hyperbaric oxygen therapy

Cerebral ischemia is one of the common denominators of all acute cerebral le- sions, whether vascular or traumatic. Hyperbaric oxygen therapy (HBOT) could replace this oxygen deficiency and reverse a theoretically reversible process of ischemia before the formation of definitive lesions. Indeed, in experimental mod- els of head trauma or cerebral ischemia, HBOT has a neuroprotective effect linked to various mechanisms such as the modulation of oxidative stress, in- flammation and particularly mitochondrial brain metabolism. However, clinical trial results have been disappointing for cerebral ischemia and uncertain for head trauma. The possibility of combining inert gases at the HBOT session, in particular argon or xenon which has experimentally proven their neuroprotec- tive effects, could bring an additional benefit in the improvement of brain le- sions. Nevertheless, better targeted, multi-center and good quality studies are needed before definitively being sure of the efficacy of HBOT and the addition of an inert gas in the neuroprotection of acute brain lesions [20].

campus using real-time PCR and Western Blotting, respectively. After hyperbaric oxygen therapy, the Bim and YKL-40 expressions were greatly reduced, with an inhibition of the SE-induced cell apoptosis and inflammatory response according to TUNEL assay. This pre- dicted a better prognosis in SE. The results of behavioral monitoring showed that the onset number of spontaneous seizures reduced remarkably after the hyperbaric oxygen thera- py; the spatial learning and memory ability of rats receiving the hyperbaric oxygen therapy was also improved effectively in the Morris water maze experiment. Thus hyperbaric oxy- gen therapy relieved the symptoms of SE and reduced the frequency of onset.

Objectives: We review outcome studies regarding the effectiveness of hyperbaric oxygen therapy (HBOT) for Autism Spectrum Disorders (ASD). Method: Studies were identified through electronic bibliographic databases and manual searches of article reference lists. Results: A total of 8 studies met eligibility criteria, consisting of three randomized controlled trials (RCTs), one quasi-experimental study involving a comparison group, two pre-experimental one-group pretest–posttest studies, and two single-system designs. Studies reviewed did not offer credible evidence to suggest that HBOT is an effective treatment for autism. Conclusion: It is premature to call HBOT an effective treatment for Autism and ASD. Individuals clinically treated with HBOT outside the context of a RCT should have the effects of the therapy evaluated using rigorous single-subject designs.

Tlenoterapia hiperbaryczna (HBO) jest oddychaniem 100% tlenem w warunkach podwyższonego ciśnienia o war- tości przynajmniej 1,4 atmosfer. W tej metodzie wykorzystuje się tlen jako środek leczniczy. Dochodzi do roz- puszczenia go w surowicy i roznoszenia do tkanek. Tlenoterapia hiperbaryczna sprzyja wrastaniu nowych naczyń krwionośnych w obszarach niedokrwionych tkanek spowodowanych ich gorszym unaczynieniem oraz gojeniu ran i leczeniu napromieniowanych tkanek przez fibroplazję i działanie przeciwbakteryjne. Guzy mogą być uwrażliwia- ne na radioterapię przez podniesienie wewnętrznego ciśnienia tlenu. Autorzy opisali wpływ tlenoterapii hiperba- ryczej na przemiany molekularne, biochemiczne i komórkowe w napromieniowanych tkankach. Próbowali także ustalić znaczenie tej metody w onkologii guzów w obrębie głowy i szyi, w chirurgii plastycznej i szczękowo-twa- rzowej, a zwłaszcza w leczeniu martwicy popromiennej, zapaleniach kości i utrudnionym gojeniu ran. Tlenoterapia hiperbaryczna może być stosowana podczas pierwotnej radioterapii w celu zwiększenia jej skuteczności i przeciw- działaniu powikłaniom popromiennym oraz w leczeniu późnych jej następstw w obszarze głowy i szyi jako terapia wspomagająca. Autorzy ocenili bezpieczeństwo stosowania HBO (hyperbaric oxygen therapy) i jej związek ze stre- sem oksydacyjnym i emisją reaktywnych form tlenu (Dent. Med. Probl. 2011, 48, 1, 55–60).

