Application Of Hyperbaric Oxygen Therapy Research Articles

Computerized planimetry evaluation of hyperbaric oxygen therapy in the treatment of diabetic foot.

Diabetic foot ulcer is one of the major complications of diabetes mellitus in adults. The aim of the study was to conduct a planimetry evaluation of the effectiveness of hyperbaric oxygen therapy (HBOT) in the treatment of patients with vascular disorders caused by diabetic foot. The study included 94 patients, 30 females (32%) and 64 males (68%), aged 33-76 years, with diabetes lasting 1.5-32 years, who underwent HBOT due to diabetic foot. All patients from that group underwent vascular procedures prior to HBOT. In qualifying patients for hyperbaric oxygen therapy, transcutaneous oximetry method was applied (30-60 exposures in hyperbaric oxygen at pressure of 2.5 ATA). Progress in wound healing was evaluated by computerized planimetry system IRIS 4. In 26 patients the wounds were completely closed and in 37 patients the topical state was significantly improved - the wound surface decreased by 34% in average. During the treatment, in 11 patients amputation of fingers and metatarsal necrotic bones was performed, while in 9 patients amputation was prevented. A planimetry evaluation showed that the application of HBOT in the treatment of diabetic foot enhances foot ulcer healing, reduces tissue damage, contributes to the reduction of complications related to soft tissue and bone infections.

Hyperbaric oxygen for idiopathic sudden hearing loss: is the routine application helpful?

Conclusion: We recommend the routine application of hyperbaric oxygen (HBO) in conjunction with intravenous steroid (IVS) for all patients with idiopathic sudden sensorineural hearing loss (ISSNHL). For best results, this therapy must be started within 14 days. Objective: To investigate the necessity of routine application of HBO therapy for ISSNHL. Methods: This was a retrospective cohort study. A total of 300 patients (300 diseased ears) were divided into 3 groups according to the therapy received: IVS (group A), HBO (group B), or IVS + HBO (group C). Patients in each treatment group were subdivided into subgroups according to the time of therapy initiation. The outcomes of their hearing recovery were classified into three recovery grades: good, fair, and poor. Results: The proportion of patients responding to therapy and those with complete recovery was the highest in the combined treatment group, 84% and 58%, respectively, regardless of the initial hearing levels. In all the groups, mean gains of cases in whom therapy was started in the first 2 weeks were significantly higher (p < 0.05) and hypercholesterolemia (>240 mg/dl) caused significantly worse responses (p < 0.05).

Effects of hyperbaric oxygen therapy on NACHT domain-leucine-rich-repeat- and pyrin domain-containing protein 3 inflammasome expression in rats following spinal cord injury.

The clinical application of hyperbaric oxygen therapy (HBOT) in spinal cord injury (SCI) has been reported, however the mechanism underlying its therapeutic effects remains to be elucidated. In the present study, SCI was modeled in male Sprague‑Dawley rats. A total of 120rats were randomly divided into four groups: Sham‑operated group (SH); sham‑operated and hyperbaric oxygen group (SH+HBO); spinal cord injury group (SCI) and spinal cord injury and hyperbaric oxygen treatment group (SCI+HBO). The rats in each group were randomly divided into five smaller groups (12h, 1, 3,7and 14days after surgery). The mRNA and protein expression levels of NACHT domain‑, leucine‑rich‑repeat‑ and pyrin domain‑containing protein3 (NALP3) inflammasome, including NALP3, adaptor molecule apoptosis‑associated speck‑like protein (ASC) and caspase‑1 were determined at several time points following injury. The results of the present study demonstrated that HBOT compromised the mRNA and protein expression levels of NALP3, ASC and caspase‑1 in the SCI model rats and HBOT mitigated SCI‑induced interleukin1β release in the injured spinal cord tissue. It was concluded that HBOT is an effective approach, which can prevent against spinal cord injury, likely by inactivating NALP3 inflammasome.

The Use of Hyperbaric Oxygen Therapy in Dentistry.

