Talk:Hyperbaric medicine

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Controversy section?[edit]

HBOT seems a little hokey and alternative-mediciny, and the Indications paragraph does mention that there has been controversy around the treatment. But it would seem this should warrant a whole section, not just a sentence with an external link to sources. Psychlohexane (talk) 02:51, 17 November 2010 (UTC)

And Why Does It Work?[edit]

Please explain why this might be effective. —Preceding unsigned comment added by 67.241.32.110 (talk) 05:48, 23 May 2008 (UTC)

Mechanism?[edit]

Can somebody please explain which therapeutic mechanism is at work in air/gas embolism? It seems quite plausible that it is the overall pressure which would serve to minimize the volume of any given amount of gas, but I don't have any references for that. Comments, please? Kosebamse 21:08, 11 Feb 2004 (UTC)

Indeed the pressure causes a decrease in the volume and therefor surface area of the bubble. The bubble acts to stop blood flow in the vessel in which it is impacted. Decreasing the surface area causes the bubble to migrate peripherally and thus impact smaller vessels. The bubble is comprised of 79% nitrogen. Using 100% oxygen causes a nitrogen gradient which causes the bubble to dissolve over time.

eyesight[edit]

After regular treatment (for unrelated ailments), my uncle reports that he no longer needs his thick glasses for driving. 68.167.2.149

This is probably due to a side effect of hyperbaric oxygen that is poorly understood. Some people find that after usually 20-30 treatments with hyperbaric oxygen they develop short sightedness (myopia). This may infact have the effect of correcting your uncles hypermetropia (long sightedness)to a small degree "improving" his eyesight.

Unfortunately the effect is usually temporary and resolves within 6 weeks to 4 months after the end of treatment.

Suggest Defining "Hyperbaric"[edit]

This may sound obvious, but the article launches into HBOT without defining the term "hyperbaric". Many readers will not know what that means. In fact HBOT is so common that sometimes "hyperbaric" is merely assumed to mean HBOT, whereas the actual definition is "of, relating to, or utilizing greater than normal pressure". Joema 23:35, 23 December 2005 (UTC)

4.1 PSI[edit]

4.1 PSI is not the pressure at 10 ft below water

No, but it's the gauge pressure of a gauge zeroed at sea level. Whoever put in that fact meant 4.1 psi gauge pressure or overpressure, not 4.1 psi absolute (which should ring alarms right there as it's, oh, dangerously lower than the standard atmosphere). Why point out the mistake if one isn't going to take the time to fix it? --The Centipede 12:38, 5 March 2007 (UTC)

Practicing Physicians[edit]

Why are most certified physicians who use hyperbaric medicine for clinical purposes anesthesiologists?

Probably because hyperbaric oxygen therapy uses pure oxygen, there's still a debate on whether or not pure oxygen is a euphoric, and it's probably a matter of "better safe than sorry." Anesthesiologists would be expected to know the narcotic (term used very loosely) limits and toxicity of pure oxygen better than, say, a general practicioner and HBOT strikes me as a bit too ground-level for those relatively rare doctors that specialize in organic chemistry. --The Centipede 12:34, 5 March 2007 (UTC)

Reverting page that was somewhat messed up[edit]

Some recent edits seem to have broken the page structure and I have reverted to an earlier version. Some edits may have been lost. My apologies, will try to restore what's worth restoring. And please, everybody, do try and use the preview function when editing, it would really help. Kosebamse 08:56, 26 April 2007 (UTC)

Separate hyperbaric chamber from HBOT[edit]

I suggest material describing the physics and engineering of the hyperbaric chamber be split off into a separate article called Hyperbaric chamber not redirecting here, since such chambers have other uses than HBOT, in (actual) diving and decompression. I was going to direct some diving technology links to 'hyperbaric chamber' but it makes no sense to do so when they end up at an article headed HBOT. Rexparry sydney 11:32, 2 August 2007 (UTC)

As there is now a combined article for diving chambers/Hyperbaric chambers I have put in a link to that and I suggest this article in future emphasise the particular features used in or adapted for HBOT.Rexparry sydney 06:15, 6 August 2007 (UTC)

Requested move[edit]

Hyberbaric medicine seems like a much better name. Any objections? User:Hopping T 19:45, 3 September 2007 (UTC)

  • Comment sounds weird. Does this involve increasing atmospheric pressure for uses OTHER THAN for oxygen? Hyperbaric helium therapy, hyperbaric phosgene therapy, or something? WP:COMMONANME would suggest that this is currently the proper name. 132.205.44.5 23:39, 4 September 2007 (UTC)

Reworks[edit]

I have been rewriting several parts of the article. Mostly reorganizations for logical flow and readability, and removing a lot of tangental material. I see some additional things to do as well, mainly involving references. I will try to get sources where requested, check that the present ones are reflected accurately, and unify their formatting. Baccyak4H (Yak!) 14:01, 10 October 2007 (UTC)