Introduction: Hyperbaric oxygen therapy (HBO) is emerging as an alternative technique for treating refractory intersti- tial cystitis (IC). The theory is that the increased dissolved oxygen in the blood raises the levels of oxygen in the tissues and improves tissue healing. Other urological disorders such as radiation cystitis, Fournier’s gangrene and cyclophos- phamide cystitis have also shown a good response to HBO therapy. Method: A literature search with the terms “inter- stitial cystitis”, “painful bladder syndrome” and “hyperbaric oxygen therapy” found four papers that have trialed HBO therapy in IC patients; three case series and one randomized control trial. Results: A total of 31 patients have been treated with HBO therapy. All four studies show a symptomatic improvement in pain, urgency, bladder capacity and O’Leary-Sant interstitial cystitis index. Urinary frequency only improved in three out of four of the trials. The percent- age of patients considered as responders to treatment varied at 25%, 66.7%, 82% and 100%. Conclusion: Preliminary trials of HBO therapy seem to have a good patient response with effective symptomatic relief. The patient response rates varied greatly between the trials. This is due to each trial’s different definition of a “patient responder”. Further work in urology departments at HBO centers is required to further assess the benefits of HBO treatment in IC.

Hyperbaric oxygen therapy (HBOT), which utilizes both high pressure and high concentrations of oxygen, in multiple daily sessions per patient, has the potential to induce pulmonary oxygen toxicity. Two previous studies evaluated the effects of repetitive HBOT on pul- monary function. Pott et al. [7] studied 14 patients who underwent 30 daily sessions of 90 min exposure to 2.4 ATA pure oxygen in a monoplace chamber. Patients were exposed to hyperoxia without any air breaks during the sessions. There were no significant changes in forced vital capacity (FVC) or diffusing capacity. Furthermore, most of the patients in this study were heavy smokers with impaired diffusing capacity at baseline. Thorsen et al. [8] included 20 patients who underwent 21 repetitive daily HBOT sessions. The protocol included 90 min of 2.4 ATA 100% oxygen in 3 cycles of 30 min each, separated by two 5 min breaks where patients breathed air in-between (“air breaks”). There were no significant changes in FVC, forced expiratory flow at 25% of pul- monary volume (FEF25%) or peak expiratory flow rate (PEF). However, there were significant reductions in forced expiratory volume in 1 second (FEV1). No signifi- cant change was noticed in diffusing capacity.

Background. Diabetic foot ulcer is one of the major complications of diabetes mellitus in adults. Objectives. 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. Material and methods. 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. Results. In 26 patients the wounds were completely closed and in 37 patients the topical state was signifi- cantly 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.

Pervasive developmental disorders is umbrella of five disorders: Autistic disorder, Asperger's Pervasive developmental disorder not otherwise specified, Rett’s disorder and Childhood disintegrative disorder. Each one differ than other in degree of symptoms. Generally, all of them g autistic children are better in response to treatment by either hyperbaric oxygen therapy or combination of hyperbaric oxygen therapy and Risperidone. They have better cognitive abilities. Therefore, this study aimed to determine effects of hyperbaric oxygen therapy and Risperidone in decreasing degree of autism and to predict risk factors that leads to sever autism. The sample consisted of 80 Egyptian autistic children aged 5-7.They diagnosed and followed (CARS2) between 2015 and 2017. Our studied (80%) male and (20%) female, after adjustment for familial, socio-demographic and individual factors. We concluded that hyperbaric oxygen therapy alone or combination of hyperbaric isperidone has superior effect than Risperidone alone in decreasing degree of autism. In addition, positive consanguinity is a risk factor for severity of autism.

