Results Of Hyperbaric Oxygen Therapy Research Articles

Hyperbaric Oxygen Therapy for Nonhealing Wounds-A Long-term Retrospective Cohort Study.

To analyze wound healing results of hyperbaric oxygen therapy (HBOT) for a variety of different wound types. This retrospective cohort study included all patients treated with HBOT and wound care at a single hyperbaric center between January 2017 and December 2020. The primary outcome was wound healing. Secondary outcome measures were quality of life (QoL), number of sessions, adverse effects, and treatment cost. Investigators also examined possible influencing factors, including age, sex, type and duration of wound, socioeconomic status, smoking status, and presence of peripheral vascular disease. A total of 774 treatment series were recorded, with a median of 39 sessions per patient (interquartile range, 23-51 sessions). In total, 472 wounds (61.0%) healed, 177 (22.9%) partially healed, 41 (5.3%) deteriorated, and 39 (5.0%) minor and 45 (5.8%) major amputations were performed. Following HBOT, median wound surface area decreased from 4.4 cm 2 to 0.2 cm 2 ( P < .01), and patient QoL improved from 60 to 75 on a 100-point scale ( P < .01). The median cost of therapy was €9,188 (interquartile range, €5,947-€12,557). Frequently recorded adverse effects were fatigue, hyperoxic myopia, and middle ear barotrauma. Attending fewer than 30 sessions and having severe arterial disease were both associated with a negative outcome. Adding HBOT to standard wound care increases wound healing and QoL in selected wounds. Patients with severe arterial disease should be screened for potential benefits. Most reported adverse effects are mild and transient.

Assisted reproductive treatments with hyperbaric oxygen therapy in male infertility.

This study aimed to analyze the results of hyperbaric oxygen therapy (HBOT) in addition to assisted reproductive technologies in male infertility cases. Medical records of male infertility patients who had HBOT sessions for any reason between January 1, 2015-December 31, 2019, were analyzed retrospectively. A total of 15 male patients were included. Patients were classified as group 1 [DNA fragmentation (n=5)], group 2 [globozoospermia (n=5)], and group 3 [azoospermia (n=5)]. Round spermatid injection (ROSI), intrauterine insemination (IUI), or intracytoplasmic sperm injection (ICSI) procedures were performed in 10 of the 15 patients. A total of 31 embryos were obtained out of which 19 (61%) were transferred. While a total of 15 embryos were obtained in the globozoospermic group, which was the highest number, 10 were obtained from the azoospermic patients, and 6 from the DNA fragmentation patients (p=0.515). A total of 3 (30%) healthy pregnancies were obtained, overall. The mean sperm count of the patients (n=9) before HBOT was 8.4±11.1 mil/mL, while it was found to be 15.7±15.0 mil/mL after HBOT (azoospermic patients were not included). The TESE results were analyzed for azoospermic patients; positive changes were observed in 4 patients (80%). On the other hand, there was an improvement in 50% of group 1 according to sperm DNA fragmentation after HBOT (p=0.500). While a total of 15 embryos were obtained in the globozoospermic group, which was the highest number, 10 were obtained from the azoospermic patients.. Further studies should be conducted on HBOT and male infertility.

Hyperbaric oxygen therapy for radiation-induced tissue injury following sarcoma treatment: A retrospective analysis of a Dutch cohort.

Sarcomas are commonly managed by surgical resection combined with radiotherapy. Sarcoma treatment is frequently complicated by chronic wounds and late radiation tissue injury (LRTI). This study aims to gain insight in the use and results of hyperbaric oxygen therapy (HBOT) for radiation-induced complications following sarcoma treatment. All sarcoma patients treated between 2006 and 2017 in one of the five centers of the Institute for Hyperbaric Oxygen in the Netherlands were included for retrospective analysis. Thirty patients were included, 18 (60.0%) patients were treated for chronic wounds and 12 (40.0%) for LRTI. Two patients with chronic wounds were excluded from analysis as HBOT was discontinued within five sessions. In 11 of 16 (68.8%) patients treated for chronic wounds, improved wound healing was seen. Nine of 12 (75.0%) patients treated for LRTI reported a decline in pain. Reduction of fibrosis was seen in five of eight patients (62.5%) treated for LRTI. HBOT is safe and beneficial for treating chronic wounds and LRTI in the sarcoma population. Awaiting further prospective results, we recommend referring to HBOT centers more actively in patients experiencing impaired wound healing or symptoms of delayed radiation-induced tissue injury following multimodality sarcoma treatment.

