCAo. In the acute experiment pMCAo resulted in cerebral infarction and functional deterioration and reduced brain expression of PP1-γ, which led to increased phosphorylation and ubiquitination of CREB 24h after MCAo. However HBOT administered 3h after ischemia reversed these molecular events and resulted in CREB stabilization, infarct size reduction and neurobehavioral improvement. Gene silencing with CREB siRNA or PP1-γ siRNA reduced acute beneficial effects of HBO. In conclusion, delayed daily HBOT presented as potent neuroprotectant in pMCAo rats, increased CREB expression and signaling activity, and bolstered regenerative type cell proliferation in the injured brain. As shown in the acute experiment these effects of HBO were likely to be mediated by reducing ubiquitin-dependent CREB degradation owing to HBO-induced activation of PP1γ.

Two Patients With Delayed Neuropsychiatric Sequelae Caused by Exposure to Carbon Monoxide Under the Same Conditions

Two Patients With Delayed Neuropsychiatric Sequelae Caused by Exposure to Carbon Monoxide Under the Same Conditions

Early Administration of Hyperbaric Oxygen Therapy in Distraction Osteogenesis - A Quantitative Study in New Zealand Rabbits

We investigated the effect of hyperbaric oxygen (HBO) therapy on the early phase of tibial lengthening in our established rabbit model. Twenty-four male rabbits (six per group) underwent right tibial lengthening by 5 mm. Group 1 then underwent 2.5 atmospheres of absolute hyperbaric oxygenation for 2 hours daily for 6 weeks postoperatively; group 2, for early 5 weeks (weeks 1-5), group 3, for late 5 weeks (weeks 2-6), and group 4 had no HBO therapy. Bone mineral density (BMD) was measured before surgery and weekly thereafter from weeks 2 through 6. The mechanical strengths of the lengthened tibias were measured. Significantly higher mean %BMDs were obtained for groups 1 and 2 compared with groups 3 and 4. There was no difference in the mean %BMD between groups 1 and 2 (p > 0.05). The results were similar for mean percentage maximal torque; group 1 had the maximum torque, followed sequentially by groups 2 though 4. The study results suggest that early and full-term administration of HBO therapy on tibial lengthening may achieve better benefits.

Delivery of hyperbaric oxygen therapy to critically Ill, mechanically ventilated children

Purpose :The purpose of this article is (1) to describe our method of mechanical ventilation and monitoring of critically ill children during administration of hyperbaric oxygen therapy (HBO 2) in a multiplace chamber; and (2) to review the complications they experienced during transport to the HBO 2 chamber and HBO 2 treatment. Materials and Methods :A case series from a universitya-ffiliated children's hospital and regional hyperbaric medicine treatment facility. Patients studied included all children who required HBO 2 therapy while mechanically ventilated at any time between April 1985 and June 1995. Results :Thirty-two children were treated with HBO 2 while mechanically ventilated. Ages ranged from 3 days to 11.3 years (mean 4.8 ± 3.5 years). There were 22 males. Twenty-one children had necrotizing infections, 9 had carbon monoxide (CO) poisoning, and 2 had iatrogenic arterial air embolism. Complications or events occurring during HBO 2 therapy included hypotension (63%), bronchospasm (34%), hemotympanum (13%), and progressive hypoxemia (6%). The only complication during transport was one accidental extubation (3%). Conclusion :Hyperbaric oxygen therapy can be administered safely to most critically ill children in a multiplace chamber if they are monitored closely. Although complications are not uncommon, most can be managed easily by a team skilled in treating ill children and knowledgeable of possible complications of HBO 2 therapy.

Hyperbaric oxygen therapy for gas gangrene in war wounds

Adequate and early debridement is still the most significant factor in the prevention of gas gangrene. But once gas gangrene has developed, administration of hyperbaric oxygen therapy before operation has proved a valuable adjunct to treatment in our experience.