Cerebral palsy manifests itself in the form of multiple syndromes mainly related to posture and mobility disorders. Brain injury is the major cause of this medical condition. Cerebral palsy is prevalent among young children, with about 50 percent of such children having been born premature (Montgomery et al., 1999). Treatments, including pharmacology and surgery, focus on increasing motor functions by lowering the chances of experiencing spasticity. However, these medications may have unintended outcomes on children. For instance, those with spasticity are required to undergo various surgical processes that, in turn, may result in further complications. As this paper reveals, hyperbaric oxygen (HBO) therapy is used as an alternative to these procedures. Nevertheless, it has effects that have led to wide scholarly discussions regarding its efficacy in the treatment of cerebral palsy patients. Effects of Hyperbaric Oxygen Therapy

Idiopathic sudden sensorineural hearing loss (ISSHL) is an otologic emergency that can provoke anxiety in the patient and can be clinically challenging for the practitioner. The natural history of the condition can be as varied as its possible etiologies. Adding to the clinical challenge is the current debate of treatment modalities available. In what follows, we provide a case detailing our treatment course, including the novel use of hyperbaric oxygen therapy (HBOT) as an emerging therapy for sensorineural hearing loss. Additionally, we provide a brief review of the current state of treatment options available in the armament for ISSHL. As no identifying information is contained in our discussion, we believe the privacy of the patient has been protected and, as such, feel our manuscript is exempt from prior Institutional Review Board (IRB) approval.

Background: Radiation therapy is performed as an adjuvant therapy when indicated following surgical resection of malignant tumors. However, radiation exposure induces acute or chronic dermatitis, depending on the radiation dose, interval, tissue volume, or irradiated area of the body. Radiation-induced skin ulcers and osteomyelitis of the underlying bone are intractable late-stage complications of radiation therapy, and often require reconstructive surgery to cover exposed tissue. Hyperbaric oxygen therapy has been suggested as a treatment for delayed radiation injury with soft tissue and bony necrosis.

therapy for secondary prevention including aspirin 81 mg daily and a lipid lowering medication along with physical therapy and speech therapy. The patient required thera- peutic hypertension due to blood pressure-dependent mental status and aphasia fluctuations indicating unstable collaterals. Therapeutic hypertension using vasopressors was maintained for 2 days post-stroke. Systolic blood pres- sure was maintained between 160 and 180 mmH2O. However, the patient received five sessions of hyperbaric oxygen therapy (HBOT; hyperbaric chamber, model 3300, company’s name: Sechrist, Anaheim, CA, USA, year of manufacture: 2010) over a 2-week period that started in post-stroke day 2 (after stopping therapeutic hyperten- sion). HBOT was performed in post-stroke day 2 (PSD-2), PSD-4, PSD-7, PSD-10, and PSD-15. During that period, permissive hypertension was allowed. Systolic blood pressure was running between 100 and 140 mmH2O. Each HBOT session consisted of 2-h 100% O 2 at 2.5 ATA.

Hyperbaric Oxygen Therapy (HBOT) is a medical procedure and therapeutic modality that utilizes 100% oxygen. HBOT has been used various medical conditions such as progressive necrotizing fasciitis, peripheral arterial insuffi- ciency, and diabetic wounds of the lower extremities. The case report reported here describes the usage of HBOT as an adjunctive “rescue” measure to sal- vage a patient’s cranioplasty scalp flap after flap ischemia was noted 2 days post-operatively. Patient is a 54 year-old caucasian female who presented to our facility with symptoms of a left MCA infarct. CT and MRI of her brain revealed a left MCA infarct with hemorrhagic stroke with significant cerebral edema, and midline shift. She was taken to the operating room for a left de- compressive hemi-craniectomy. She had cranioplasty utilizing native bone flap delayed fashion. She had wound infection after cranioplasty which re- quired removal of native bone. After appropriate treatment for infection, she had cranioplasty utilizing prosthetic Biomet implant. Post-cranioplasty, pa- tient developed ischemic cranial flap. This was recognized within 48 hrs and HBOT was implemented. She has a successful rescue of the ischemic cranial flap after she received 14 consecutive treatments over two weeks. In our knowledge, this is the first successful treatment of HBOT reported after pros- thetic cranioplasty for scalp flap ischemia.

