Jump to content

Hyperbaric medicine: Difference between revisions

From Wikipedia, the free encyclopedia
Browse history interactively
← Previous editNext edit →
Content deleted Content added
VisualWikitext
m ISBNs (Build KE)
→Indications: they dont use dollar as currency
Line 19: Line 19:


==Indications==
==Indications==
In the United States the [[Undersea and Hyperbaric Medical Society]], known as UHMS, lists approvals for reimbursement for certain diagnoses in hospitals and clinics. The following [[Indication (medicine)|indications]] are approved (for reimbursement) uses of hyperbaric oxygen therapy as defined by the UHMS Hyperbaric Oxygen Therapy Committee:<ref name=isbn0930406230/><ref name="uhmsindications">{{cite web|url=http://www.uhms.org/?page=Indications |title=Indications for hyperbaric oxygen therapy |year=2011 |publisher=Undersea & Hyperbaric Medical Society |accessdate=21 August 2011}}</ref> However, these are reimbursement decisions based on cost of medical treatments vs HBOT at the average U.S. hospital charge of $1,800.00 per 90 minute HBOT treatment. China and Russia treat more than 80 maladies, conditions and trauma with HBOT, since dollar costs are insignificant in those countries.<ref>Textbook of Hyperbaric Medicine KK Jane, 5th Edition, 2010</ref>
In the United States the [[Undersea and Hyperbaric Medical Society]], known as UHMS, lists approvals for reimbursement for certain diagnoses in hospitals and clinics. The following [[Indication (medicine)|indications]] are approved (for reimbursement) uses of hyperbaric oxygen therapy as defined by the UHMS Hyperbaric Oxygen Therapy Committee:<ref name=isbn0930406230/><ref name="uhmsindications">{{cite web|url=http://www.uhms.org/?page=Indications |title=Indications for hyperbaric oxygen therapy |year=2011 |publisher=Undersea & Hyperbaric Medical Society |accessdate=21 August 2011}}</ref> However, these are reimbursement decisions based on cost of medical treatments vs HBOT at the average U.S. hospital charge of $1,800.00 per 90 minute HBOT treatment. China and Russia treat more than 80 maladies, conditions and trauma with HBOT, since costs are insignificant in those countries.<ref>Textbook of Hyperbaric Medicine KK Jane, 5th Edition, 2010</ref>
*Air or [[gas embolism]];<ref>{{cite web|url=http://www.uhms.org/?page=AGE |title=Air or Gas Embolism |author=Undersea and Hyperbaric Medical Society |accessdate=2011-08-21 }}</ref>
*Air or [[gas embolism]];<ref>{{cite web|url=http://www.uhms.org/?page=AGE |title=Air or Gas Embolism |author=Undersea and Hyperbaric Medical Society |accessdate=2011-08-21 }}</ref>
*[[Carbon monoxide poisoning]];<ref>{{cite web|url=http://www.uhms.org/?page=CMP |title=Carbon Monoxide |author=Undersea and Hyperbaric Medical Society |accessdate=2011-08-21 }}</ref><ref name="pmid15233173">{{Cite journal|author=Piantadosi CA |title=Carbon monoxide poisoning |journal=Undersea Hyperb Med |volume=31 |issue=1 |pages=167–77 |year=2004 |pmid=15233173 |url=http://archive.rubicon-foundation.org/4002 |accessdate=2008-05-19}}</ref>
*[[Carbon monoxide poisoning]];<ref>{{cite web|url=http://www.uhms.org/?page=CMP |title=Carbon Monoxide |author=Undersea and Hyperbaric Medical Society |accessdate=2011-08-21 }}</ref><ref name="pmid15233173">{{Cite journal|author=Piantadosi CA |title=Carbon monoxide poisoning |journal=Undersea Hyperb Med |volume=31 |issue=1 |pages=167–77 |year=2004 |pmid=15233173 |url=http://archive.rubicon-foundation.org/4002 |accessdate=2008-05-19}}</ref>

