What is hyperbaric oxygen therapy ?
Hyperbaric oxygen therapy is a treatment method which the patient breathe 100% oxygen in cabin pressurization in which the pressure is higher than ambient pressure.
Introduction
Hyperbaric oxygen therapy is also referred to as hyperbaric medicine. Normal air contains about 78% nitrogen, 21% oxygen and 1% other substances. Under normal atmospheric pressure fill the erythrocytes (red blood cells) is for 98% with oxygen (saturation of 98%). By patients to give 100% oxygen saturation can be 100%, but this is not yet the essence of therapy. Fix gases under pressure in liquid (Henry's law), so if the patient breathe 100% oxygen in the cabin pressurization will solve more oxygen in the blood. This extra dissolved oxygen is in the blood plasma and not in the red cells. Since red cells need blood vessels to go to the place where they can give their oxygen to the tissue that needs this oxygen vascular damage in tissue with little oxygen. However dissolved oxygen in blood plasma can freely diffuse into tissue with vascular damage, and because the therapy more oxygen is resolved is the diffusion distance increases, causing the tissue with the necessary oxygen get vascular damage. The function of the high pressure around the patient depends on the type of therapy. When in the cab 100% oxygen is the pressure directly for the increased plasma concentration. Because oxygen is highly reactive (fire hazard), all the way in high concentrations, only in hospitals through a mask is 100% oxygen. The rest of the cabin contains ' just ' 21% oxygen and pressure is brought on.
Operation
The effect of hyperbaric oxygen therapy is based on Henry's law. Because the blood in the lungs in contact with 100% oxygen over increased pressure (2.5, 2.4 or 2.0 atmosphere absolute (ATA) lost there to 12 percent more oxygen in on, especially in the blood plasma. This strongly increased oxygen concentration (hyper saturation) has after 10-15 treatments, for example, by at least an hour's healing effects on radiation therapy, diabetes mellitus, or infection affected tissue.
Hyper saturation allows for the release of major vascular growth factors. This will start a process of production of new capillary capillaries (neo-angiogenesis). The hyperbaric therapy also ensures mobilization of stem cells and the combination of stem cell mobilization and neo-angiogenesis create the conditions for an improved wound healing. The increased oxygen tension in the tissues also caused an increase in the effectiveness of certain types of antibiotics.
Applications
In Netherlands is Hyperbaric Medicine mostly known as treatment of decompression sickness in divers. This one treats patients with decompression sickness by putting them on to bring pressure and let them there to breathe 100% oxygen. The implications of this are two-fold. By the pressure increase reduce the diameter of the closing bell and by the increased oxygen pressure one limits the effects of ischemia.
In addition to the treatment of diving-related diseases there are still various other treatment indications. Although these disorders for decades treated with hyperbaric oxygen therapy is the medical field only sparingly use of this treatment method. The positive effect of hyperbaric oxygen on some diseases is sufficiently proven so that the health insurers reimburse fully the therapy in the following indications:
-Chronic wounds (diabetic ulcers, diabetic ulcers, open leg).
-Infection of bone (chronic osteomyelitis). Note that chronic wounds in the proximity of bone tissue often maintained by an infection of that underlying bone.
-Damage by radiation to the skin, subcutaneous tissue, muscle or mucous membranes. This includes wounds in irradiated territory or to function loss due to scarring.
-Blood loss through urine by radiation damage to the bladder (radiation cystitis).
-Inflammation of the intestines or blood loss there by radiation damage (radiation proctitis or radiation enteritis).
-Radiation damage in the ENT area. Hyperbaric oxygen therapy, as it not only has a very beneficial effect in case of wounds or scarring in this area. Also before the start of reconstruction operations at the jaw has this treatment a pretty positive influence on the ultimate prognosis and the quality of the result.
-Large plastic surgery operations (crushletsels and replantatie of limbs) in which the blood flow in the operated area is not optimal.
-Serious bacterial infections of the skin.
-Carbon monoxide Poisoning
-Decompression sickness and gasembolie.
-Gasgangreen/anaerobic bacterial infection.
In treating patients 100% oxygen through a mask or a hood and they go to a pressure as if they stay 15 feet under water. As a result, increases the oxygen pressure of 1 bar (normal ambient pressure) to 2.5 bar. The treatment takes about 2 hours including "valleys and take off". Depending on the condition there are usually 20 to 40 treatments necessary, for example, once a day five days a week. A treatment of 20 sessions takes 4 weeks. In Netherlands are treatment options on about nine places.
History
The Amsterdam Professor of surgery Ite Bajaj and his student Pim Banerji, adapted hyperbaric theapie already around 1960 after open heart-surgery and life-threatening infections with organisms that are not good against oxygen, as the causative agent of gasgangreen, (Clostridium welchii). This could often be avoided amputation Vrij or saved the life of a patient.
Contra-indications
The only absolute contraindication is
-An untreated pneumothorax
-Need to use during therapy of ADRIAMYCIN
Relative contraindications include:
-Serious pulmonary disease
-Epilepsy who are not well under control doesn't respond
-Cold or a clogged Eustachian tube which done not possible
-Heart disease in which the heart function is reduced (heart failure)