Imaging-based predictors for hyperbaric oxygen therapy outcome in post-stroke patients. Report 1

We tested the hypothesis that if SPECT/CT-detected volumes of active and inactive parts of brain tissue present correlation with the results of hyperbaric oxygen therapy (HBOT) of ischemic stroke, SPECT imaging may serve as a selective tool for post-stroke patients to indicate cases that may significantly benefit from HBOT. A retrospective analysis was conducted on 62 consecutive patients administered for HBOT after the ischemic stroke episode. All patients received 60 daily hyperbaric sessions consisting of 90 min of exposure to 100% oxygen at a pressure of 0.2 MPa. The results of the treatment were assessed in correlation with SPECT/CT-detected changes of volumes of the penumbra area around the stroke zone. Patients who significantly benefitted from HBOT (n = 24) by an improvement of their clinical neurologic status and quality of life had the large penumbra zone (363 ± 20.5 ml) that was significantly diminished during HBOT. Patients who did not benefit from HBOT (n = 20) had a relatively small volume of the penumbra zone (148 ± 29.3 ml) and its further diminishing during HBOT was insignificant. The HBOT results were unclear in 18 patients with penumbra volumes between these values. These findings support our hypothesis that the large volume of the penumbra area around the stroke zone can serve as a significant predictor for positive clinical outcome following HBOT in post-stroke patients. The SPECT/CT-based assessment procedure of the volume of the penumbra may serve as an effective selecting tool when HBOT is administered for patients with ischemic stroke.

The role of hyperbaric oxygen therapy and antioxidant administration in treatment of idiopathic male infertility

Introduction. In clinical andrology practice, the cause of infertility in 40–70 % cases is idiopathic male infertility. The treatment involves empirical therapy based on the knowledge of spermatogenesis. In recent years, dietary supplements are used as the first line therapy of male infertility. Among these multicomponent dietary supplements are combination supplement for increasing male fertility Speroton and antioxidant complex Sinergin (Acvion, Russia). The study objective is to optimize the results of hyperbaric oxygen therapy (HBOT) in combination treatment of patients with idiopathic abnormalities in semen analysis. Materials and methods. The study included 155 males aged 20–45 years. Among them, 120 males were diagnosed with idiopathic infertility, 35 were practically healthy (control group). Patients with infertility (n = 120) were divided into 3 groups, 40 patients each. In all 3 groups, patients received HBOT in combination with Speroton and/or Sinergin: the 1st group (n = 40) received Speroton (1 sachet/day); the 2 nd group (n = 40) received HBOT and Sinergin (2 capsules/day); patients in the 3 rd group received combination of HBOT + Speroton (one sachet/day) + Sinergin (2 capsules/day). Patients in the 3 groups continued to receive the supplements 3 months after the completion of HBOT. The HBOT course consisted of 10 60-minute daily sessions. In patients of the 4 groups, including the control group, the levels of oxidative stress products and endogenous antioxidants activity in plasma and ejaculate were evaluated, as well as the main semen characteristics. Results. The administered therapies normalized thiol-disulfide metabolism in plasma and semen, antioxidant protection, and the main semen characteristics. In patients of the 1st group (HBOT + Speroton), sperm count in the ejaculate increased 3-fold compared to the baseline (before treatment), motile sperm forms increased 2.4-fold, the number of degenerated sperm cells decreased 1.3-fold. In the 2 nd group (HBOT + Sinergin), sperm count in the ejaculate increased 2.2-fold in the course of treatment, motile sperm count increased 2.7-fold, the number of degenerated sperm cells decreased 1.4-fold. In the 3 rd group (HBOT + Speroton + Sinergin), sperm count in the ejaculate increased 4.7-fold, motile sperm count – 5.3-fold, the number of degenerated sperm cells decreased 1.8- fold. Conclusion. Combined administration of Speroton and Sinergin in combination with HBOT has shown high effectiveness in correction of the main ejaculate characteristics and can be recommended as a therapy for various forms of asthenozoospermia.