Diabetic foot ulcers (DFUs) are the most common musculoskeletal infections and complications in patients with diabetes mellitus. DFUs require comprehensive multidisciplinary treatment and also long period time of healing. Hyperbaric oxygen therapy (HBOT) is one of adjuvant therapy for DFUs with promising results. The aim of our study was to test the hypothesis that serum album in patients with DFU is affected by HBOT. We used randomized pre- and post-test control group design with permuted block from all patients who met the inclusion criteria. We recruited 36 patients who then divided into two groups, HBOT and non HBOT group. Each patient’s blood sample was taken twice, before and after therapy. HBOT group showed significant increase in serum albumin, from 2.96 ± 0.43 g/dL to 3.51 ± 0.46 g/dL (p < 0.0001) while non HBOT group did not show any significant change, from 2.92 ± 0.51 g/dL to 3.01 ± 0.41 g/dL (p = 0.440). We also calculate the effect size of serum albumin increased level. The effect size was differed significantly between HBOT and non HBOT groups (0.55 ± 0.38 g/dL and 0.09 ± 0.49 g/dL, p = 0.007). There is a significant increase in serum albumin level in DFUs patient who underwent HBOT therapy.

All patients from both groups were referred for HBOT after ineffective conservative treatment: compression therapy, targeted antibiotic treatment, local use of an- tiseptics, phlebotropic drugs, diabetes medications, and special dressings. Before the beginning of treatment in the hyperbaric chamber, all patients were prepared and qualified for HBOT by their physicians-in-charge or were referred to the Hyperbaric Oxygen Therapy Unit at the Dr Stanisław Sakiel Centre for Burns Treatment in Siemianowice Śląskie (Poland) after hospitalization at internal medicine, surgery or dermatology depart- ments, or after outpatient treatment. The patient’s quali- fication for HBOT was finally approved by a multidisci- plinary medical council. Apart from the medical history, physical examination and photographic documentation, planimetric measurements and partial oxygen concentra- tion measurements in the skin around the wound were performed using transcutaneous oximetry. Each patient qualified for HBOT was provided with local and general treatment at the Outpatient Unit of the Centre for Burns Treatment. If pain symptoms occurred, all patients took nonsteroidal anti-inflammatory drugs. A coexisting dis- ease stabilization standard was applied in all patients. In patients with diabetes, glucose levels were stabilized before start of HBOT and maintained during the en- tire treatment period. Each patient qualified for HBOT received standard local treatment in accordance with the guidelines of Polish Wound Treatment Society. 10,11

some of the manifestations of clinical autism. In some subjects it is also possible that anomalies in the white matter predominate over those of the grey matter. This heterogeneity could explain the differences in the quality and intensity of responses to the hyperbaric treatment, considering that supplying the cells with oxygen and returning them to good metabolic conditions is without doubt a more rapid process than stimulating the production and mobilization of stem cells to substitute or change the connectivity of the damaged nerve fibers. We report a summary of the clinical trials currently published. The literature is somewhat controversial (106-109), at present the double-blind studies are limited to those of Rossignol et al. (2009) and of Granpeesheh et al. (2010). Rossignol et al (2007) described an open-label study, in which 12 children between three and sixteen years old underwent 40 session of hyperbaric oxygen therapy at 1.5 ATA and 100% oxygen for 45 minutes. A control group of six children was treated at 1.3 ATA and 24% oxygen. The authors demonstrate the decrease in the CRP (C-reactive protein) that is an indicator of inflammation (in this case attributed to neuroinflammation and to the entero-imflammation) and no variation of the indicators of oxidative stress. The evaluation scales (ABC-C, SRS, ATEC), administered before and after the treatment, show significant improvement in the areas of sociability and communication, of the state of awareness and eye contact (20). Levy et al. (2008), in a review of the complementary and alternative treatments for autism, Levy et al. discuss Rossignol's open-label study and do not take a position, limiting themselves to pointing out the necessity of randomized and controlled trials (108).