Dear Editor, We appreciate the article “Hyperbaric Oxygen Therapy(HBOT) - Can It Be the New Era in Dentistry?” written by Devaraj et al., [1]. In present review, the authors have mentioned the history, mode of action, indications, contraindications, complications and the applications of hyperbaric oxygen therapy in dentistry. Thanks to the authors for their contribution on the literature. HBOT is increasingly used to treat the many conditons. In the present review, HBOT is defined as administration of 100% oxygen to a patient with a pressure greater than one atmosphere at sea level. According to the Undersea and Hyperbaric Medical Society (UHMS) committee report 2003 and most hyperbaric medicine specialists, the oxygen pressure should be applied 1.4 atmospheres absolute (ATA) as the minimum therapeutic dosage to gain benefit from hyperbaric oxygen therapy. Besides the mentioned 13 approved indications of hyperbaric oxygen therapy, sudden hearing loss is also approved by UHMS Board of Directors since October 8, 2011 [2]. The authors stated “Asymptomatic pulmonary lesions which are seen on chest. X- ray” as one of the contraindications of hyperbaric oxygen therapy. We agree with the authors. Air cysts or blebs in the lungs may predispose pulmonary barotrauma (PBT) by causing air trapping. Interestingly, Toklu et al., surveyed 98 European HBO centres for their attitude to patients with bleb and bullae. They found that a significant portion of the HBO centers accept patients with pulmonary bleb or bullae, X-ray is the mostly used screening tool for patients with a history of pulmonary disease and the prevalence of pulmonary barotrauma in these centers was found only 0.00045%, surprisingly [3]. These study results make us to question the outcome of asymptomatic pulmonary lesions. Furthermore X-Ray screening tool has a low sensitivity for this kind of lesions. The authors mentioned about the pressure equalization problems which predominantly affect the middle ear and the nasal sinus. We think that additionally to these concerns, barotraumatic lesions can occur in any trapped air e.g. dental abscess after failed filling or in periodontitis and subgingival anaerobes which may cause gaseous lesions. These lesions can cause a very strong sharp pain particularly in the ascent phase of the hyperbaric oxygen therapy when the pressure decreases and volume begins to re-expanse. As a conclusion, hyperbaric oxygen therapy provides the most benefit in tissues with vessels which have good blood flow, the anatomical structure of the mouth with its rich vascular beds is an advantage to benefit from this treatment. So we support the idea of using this treatment modality in dentistry.

The effectiveness of hyperbaric oxygen therapy on mortality in adults with craniotrauma: a systematic review protocol

Review question/objective What is the effectiveness of hyperbaric oxygen therapy on the mortality of patients with craniotrauma? Inclusion criteria Types of participa nts Adults, who are over 18 years, with craniotrauma of various severity, including mild, moderate, severe, or duration, including acute and chronic. Patients with isolated craniotrauma or with craniotrauma in the context of polytrauma will also be included. Children, who are under 18 years, and adults who have atraumatic brain injury will be excluded. Types of intervention This review will consider studies that investigated the effect of hyperbaric oxygen therapy for 30 to 120 minutes at 1.5 atmosphere absolute to 3 atmosphere absolute. Studies in which hyperbaric oxygen therapy was administered up to 40 sessions per patient will also be considered. According to the critical status of patients, the application of hyperbaric oxygen therapy at different times at acute and chronic craniotrauma will also be considered: 1) Within the first 24 hours 2) After 24 hours 3) After 48 hours 4) After “stabilization” of patients (one week) 5) Chronic status. The effect of hyperbaric oxygen therapy will be compared against standard intensive care regimens, including neurointensive care monitoring, head elevation to 30°, sedation, paralysis, barbiturate-induced coma, cerebrospinal fluid drainage, artificial ventilation-appropriate oxygenation, osmotherapy, therapeutic hypothermia, hyperventilation, and decompressive craniotomy. Types of outcomes This review will consider studies that included the following outcome measures: overall mortality,long-term effect on cognitive-behavioral functions measured by any standardized scales any time after hyperbaric oxygen therapy; and oxygen supply improvement for brain tissues as measured by oxygen tension in brain tissue (P br O 2; local), cerebral venous oxygen saturation monitoring (SjO 2 ; global), cerebral perfusion pressure, intracranial pressure values before hyperbaric oxygen therapy and after hyperbaric oxygen therapy.