Hyperbaric Oxygen Therapy for Pancreatic and Gastrointestinal Disease

We report the results of hyperbaric oxygen therapy (HBO) for pancreatic and gastrointestinal disease. Thirty-nine patients received 100% oxygen at 2 atmospheres absolute pressure for 60 min. Results: In all four patients with liver abscess, feverishness subsided within 2.7 days after the start of HBO. All of three patients with infection after hepatic resection were relieved of systemic inflammatory response system (SIRS) and showed reduced CRP levels after HBO. In all of seven patients with acute appendicitis, pyrexia was relieved at 1.8 days after HBO introduction, and further surgery was not necessary. Among five patients with colorectal disease, HBO was effective in four, but ineffective in one. Five of six cases of infection after pancreatic resection were cured immediately after HBO. There were no complications such as middle ear inflammation, oxygen intoxication or pneumothorax. Conclusions: HBO is sometimes effective for treatment of refractory gastro enteric infections, especially those for which drainage is difficult. Pyrexia improved within 2.3 days after the start of HBO in most cases. If infection is refractory to standard antibiotics or drainage, HBO should be considered as an additional treatment. Since HBO is safe and generally cost-effective, it should be considered as an adjunct therapy for all gastro enteric infections.

Hyperbaric oxygen treatment of superficial soft tissue lesions in children with oncologic disease

This study aimed to assess the feasibility and results of hyperbaric oxygen therapy (HOT) as supportive treatment of lesions of superficial soft tissues in children with oncological diseases. This was a retrospective analysis and review of all records of children observed at the Pediatric Hematology-Oncology Department of the University of Padova and treated adjuvantly with HOT. Between 1996 and 2010, 12 patients (5 males and 7 females, median age 7 years, range 0.5–16) underwent HOT. The effectiveness of HOT varied according to the lesion treated. Ten out of 12 patients were cured. Efficacy was most questionable in 2 patients with skin graft and flaps at risk. Compliance to therapy was close to 100%. In just one case, HOT was interrupted for the appearance of local skin metastases close to the site of primary tumor. HOT showed itself to be safe and effective in most patients even those immunocompromised or critically ill.

Improved Quality of Life with Hyperbaric Oxygen Therapy in Patients with Persistent Pelvic Radiation-induced Toxicity

Aims We report the results of hyperbaric oxygen therapy (HBOT) used in the treatment of radiation-induced persistent side-effects after the irradiation of pelvic tumours. Materials and methods Between January 2001 and December 2005, 13 women (median age 60.3 years) with radiation combined proctitis/cystitis ( n = 6), longstanding vaginal ulcers and fistulas ( n = 5) and longstanding skin injuries ( n = 2) underwent HBOT in a multiplace chamber for a median of 27 sessions (range 16–40). The treatment schedule was HBOT 100% oxygen, at 2 absolute atmospheres, for 90 min, once a day. For radiation-induced toxicity grading we used the National Cancer Institute Common Toxicity Criteria (CTC) grading system, before and after HBOT. Results Thirteen patients underwent an adequate number of HBOT sessions. The mean CTC grading score before HBOT was 3.3 ± 0.75, whereas the mean CTC grading score after HBOT was 0.3 ± 0.63. The scores showed a significant improvement after HBOT ( P = 0.001; exact Wilcoxon signed-rank test). Rectal bleeding ceased in five of six patients with proctitis and dysuria resolved in six of seven cystitis patients. Macroscopic haematuria stopped in seven of seven patients. Scar complications resolved in two of two patients. None reported HBOT-associated side-effects. Conclusion HBOT is apparently safe and effective in managing radiation-induced late side-effects, such as soft tissue necrosis (skin and vagina), cystitis, proctitis and fistulas.