Policy: This policy lists accepted conditions or indications for insurance reimbursement for Hyperbaric oxygen therapy (HBOT), contraindications and relative contraindications, and complications that may occur with and/or during HBOT. Additional information is provided regarding drug therapy with HBOT.

Hyperbaric medicine is the fascinating use of barometric pressure for delivering increased oxygen dissolved in plasma to body tissues. Hyperbaric oxygen therapy (HOT) or hyperbaric oxygen (HBO) involves intermittent inhalation of 100% oxygen under a pressure exceeding that of the atmosphere, that is greater than 1 atmosphere absolute (ATA). Therapy is given in special therapeutic chambers which were earlier used primarily to treat illnesses of deep sea divers. There is recently a renewed interest in this field all over the world. Acute traumatic wounds, crush injuries, burns, gas gangrene and compartment syndrome are indications where addition of hyperbaric oxygen may be life and limb saving. Patients who are suffering with non-healing ulcers, decubitus ulcers (bed sores) and all late sequelae of radiation therapy are also benefited with HBO therapy. Acute hearing loss and many neurological illnesses are also now known to possibly benefit from hyperbaric oxygen therapy. This article aims to give a brief overview of the rationale, existing trends and applications of this therapy.

A chronic wound is any interruption in the continuity of the body’s surface that requires a prolonged time to heal, does not heal, or re- curs (Wysocki 1996). For the purpose of this review we have gen- erally defined ’chronic’ as those wounds where attempts to heal by means other than hyperbaric oxygen therapy have failed. Chronic wounds arise in a great variety of situations and may be associated with a number of pathological processes. In order to institute ap- propriate therapy, it is common practice to define such wounds by their most likely aetiology. Thus, wounds developing in the presence of demonstrated arterial insufficiency would be termed ’arterial ulcers’ and therapeutic measures would aim to improve is- chaemia in the limb in order to promote healing, perhaps through bypass surgery when technically possible (Fowkes 2008). In ulcers associated with venous insufficiency, on the other hand, compres- sion bandaging is likely to be more appropriate (O’Meara 2009; Escaleira 2010). The most common chronic wounds encountered in western medical practice are a consequence of diabetes, arterial and/or venous disease, sustained pressure, and those as a result of therapeutic irradiation for the treatment of tumours. More than one such process may be present in an individual and contribute to the wound and they are more common in the elderly and those with multiple health problems (Dealey 1994; Lauterbach 2010). Chronic wounds are common and constitute a significant health problem. The true incidence and impact are difficult to assess ac- curately given the wide range of disease, the fact that much care is delivered at home and that many wound care products are pur- chased directly in some countries. While most leg ulcers will be the result of venous insufficiency, about 25% are likely to be ar- terial (Andersson 1993; O’Meara 2009). Wound care in the UK costs in excess of GBP 1 billion per year and therefore treatment options that are both clinically effective

Abstract: Hypoxia causes a cascade of activity from the level of the individual down to the regulation and function of the cell nucleus. Prolonged periods of low oxygen tension are a core feature of several disease states. Advances in the study of molecular biology have begun to bridge the gap between the cellular response to hypoxia and physiology. Hyperbaric oxygen therapy is a treatment for hypoxic- and inflammatory-driven conditions, in which patients are treated with 100% oxygen at pressures greater than atmospheric pressure. This review discusses hypoxia, the physiologic changes associated with hypoxia, the responses that occur in the cells during hypoxic conditions, and the role that hyperbaric oxygen therapy can play as part of the treatment for many patients suffering from diseases with underlying hypoxia.