Evaluation of TCOM/HBOT practice guideline for the treatment of foot burns occurring in diabetic patients

ObjectivesA multidisciplinary team developed an evidence-based guideline for the management of foot burns occurring in diabetic patients that included transcutaneous oxygen measurements (TCOM) and application of hyperbaric oxygen therapy (HBOT) to selected patients. This report represents an evaluation of preliminary TCOM/HBOT data. MethodsThis is a retrospective review of patients with diabetes mellitus (DM) who were admitted to a single American Burn Association (ABA) verified burn center for the treatment of foot burns. Patients were treated via the guideline if they were over the age of 16, admitted for the initial care of burns involving the feet between 4/01/2012 and 7/22/2013, and had a known or new diagnosis of DM. ResultsEighteen patients were treated according to the guideline, 14 men and 4 women. Average age was 54 years+14.78. Average BMI was 30.63+6.34. Median burn size was 0.88% TBSA (median partial thickness of 1% and median full thickness of 0.5%). The average HbA1c was 9.08+2.42. Seven patients received pre-operative HBOT, two received post-operative HBOT and three patients healed their wounds with HBOT alone. Average hospital length of stay was 13.39 days+9.94 and was significantly longer for the group receiving HBOT. Admission HbA1c was not a predictor of the need for HBOT. ConclusionsWhile TCOM/HBOT therapy has not been widely applied to the management of diabetic foot burns, the use of an evidence-based guideline incorporating TCOM/HBOT can provide a systematic way to evaluate the patients’ microcirculation and ability to heal burns of the foot. The incorporation of TCOM determination and application of HBOT in selected patients with DM and burns of the feet warrant continued study.

Hyperbaric oxygen therapy - can it be the new era in dentistry?

Hyperbaric oxygen therapy is a rapidly developing treatment modality in various fields of dentistry. It is the administration of 100% oxygen to the patient for a specified time period, to increase the oxygen tension in the tissues and also its dissolution in the blood. This review aims to briefly discuss the history, mode of action, indications, contraindications, complications and the applications of hyperbaric oxygen therapy in dentistry.

Effect of hyperbaric oxygen therapy on cerebral vasospasm: a vascular morphometric study in an experimental subarachnoid hemorrhage model

This study was undertaken to investigate the preventive or therapeutic effect of hyperbaric oxygen therapy (HBOT) on cerebral vasospasm following experimental subarachnoid hemorrhage (SAH). Twenty rabbits were assigned randomly to one of four groups. Animals in Group I were not subjected to SAH or sham operation (control group, n = 5). Animals in Group II were subjected to sham operation and received no treatment after the procedure (sham group, n = 5). Animals in Group III were subjected to SAH and received no treatment after SAH induction (SAH group, n = 5). Animals in Group IV were subjected to SAH and received five sessions of HBOT at 2.4 atmospheres absolute (ATA) for 2 h (treatment group, n = 5). Animals were euthanized by perfusion and fixation 72 h after procedures. Basilar artery vasospasm indices, arterial wall thicknesses, and cross-sectional luminal areas were evaluated. Statistical comparisons were performed using Kruskal–Wallis and Mann–Whitney U tests. Mean basilar artery vasospasm index in the treatment group was significantly smaller than in the SAH group. Mean basilar artery wall thickness in the treatment group was significantly smaller than in the SAH group. Mean basilar artery cross-sectional luminal area in the treatment group showed an increase relative to the SAH group, but this difference remained statistically insignificant. Our results demonstrated that repeated application of HBOT at 2.4 ATA for 2 h attenuated vasospastic changes such as increased vasospasm index and arterial wall thickness. HBOT is thus a promising candidate for SAH-induced vasospasm. Further studies are needed to evaluate maximal effect and optimal application regimen.