Hyperbaric oxygen in the treatment of patients with cerebral stroke, brain trauma, and neurologic disease

Hyperbaric oxygen (HBO) therapy has been used to treat patients with numerous disorders, including stroke. This treatment has been shown to decrease cerebral edema, normalize water content in the brain, decrease the severity of brain infarction, and maintain blood-brain barrier integrity. In addition, HBO therapy attenuates motor deficits, decreases the risks of sequelae, and prevents recurrent cerebral circulatory disorders, thereby leading to improved outcomes and survival. Hyperbaric oxygen also accelerates the regression of atherosclerotic lesions, promotes antioxidant defenses, and suppresses the proliferation of macrophages and foam cells in atherosclerotic lesions. Although no medical treatment is available for patients with cerebral palsy, in some studies, HBO therapy has improved the function of damaged cells, attenuated the effects of hypoxia on the neonatal brain, enhanced gross motor function and fine motor control, and alleviated spasticity. In the treatment of patients with migraine, HBO therapy has been shown to reduce intracranial pressure significantly and abort acute attacks of migraine, reduce migraine headache pain, and prevent cluster headache. In studies that investigated the effects of HBO therapy on the damaged brain, the treatment was found to inhibit neuronal death, arrest the progression of radiation-induced neurologic necrosis, improve blood flow in regions affected by chronic neurologic disease as well as aerobic metabolism in brain injury, and accelerate the resolution of clinical symptoms. Hyperbaric oxygen has also been reported to accelerate neurologic recovery after spinal cord injury by ameliorating mitochondrial dysfunction in the motor cortex and spinal cord, arresting the spread of hemorrhage, reversing hypoxia, and reducing edema. HBO has enhanced wound healing in patients with chronic osteomyelitis. The results of HBO therapy in the treatment of patients with stroke, atherosclerosis, cerebral palsy, intracranial pressure, headache, and brain and spinal cord injury are promising and warrant further investigation.

Hyperbaric oxygen therapy in the treatment of chronic refractory osteomyelitis: a preliminary report.

Hyperbaric oxygen (HBO) has been proven to enhance bone and soft tissue healing in ischemic tissue in vitro and in vivo studies. Although only a few reports have been proven using controlled studies, this treatment modality remains encouraging for chronic refractory osteomyelitis. In this retrospective study, we reported the clinical results of HBO therapy for chronic refractory osteomyelitis. From January through August 2000, 14 patients with chronic refractory osteomyelitis of the tibias treated with HBO were available for follow-up examination. According to the Cierny-Mader classification, all patients were classified as type III or IV osteomyelitis. Adequate debridement and parenteral antibiotic treatment in conjunction with HBO therapy at 2.5 atmospheres absolute for 120 minutes, and 5 days per week regimen was used in all patients. The patients were followed-up for an average of 15 months after completion of HBO therapy. The most common infecting microorganism was Staphylococcus aureus. Mixed infections were usually found in patients with open fractures. The average number of operations before HBO therapy was 5.4 including soft tissue reconstruction in 11 patients. The average number of HBO treatments was 33.6 times. There were no HBO related complications. No recurrence of infection was noted in 11 patients, which resulted in a success rate of 79%. Hyperbaric oxygen therapy is effective and safe for chronic refractory osteomyelitis provided that patients had received appropriate medical and surgical management.