HBOT[edit]

The HBOT has been shown to help because it increases the amount of oxygen the blood plasma can hold, should we include this in the article?--Ngilliamdesmet (talk) 19:39, 22 October 2008 (UTC)

Yes, of course, but remember to cite reliable sources: some of the refs in Oxygen toxicity may be suitable. It would be worth mentioning the relatively small increase in total oxygen transported normally, since hemoblogin can carry far more oxygen than plasma - but this is particularly relevant when hemoglobin levels are compromised, such as in carbon monoxide poisoning. --RexxS (talk) 22:20, 22 October 2008 (UTC)

Neuro Rehab section: Only positive results of research are listed[edit]

This gives the appearance of being one sided, unless of course there have never been reports that HBOT was of no benefit. I don't mean complications such as barotrauma, I mean someone who reliably tested Neuro Rehab HBOT and saw no benefit. If they exist they should also be listed. —Preceding unsigned comment added by Chamblis (talkcontribs) 18:43, 25 October 2007 (UTC)

why does it say that it can heal cancer?[edit]

why is it that some other pages that this can help with cancer and really there is no proven fact that it can also that they know that it can't. Do you know why it says that? —Preceding unsigned comment added by 198.236.239.2 (talk) 22:23, 18 November 2008 (UTC)

The simplest answer is that this article doesn't claim that HBOT can heal cancer. Cancer is only mentioned (three times) in the section called "Contraindications" - that is, the conditions where HBOT is not appropriate. To be precise, it states that HBOT promotes growth of new blood vessels (which encourages tumours to grow) but that high oxygen levels may discourage the growth of tumours. It would be worth reading the references cited (Takenaka et al and Stubbs et al) for more information on the interaction of HBOT with cancer treatment. Hope that helps. --RexxS (talk) 04:28, 19 November 2008 (UTC)

ORN[edit]

No mention is made specifically about ORN of the mandible.

Gerlach NL, Barkhuysen R, Kaanders JH, Janssens GO, Sterk W, Merkx MA (March 2008). "The effect of hyperbaric oxygen therapy on quality of life in oral and oropharyngeal cancer patients treated with radiotherapy". Int J Oral Maxillofac Surg 37 (3): 255–9. doi:10.1016/j.ijom.2007.11.013. PMID 18262761. 

Pitak-Arnnop P, Sader R, Dhanuthai K, et al (October 2008). "Management of osteoradionecrosis of the jaws: an analysis of evidence". Eur J Surg Oncol 34 (10): 1123–34. doi:10.1016/j.ejso.2008.03.014. PMID 18455907. 

--Doc James (talk · contribs · email) 04:31, 10 January 2009 (UTC)

MS section[edit]

In the neuro section, there is a paragraph giving considerable detail on the first RDB HBOT trial for MS, and then augments it by referencing a couple more studies with similar results. The following (single-sentence) paragraph gives a Cochrane review of upwards of twenty trials, which comes to the opposite conclusion.

For both prose and WEIGHT considerations, I propose to trim the first PP to only mention the 1983 study (as it was the first), but summarize much more succinctly its results - that HBOT showed promise. Then refer to the Cochrane review which "updates" that commentary to current state of affairs. This will have several advantages: reduced statisticruft, better showing the historical trajectory of the evidence, and NPOV. Baccyak4H (Yak!) 19:09, 26 January 2009 (UTC)

I would support doing just that. Although the Cochrane review has its detractors, an encyclopedia is better built on good secondary sources such as reviews, rather than the results of individual trials. The balance you suggest would seem to me to meet WP:NPOV, particularly WP:UNDUE. --RexxS (talk) 23:12, 20 May 2009 (UTC)

TCOMs[edit]

Here is an image of a TCOM machine for determining if a patient with diabetic foot ulcers is suitable for HBOT tx.

TCOMs.JPG

--Doc James (talk · contribs · email) 21:44, 20 May 2009 (UTC)

Difference between 80 and 100 percent oxygen[edit]

I've requested a source for the claim "Physiologically, the human body cannot tell the difference between 80% and 100% Oxygen. (The difference is clinically insignificant ...". While the difference between 80% and 100% oxygen when considering home treatment may be insignificant, the unqualified statement is false in my experience. In particular, treating gas embolism with 80% oxygen is not preferred, since it reduces the inert gas pressure gradient and reduces its effectiveness. If a reliable source exists that verifies the claim, then I'm content if it is supplied; otherwise I'd prefer the article not to make blanket statements that I don't believe are supportable. --RexxS (talk) 21:16, 25 May 2009 (UTC)

Autism[edit]