Comparison of therapeutic results in sudden sensorineural hearing loss with/without additional hyperbaric oxygen therapy: a retrospective review of 465 audiologically controlled cases

To investigate the necessity of routine application of hyperbaric oxygen therapy for sudden sensorineural hearing loss. DESIGN/SETTING AND PARTICIPANTS: A retrospective chart review looked at 465 patients, with 353 of them receiving pharmacologic treatments alone. Among these patients, 76 underwent systemic steroid treatment only (steroid group) and 277 received systemic steroids and dextran (steroid-dextran group). The remaining 112 patients were treated with hyperbaric oxygen in addition to pharmacologic agents (steroid-dextran-hyperbaric oxygen group). The outcome was determined by comparing the difference of pure-tone thresholds and absolute hearing gains after treatment calculated at each audiometric octave frequency or grouped frequencies of audiograms. On the basis of the severity of initial hearing loss, patients were classified at three scales of hearing impairments measured in decibels hearing level (dBHL): ≦ 70 dBHL, less severe; 71-90 dBHL, severe; and ≧ 91 dBHL, profound. The outcomes of their hearing recovery were classified into three recovery grades: good, fair and poor. In those patients with initial hearing loss >90 dBHL, the addition of hyperbaric oxygen to steroid-dextran gave a significant hearing gain difference (P = 0.030) by showing a greater hearing gain of 24.5 ± 2.7 dB compared with steroid only (12.9 ± 3.7 dB) or steroid-dextran (15.6 ± 2.7 dB). This outcome was confirmed when we compared the outcome using the recovery grading; steroid-dextran-hyperbaric oxygen group showed that more patients with initial profound (≧ 91 dBHL) hearing loss responded to hyperbaric oxygen treatment by exhibiting good and fair recoveries (2% and 70%) as compared with steroid only (0% and 42%) or steroid-dextran (8% and 46%) groups (P = 0.043), while the patients with initial severe (71-90 dBHL) and less severe (≦ 70 dBHL) hearing loss responded to the addition of hyperbaric oxygen treatment with less favourable recoveries. Furthermore, the addition of dextran in steroid-dextran group showed no significant benefit compared with the steroid group (P = 0.435). When applied as an adjuvant to pharmacologic agents, hyperbaric oxygen benefits patients with initial profound sudden sensorineural hearing loss. Therefore, we recommend the routine application of hyperbaric oxygen in conjunction with pharmacologic agents for those patients. The addition of dextran to steroid has no benefit and cannot be recommended.

Crohn's disease and hyperbaric oxygen therapy

Evaluate the application of Hyperbaric Oxygen Therapy (HBO) in patients with Crohn's disease (CD) refractory to pharmacologic therapy, who developed abdominal, anorectal or skin complications. Fourteen selected patients with refractory CD and treated at the School of Medicine of Ribeirao Preto, University of Sao Paulo (FMRP-USP) and at the Center of Hyperbaric Medicine, São Paulo Hospital (CEMEHI) were submitted to HBO. Of the 14 patients evaluated, 11 had a satisfactory response. HBO has shown benefits in patients with CD refractory to pharmacologic therapy.

Avaliação funcional e histológica da oxigenoterapia hiperbárica em ratos com lesão medular

OBJETIVOS: Avaliar a eficácia da aplicação da oxigenoterapia hiperbárica em ratos Wistar, com lesão medular contusa produzida por equipamento computadorizado para impacto por queda de peso, NYU Impactor. MÉTODOS: Avaliaram-se 17 ratos machos com peso variando de 265 a 426 g; realizaram-se impactos com peso de 10 g de uma altura pré-determinada de 12,5 mm ao nível da décima vértebra torácica, após realização de laminectomia prévia. Os ratos foram divididos aleatoriamente em grupo controle e grupo oxigênio hiperbárico. Este último, submetido à tratamento com oxigenoterapia em câmara hiperbárica, durante uma hora diária por um período de 30 dias. A avaliação da recuperação locomotora foi realizada no 2º, 9º, 16º, 23º e 30º dia pós-operatório, avaliados através de escala funcional e o sítio de lesão submetido à exame anatomopatológico. RESULTADOS: Demonstrou-se melhora da recuperação locomotora nos ratos tratados com oxigênio hiperbárico nas fases iniciais de avaliação mas no final da avaliação não havia diferença estatisticamente significante entre ambos grupos. O exame anatomopatológico comprovou as alterações estruturais da medula espinal nos dois grupos. CONCLUSÃO: A lesão medular leve provocada nos ratos evoluiu de maneira diferente no grupo da oxigenoterapia hiperbárica comparativamente ao grupo controle, na fase inicial.