Hyperbaric oxygen – an effective tool to treat radiation morbidity in prostate cancer

Purpose: We report the results of hyperbaric oxygen therapy (HBO) used in the treatment of radiation cystitis and proctitis following irradiation of prostate cancer. Materials and methods: Between June 1995 and March 2000, 18 men (median age 71 years) with radiation proctitis ( n=7), cystitis ( n=8), and combined proctitis/cystitis ( n=3) underwent HBO therapy in a multiplace chamber for a median of 26 sessions (range 2–60). The treatment schedule (2.2–2.4 atmospheres absolute, 60 min bottom time, once-a-day, 7 days a week) was set at a lower limit of 20 sessions; the upper limit was left open to symptom-related adjustment. Prior to HBO treatment, RTOG/EORTC late genitourinal (GU) morbidity was Grade 2 ( n=3), Grade 3 ( n=6) or Grade 4 ( n=2); modified RTOG/EORTC late gastrointestinal (GI) morbidity was either Grade 2 ( n=4) or Grade 3 ( n=6). Results: Sixteen patients underwent an adequate number of sessions. RTOG/EORTC late GU as well as modified GI morbidity scores showed a significant improvement after HBO (GI, P=0.004; GU, P=0.004; exact Wilcoxon signed rank test); bleeding ceased in five out of five patients with proctitis and in six out of eight patients with cystitis; one of those two patients, in whom an ineffective treatment outcome was obtained, went on to have a cystectomy. Conclusions: HBO treatment seems to be an effective tool to treat those patients with late GI and GU morbidity when conventional treatment has led to unsatisfactory results. Particularly in patients with radiation cystitis, HBO should not be delayed too long, as in the case of extensive bladder shrinkage improvement is hard to achieve.

Successful treatment of radiation cystitis with hyperbaric oxygen.

This report describes the results of hyperbaric oxygen therapy in 10 patients with radiation-induced cystitis. Severe macroscopic hematuria was present in all patients and was resistant to current therapy. Previously 8 patients had been treated for bladder carcinoma and 2 for prostatic carcinoma with 60 Gy radiotherapy. Hyperbaric oxygen therapy consisted of 20 sessions of 100% oxygen inhalation at 3 bar pressure for 90 min. In 6 patients the macroscopic hematuria stopped completely and it decreased in the other patients. These 4 patients had recurrent or residual bladder malignancies.

Results of Hyperbaric Oxygen Therapy During Temporary Middle Cerebral Artery Occlusion in Unanesthetized Cats

We evaluated the effect of hyperbaric oxygen (HBO) therapy on neurological function and infarct size in 33 unanesthetized cats subjected to temporary 6-hour or 24-hour occlusion of the middle cerebral artery (MCA) 7 to 10 days after transorbital implantation of a vessel occluder. HBO therapy (100% oxygen at 1.5 atmospheres absolute) was administered for 40 minutes during or after 6-hour occlusions and before, during, and after 24-hour occlusions. Neurological function was graded on a scale of 0 to 10 every 30 minutes before, during, and after occlusion and HBO treatments until it stabilized and then daily until the cats were killed 10 days after occlusion. The results were compared with observations in 13 untreated controls and 6 cats that received 100% O2 at atmospheric pressure during a 6-hour MCA occlusion. HBO therapy during the 1st or 3rd hour of a 6-hour MCA occlusion resulted in a four-grade improvement of the initial neurological function; this effect persisted during the remainder of the occlusion. The average grade of neurological deficit at death was 94% less than in the untreated cats (P less than 0.03). Infarct size in the HBO-treated group was 58% less than in controls (P less than 0.03). There was no significant difference in infarct size between the untreated cats and those treated with 100% O2 at atmospheric pressure. HBO therapy during the 4th hour of a 6-hour MCA occlusion had no statistically significant effect on infarct size, even though the mean neurological deficit was 73% less than in controls (P less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Results of hyperbaric oxygen therapy during temporary middle cerebral artery occlusion in unanesthetized cats.