Every once in a while, content is added describing the use of HBOT to treat autism. While I have no opinion on the truth or falsehood of such claims, I do believe that content in Wikipedia must meet the requirements of verifiability from reliable sources. I've removed a paragraph from "Neuro-rehabilitation" for that reason, even though the original poster did note that they "... do not know how to link the Maia Chung art. to this one." - unfortunately Wikipedia itself is not a reliable source, so can't be used to cite claims in other articles. The article is Maia Chung Autism and Disabilities Foundation, which I've removed from "See also" as there is no verifiable reason why it should be linked from here. --RexxS (talk) 23:21, 3 July 2009 (UTC)

Well, there has been a recent study and I saw Dr. Rossignol present this at the UHMS Meeting last week. The problems with this study are many and I still have issues using the term "hyperbaric" when the paper describes what is around 31.2% O2 at 1 Bar equivalent. Is this a study of the effects from O2 alone? Unfortunately, the analysis is not one that can really answer this question but it does make me think it is something that should be evaluated with unmotivated participants and clinical sites and better objective measures.
This kind of work is a step in the right direction. Just my $0.02... --Gene Hobbs (talk) 00:16, 4 July 2009 (UTC)
Thanks, Gene. As an area of ongoing research, it looks good. My grumble is I just wish contributors would read sources first, and add verifiable content second; rather than adding their opinions and looking for sources afterwards! --RexxS (talk) 01:58, 4 July 2009 (UTC)
I see that most of the cleanup was done already before I looked into this, but I attempted to improve the article's coverage of autism further by moving it from Home treatment (where it didn't belong) to Uses, and summarizing the result more accurately. Eubulides (talk) 07:38, 4 July 2009 (UTC)
Nice work! Having some verifiable content may dissuade further contributors who have seen a YouTube video from attempting to fill the article up with it. I also think your revision nicely meets WP:UNDUE. Given that CP & MS are covered to some extent in " Neuro-rehabilitation", should they be mentioned briefly in "Uses" as well, or is that too much? - or does the article need restructuring entirely! --RexxS (talk) 17:31, 4 July 2009 (UTC)
Please see #Neuro-rehabilitation below. Eubulides (talk) 18:15, 4 July 2009 (UTC)

Neuro-rehabilitation[edit]

I hadn't seen the Hyperbaric medicine #Neuro-rehabilitation section and agree that it overlaps with Uses. Two things:

  • Why are there two sections Uses and Treatments? They cover essentially the same thing, and surely should be merged.
  • A brief look at Neuro-rehabilitation suggests that it relies entirely too much on primary sources, and should be citing reviews. The overall coverage appears to be using weights assigned by Wikipedia editors rather than that of recent reliable sources. Here are the sort of sources that should be cited instead:
I'm sure there are many others; this is just from a very brief search.

Eubulides (talk) 18:15, 4 July 2009 (UTC)

This is how articles evolve, I guess, different editors add their 2 cents all over the place. Can I suggest that some thought is put into the structure of the article? My thoughts are:
  • A section briefly describing what happens in HBOT, and perhaps a little history of how it started
  • A section describing the known effects of HBO2 on the body
  • A section describing different equipment used
  • A section on uses/benefits: broken down into prescription and off-label; this would be the bulk of the article, mentioning prognosis and criticisms per use, but weighted as required by WP:UNDUE
  • A section on risks, contraindications and complications
The order can be changed to make a it read better, but have I missed any key parts? or better ideas for how to structure it? I've also sought advice at WP:MEDMOS#Recomendations for sections for treatments. --RexxS (talk) 21:35, 4 July 2009 (UTC)

It's important to note that Rossignol is associated with the 'International Child Development Resource Center', a group which fleeces desperate parents of autistic children, and aids other frauds in fleecing them. The ICDRC employs other laudable paragons of modest ethical conduct like Andrew Wakefield.[1] Nevard (talk) 08:51, 3 November 2009 (UTC)

I agree that this section of the article is very seriously problematic, including clear original research and selective use of primary studies etc etc. I'll get to it soon, if somebody else doesn't. --Slp1 (talk) 12:11, 10 September 2010 (UTC)

Purely anecdotally, a friend's son who's recently started hyperbaric oxygen therpay has been 'transformed' (positively) by it, said the father. — Preceding unsigned comment added by 92.23.125.239 (talk) 09:54, 26 February 2013 (UTC)

Wikipedia Quality Scale[edit]

Against a B-class checklist, the article has some shortcomings:

  1. B-Class-1: It is suitably referenced, and all major points have appropriate inline citations. - Fail
    Section "Therapeutic principles" needs more references
    Section " Structure" and its sub-sections need a lot more references
    Section " Treatments" needs references
  2. B-Class-2: It reasonably covers the topic, and does not contain obvious omissions or inaccuracies. - Pass
    Could be expanded (e.g. ORN as suggested above), but major points covered
  3. B-Class-3: It has a defined structure, including a lead section and one or more sections of content. - Fail
    Lead requires considerable expansion
    Structure needs improvement (perhaps as suggested above)
  4. B-Class-4: It is free from major grammatical errors. - Pass
  5. B-Class-5: It contains appropriate supporting materials, such as an infobox, images, or diagrams. - Pass