Hyperbaric oxygen therapy. Part 2: application in disease

Review the mechanisms of action and clinical application of hyperbaric oxygen therapy (HBOT) based on human and veterinary clinical and experimental literature. Pubmed and Veterinary Information Network databases were searched for human and veterinary journal articles on hyperbaric therapy in clinically applicable situations. Historical reference searches on several articles in addition to basic physiologic concepts were also reviewed. HBOT has gained acceptance as an adjunctive treatment in clinical conditions other than diving-related injuries, such as select problem wounds and central nervous system diseases, in human medicine. Access to hyperbaric therapy has increased and ongoing research has furthered understanding of the mechanisms and potential therapeutic uses of HBOT. Several animal models have been utilized to examine the effects of HBOT; primarily rodents (mice, rats) and rabbits but also dogs, cats, and pigs. Data related to animal model research as it pertains to clinical application of HBOT is reviewed. There is a substantial body of literature that has examined the adverse and beneficial effects of HBOT in animal models. As technology becomes more readily available to clinical practice and more clinical trials are performed to define its effectiveness, HBOT may be considered as an additional therapeutic option in many conditions including select problem wounds, spinal cord injury, and cerebral ischemic injury. Understanding the mechanisms by which HBOT exerts its effects will help guide research and use of the modality in clinical patients.

Atypical Calciphylaxis in a Patient Receiving Warfarin Then Resolving With Cessation of Warfarin and Application of Hyperbaric Oxygen Therapy

Calciphylaxis is a rare, usually fatal vasculopathic disorder characterized by cutaneous ischemia and necrosis due to calcification of arterioles. Although calciphylaxis is most frequently associated with end-stage renal disease (ESRD) and secondary hyperparathyroidism, it has been reported infrequently among patients on warfarin. No standard treatment has been established for atypical calciphylaxis; however, a potentially beneficial treatment is hyperbaric oxygen therapy (HBOT). A high degree of clinical suspicion, early diagnosis, and understanding the pathophysiology of this disease promotes the optimal management of this extremely morbid and often fatal condition. We present a 63-year-old Polynesian woman with biopsy-proven calciphylaxis in the absence of ESRD or elevated serum calcium levels while taking warfarin. Therapeutic dose enoxaparin was substituted for warfarin and she received 40 sessions of HBOT during which lower extremity ulcers resolved. Warfarin has been implicated when calciphylaxis presents in an atypical fashion. No guidelines exist for treatment of atypical calciphylaxis in the setting of concomitant warfarin therapy. Up to 80% of calciphylaxis patients die within 1 year of diagnosis. Our patient was changed to low-molecular-weight heparin and received HBOT. We present what we believe is the first case of atypical calciphylaxis thought to be attributable to warfarin treated with a therapeutic substitution of anticoagulant and HBOT leading to resolution of cutaneous lesions.

Effects of hyperbaric oxygen therapy after spinal cord injury: systematic review

OBJECTIVE: to conduct a systematic review of experimental and clinical studies evaluating the effect of hyperbaric oxygen therapy on the spinal cord injury. METHODS: ninety-three studies were identified in the database Pubmed. Among these, through a set of inclusion/exclusion criteria, 11 articles published between 1963 and 2009 were selected. In the nine experimental studies, different ways to apply the treatment were observed. The measured outcomes were: functional, histological, biochemical and electrophysiological. RESULTS: in most of the studies, the results show recovery of locomotor function, histology and/or biochemical features. Regarding the two studies in clinical samples, the results are controversial. The samples are heterogeneous and the application of hyperbaric oxygen therapy is not the same for all patients in each study. CONCLUSION: considering the results of this review, further studies are necessary to define the role of hyperbaric oxygen therapy in acute spinal cord injury.

A three species model to simulate application of Hyperbaric Oxygen Therapy to chronic wounds.