We evaluated the effect of hyperbaric oxygen (HBO) therapy on neurological function and infarct size in 33 unanesthetized cats subjected to temporary 6-hour or 24-hour occlusion of the middle cerebral artery (MCA) 7 to 10 days after transorbital implantation of a vessel occluder. HBO therapy (100% oxygen at 1.5 atmospheres absolute) was administered for 40 minutes during or after 6-hour occlusions and before, during, and after 24-hour occlusions. Neurological function was graded on a scale of 0 to 10 every 30 minutes before, during, and after occlusion and HBO treatments until it stabilized and then daily until the cats were killed 10 days after occlusion. The results were compared with observations in 13 untreated controls and 6 cats that received 100% O2 at atmospheric pressure during a 6-hour MCA occlusion. HBO therapy during the 1st or 3rd hour of a 6-hour MCA occlusion resulted in a four-grade improvement of the initial neurological function; this effect persisted during the remainder of the occlusion. The average grade of neurological deficit at death was 94% less than in the untreated cats (P less than 0.03). Infarct size in the HBO-treated group was 58% less than in controls (P less than 0.03). There was no significant difference in infarct size between the untreated cats and those treated with 100% O2 at atmospheric pressure. HBO therapy during the 4th hour of a 6-hour MCA occlusion had no statistically significant effect on infarct size, even though the mean neurological deficit was 73% less than in controls (P less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Results of hyperbaric oxygen therapy during temporary middle cerebral artery occlusion in unanesthetized cats

We evaluated the effect of hyperbaric oxygen (HBO) therapy on neurological function and infarct size in 33 unanesthetized cats subjected to temporary 6-hour or 24-hour occlusion of the middle cerebral artery (MCA) 7 to 10 days after transorbital implantation of a vessel occluder. HBO therapy (100% oxygen at 1.5 atmospheres absolute) was administered for 40 minutes during or after 6-hour occlusions and before, during, and after 24-hour occlusions. Neurological function was graded on a scale of 0 to 10 every 30 minutes before, during, and after occlusion and HBO treatments until it stabilized and then daily until the cats were killed 10 days after occlusion. The results were compared with observations in 13 untreated controls and 6 cats that received 100% O2 at atmospheric pressure during a 6-hour MCA occlusion. HBO therapy during the 1st or 3rd hour of a 6-hour MCA occlusion resulted in a four-grade improvement of the initial neurological function; this effect persisted during the remainder of the occlusion. The average grade of neurological deficit at death was 94% less than in the untreated cats (P < 0.03). Infarct size in the HBO-treated group was 58% less than in controls (P < 0.03). There was no significant difference in infarct size between the untreated cats and those treated with 100% O2 at atmospheric pressure. HBO therapy during the 4th hour of a 6-hour MCA occlusion had no statistically significant effect on infarct size, even though the mean neurological deficit was 73% less than in controls (P < 0.02). Cats treated with HBO during the 3rd hour of a 24-hour MCA occlusion had a four-grade (74%) improvement in neurological function (p < 0.02) and a 41% reduction in infarct size (P < 0.001) compared with the untreated controls. HBO therapy after 6-hour and 24-hour MCA occlusions was of no benefit. These results demonstrate that HBO therapy administered early after MCA occlusion had a significant protective effect during temporary regional ischemia in cats. (Neurosurgery 20:518-524, 1987)

Oxygen therapy.

Mea'iurements of abnormalities in the interrelationship of pulmonary ventilation and perfusion have become common in oxygen therapy. The techniques by which these measurements are now made and their value in guiding oxygen therapy are discussed. Each phase of oxygen transport to the tissues can be infiuenced by properly regulated oxygen therapy. Oxygen is a poison when given in too high a dose. Pulmonary oxygen toxicity occurs at tensions well below one atmosphere, and at higher tensions almost every cell in the body is affected. The results of hyperbaric oxygen therapy are frequently questionable, and the physiologic rationale often obscure; however, hyperbaric treatment, when properly regulated, will probably continue to have therapeutic application. Likely area‐i of usefulness for hyperbaric medicine are outlined.