I've graded it C-class for WikiProject SCUBA. There is a lot of good content and getting good references should be a priority. --RexxS (talk) 19:56, 20 September 2009 (UTC)

Fire risk[edit]

I've just reverted the removal of the mention of fire risk from the sentence: "The exhaled gas must be removed from the chamber to prevent the build up of oxygen, which could provoke a fire". I agree that the statement needs sourcing, but I can only find the following online from Recognized Hyperbaric Safety Codes and Standards:

It is the position of the National Board of Diving & Hyperbaric Medical Technology that the codes and standards expressed in the American Society of Mechanical Engineers’ safety Standard for Pressure Vessels for Human Occupancy (ASME PVHO-1)* and the National Fire Protection Association 99, Health care Facilities, Chapter 20, (Hyperbaric Facilities)** be rigorously adhered to.

which refers to other documents that I can't track down online. Does anyone have access to any of these, particularly something that illustrates the procedure for keeping the fraction of O2 below 25%? --RexxS (talk) 12:01, 16 October 2009 (UTC)

We have always used 23.5% in my 14 years at Duke. I do think this reference will do what you need though:
If you are planning to expand this section some, here are some additional items of interest. Thanks! --Gene Hobbs (talk) 02:14, 17 October 2009 (UTC)

Post-traumatic stress disorder[edit]

Spacebus57 (talk · contribs) gave the following source:

It may be helpful for expanding the article. --RexxS (talk) 01:17, 10 May 2011 (UTC)

Efficacy?[edit]

This article describes: the principles behind hyperbaric medicine; the list of conditions for which its use has been approved; how the treatment works; possible negative side-effects; and so on, but what seems to be missing is information about how effective it is as a treatment. The last section, 'Neuro-rehabilitation', describes the results of studies into its effectiveness for treating certain neurological conditions; but what about all the other conditions? I assume that since it is approved for use for treating carbon monoxide poisoning (for example), there is some evidence that it is actually effective at treating it, but it would be nice to see such information in the article. Robofish (talk) 21:48, 26 July 2011 (UTC)

Global perspective[edit]

We need to take care not to assume that our experience of HBOT is representative of hyperbaric medicine throughout the world. Removing an external link that is outdated or duplicates content already present is good, as long as we realise that links such as the one removed actually refer to the UK, while our article section Indications lists approved indications only for the US. As I agree that it's not ideal as an external link, I'll place this link here http://www.londonhyperbaric.com/hyperbaric-treatments to point editors towards a source that lists typical indications in the UK, in the hope that someone will expand the section at some future time. --RexxS (talk) 00:24, 22 August 2011 (UTC)

breathe out?[edit]

if there is only oxygen u dont need 2 breathe out cuz ur body uses oxygen — Preceding unsigned comment added by Fduhgide (talkcontribs) 00:59, 5 September 2011 (UTC)

But the oxygen it uses makes carbon dioxide. The carbon dioxide has to be breathed out. --RexxS (talk) 02:06, 5 September 2011 (UTC)
You can read more about carbon dioxide poisoning in this article. --Gautehuus (talk) 15:32, 30 December 2012 (UTC)

Hyperbaric Treatment for Alzheimer Sufferers[edit]

My wife has been diagnosed and treated for Alzheimer's Disease. I have heard recently that there have been recorded successes of hyperbaric treatment improving the function of some individuals diagnosed with Alzheimer's disease. Where is it possible to get these results and secondly where are the hyperbaric chambers located? — Preceding unsigned comment added by 98.244.36.175 (talk) 01:53, 14 January 2012 (UTC)

I'm sorry to hear about your wife's illness and I wish you both all the best. None of us here are the best people to ask for medical advice, but I can offer you a Google Scholar search http://scholar.google.co.uk/scholar?q=hyperbaric+oxygen+therapy+alzheimer%27s+disease&hl=en&as_sdt=0&as_vis=1&oi=scholart that is likely to turn up most of the academic studies relevant to your question. --RexxS (talk) 15:13, 14 January 2012 (UTC)

Photo of father and son in chamber[edit]

A photograph is in the article of a father and son "receiving treatment for autism". Is that not WP:undue weight? I'll await consensus before removing the image from the article.Wzrd1 (talk) 14:31, 27 July 2013 (UTC)

As there have been no objections, I was bold and removed the image that gives WP:undue weight to fringe autism "treatment" theories that have only poor studies backing said approach.Wzrd1 (talk) 03:32, 9 August 2013 (UTC)