Chronic wounds are a significant socioeconomic problem for governments worldwide. Approximately 15% of people who suffer from diabetes will experience a lower-limb ulcer at some stage of their lives, and 24% of these wounds will ultimately result in amputation of the lower limb. Hyperbaric Oxygen Therapy (HBOT) has been shown to aid the healing of chronic wounds; however, the causal reasons for the improved healing remain unclear and hence current HBOT protocols remain empirical. Here we develop a three-species mathematical model of wound healing that is used to simulate the application of hyperbaric oxygen therapy in the treatment of wounds. Based on our modelling, we predict that intermittent HBOT will assist chronic wound healing while normobaric oxygen is ineffective in treating such wounds. Furthermore, treatment should continue until healing is complete, and HBOT will not stimulate healing under all circumstances, leading us to conclude that finding the right protocol for an individual patient is crucial if HBOT is to be effective. We provide constraints that depend on the model parameters for the range of HBOT protocols that will stimulate healing. More specifically, we predict that patients with a poor arterial supply of oxygen, high consumption of oxygen by the wound tissue, chronically hypoxic wounds, and/or a dysfunctional endothelial cell response to oxygen are at risk of nonresponsiveness to HBOT. The work of this paper can, in some way, highlight which patients are most likely to respond well to HBOT (for example, those with a good arterial supply), and thus has the potential to assist in improving both the success rate and hence the cost-effectiveness of this therapy.

Four Cases of a Cerebral Air Embolism Complicating a Percutaneous Transthoracic Needle Biopsy

A percutaneous transthoracic needle biopsy is a common procedure in the practice of pulmonology. An air embolism is a rare but potentially fatal complication of a percutaneous transthoracic needle biopsy. We report four cases of a cerebral air embolism that developed after a percutaneous transthoracic needle biopsy. Early diagnosis and the rapid application of hyperbaric oxygen therapy is the mainstay of therapy for an embolism. Prevention is the best course and it is essential that possible risk factors be avoided.

An Evidence-Based Review of the Neurological Applications of Hyperbaric Oxygen Therapy. Part 1

An Evidence-Based Review of the Neurological Applications of Hyperbaric Oxygen Therapy. Part 1

Interview with Dr. Paul Harch: the application of hyperbaric oxygen therapy and chronic neurological conditions

Interview with Dr. Paul Harch: the application of hyperbaric oxygen therapy and chronic neurological conditions

Investigation of the role of hyperbaric oxygen therapy in cisplatin-induced nephrotoxicity in rats

Cisplatin (CP) is an effective chemotherapeutic agent used in the treatment of a variety of solid tumours. The most frequently observed side-effect of the use of CP is nephrotoxicity. Recently, evidence has been demonstrated that reactive oxygen species forming in the tubular epithelium play an important role in CP-linked nephrotoxicity. The aim of the study was to observe the effect of hyperbaric oxygen (HBO) therapy on CP nephrotoxicity, a subject which has not been studied previously. Wistar rats were treated with CP (a single intraperitoneal (IP) dose of 0.6 mg/100 g) alone and in combination with HBO (60 min every day for seven days at 2.5 x atmospheric pressure). Effects of the treatment on renal function and histology were determined. In analyses at the end of the study it was observed that serum urea, creatinine, and daily urinary protein excretion levels of the CP group were higher than at the start of the study, and that the creatinine clearance level had fallen (P < 0.05). There was no significant difference between the CP+HBO group and HBO group serum urea, creatinine, creatinine clearance, and daily urinary protein excretion levels at the beginning and end of the study (P > 0.05). Histopathological examination showed that the necrosis score in the proximal tubule epithelial cells and average apoptitic cell numbers in the CP group were higher than those in the CP+HBO and HBO groups (P < 0.05). There was no statistical difference between the CP+HBO group and the HBO group in terms of necrosis score in the proximal tubule epithelial cells and the percentage of distal tubules containing hyaline casts in the lumen. In conclusion, in this study it was observed that in experimental study of CP nephrotoxicity the synchronous application of HBO therapy with CP prevents kidney damage.

Expanding Clinical Applications of Hyperbaric Oxygen Therapy

Alternative and Complementary TherapiesVol. 10, No. 2 ArticlesExpanding Clinical Applications of Hyperbaric Oxygen TherapySala HorowitzSala HorowitzSearch for more papers by this authorPublished Online:5 Jul 2004https://doi.org/10.1089/107628004773933316AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetails Volume 10Issue 2Apr 2004 Information© 2004 Mary Ann Liebert, Inc.To cite this article:Sala Horowitz.Expanding Clinical Applications of Hyperbaric Oxygen Therapy.Alternative and Complementary Therapies.Apr 2004.78-83.http://doi.org/10.1089/107628004773933316Published in Volume: 10 Issue 2: July 5, 2004PDF download