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Hyperbaric oxygen therapy

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Hyperbaric Oxygen Therapy.
Hyperbaric Oxygen Therapy.
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Hyperbaric oxygen therapy

  1. 1. Hyperbaric Oxygen Therapy
  2. 2. Mechanism of Actions  Increased Oxygen Delivery  Henry's Law states that the amount of an ideal gas dissolved in solution is directly proportional to its partial pressure.  Thus, the dissolved plasma oxygen concentration of 0.3 mL/dL at sea level (1.0 atm) increases to 1.5 mL/dL upon administration of 100 percent oxygen  Hyperbaric oxygen delivered at 3.0 atm yields a dissolved oxygen content of 6 mL/dL
  3. 3. Mechanism of Actions  Reduction of Gas Bubble size  Base on Boyle's Law  The volume of nitrogen bubbles is inversely related to the pressure exerted upon it.  At 3.0 atm, bubble volume decreases by approximately two-thirds.  Further bubble dissolution is accomplished by the replacement of inert nitrogen within the bubbles with oxygen, which is then rapidly metabolized by tissues
  4. 4. Mechanism of Action  Improved wound healing  Generation of Oxygen free radicals  Fibroblast proliferation, angiogenesis, and wound healing  HBO augments neutrophil bactericidal activity, limits clostridial exotoxin and spore production, kills anaerobes such as Clostridium perfringens, and inhibits the growth of several other bacterial pathogens  Antagonism of Carbon Monoxide  HBO reduces half life of Carboxyhemoglobin from 4-6hrs to 15-30min
  5. 5. TECHNIQUE  Chamber pressure is usually maintained between 2.5 and 3.0 atm,  Treatment lasts for 45 to 300 minutes depending upon the indication.  Acute therapy may require only one or two treatments  Chronic medical conditions may warrant up to 30 or more sessions.  Pressures exceeding 2.8 to 3.0 atm, particularly over prolonged exposure hyperbaric periods, dramatically increase the risk of both neurologic and pulmonary oxygen toxicity
  6. 6. Complications  Middle ear Barotrauma is the most common side effect.  Sinus Barotrauma  Common if Upper respiratory tract infection or rhinitis present  URTI and rhinitis to be treated prior to HBO  Reversible myopia  Direct oxygen toxicity to lens  Pulmonary barotrauma  Rare  Seizures  CNS toxicity  Occurs if pressure >2.5-3atm  Duration >45minutes
  7. 7. Contraindications Absolute Relative  Untreated Pneumothorax  Obstructive lung disease  Asymptomatic pulmonary blebs or bullae on chest radiograph  upper respiratory or sinus infections  recent ear or thoracic surgery,  uncontrolled fever  claustrophobia

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