Revision as of 17:28, 17 May 2012

Hyperbaric medicine
A Sechrist Monoplace hyperbaric chamber at the Moose Jaw Union Hospital, Saskatchewan, Canada
Specialtydiving medicine, emergency medicine, neurology, infectious diseases
ICD-9-CM93.95
MeSHD006931
OPS-301 code8-721

Hyperbaric medicine, also known as hyperbaric oxygen therapy (HBOT), is the medical use of oxygen at a level higher than atmospheric pressure. The equipment required consists of a pressure chamber, which may be of rigid or flexible construction, and a means of delivering 100% oxygen. Operation is performed to a predetermined schedule by trained personnel who monitor the patient and may adjust the schedule as required. HBOT found early use in the treatment of decompression sickness. But it has also shown great effectiveness in treating conditions such as gas gangrene and carbon monoxide poisoning. More recent research has examined the possibility that it may also have value for other conditions such as cerebral palsy and multiple sclerosis, but no significant evidence has been found.

Therapeutic principles

Several therapeutic principles are made use of in HBOT:[1]

  • The increased overall pressure is of therapeutic value when HBOT is used in the treatment of decompression sickness and air embolism;[2]
  • For many other conditions, the therapeutic principle of HBOT lies in its ability to drastically increase partial pressure of oxygen in the tissues of the body. The oxygen partial pressures achievable using HBOT are much higher than those achievable while breathing pure oxygen at normobaric conditions (i.e. at normal atmospheric pressure);
  • A related effect is the increased oxygen transport capacity of the blood. Under normal atmospheric pressure, oxygen transport is limited by the oxygen binding capacity of hemoglobin in red blood cells and very little oxygen is transported by blood plasma. Because the hemoglobin of the red blood cells is almost saturated with oxygen under atmospheric pressure, this route of transport cannot be exploited any further. Oxygen transport by plasma, however is significantly increased using HBOT as the stimulus.
  • Recent evidence notes that exposure to hyperbaric oxygen (HBOT) mobilizes stem/progenitor cells from the bone marrow by a nitric oxide (·NO) -dependent mechanism.[3] This mechanism may account for the patient cases that suggest recovery of damaged organs and tissues with HBOT.

Indications

In the United States the Undersea and Hyperbaric Medical Society, known as UHMS, lists approvals for reimbursement for certain diagnoses in hospitals and clinics. The following indications are approved (for reimbursement) uses of hyperbaric oxygen therapy as defined by the UHMS Hyperbaric Oxygen Therapy Committee:[1][4] However, these are reimbursement decisions based on cost of medical treatments vs HBOT at the average U.S. hospital charge of $1,800.00 per 90 minute HBOT treatment. China and Russia treat more than 80 maladies, conditions and trauma with HBOT, since costs are insignificant in those countries.[5]

HBOT is recognized by Medicare in the United States as a reimbursable treatment for 14 UHMS "approved" conditions. A 1-hour HBOT session may cost between $108 and $250 in private clinics, and over $1,000 in hospitals. U.S. physicians (either M.D. or D.O.) may lawfully prescribe HBOT for "off-label" conditions such as Lyme Disease,[44] stroke,[45][46][47] and migraines.[48][49][50] Such patients are treated in outpatient clinics. In the United Kingdom most chambers are financed by the National Health Service, although some, such as those run by Multiple Sclerosis Therapy Centres, are non-profit.

Other reported applications include:

The toxicology of the treatment has recently been reviewed by Ustundag et al.[61] and its risk management is discussed by Christian R. Mortensen, in light of the fact that most hyperbaric facilities are managed by departments of anaesthesiology and some of their patients are critically ill.[62]

Hyperbaric chambers

Collage of 4 images of multiplace hyperbaric chambers
Multiplace hyperbaric chambers, showing control panel, monitoring facilities, and different chamber sizes in Spanish facilities

Construction

The traditional type of hyperbaric chamber used for HBOT is a hard shelled pressure vessel. Such chambers can be run at absolute pressures as much as 6 bars (87 psi), 600,000 Pa. Navies, diving organizations, hospitals, and dedicated recompression facilities typically operate these. They range in size from semi-portable, one-patient units to room-sized units that can treat eight or more patients. Recent advances in materials technology have resulted in the manufacture of portable, "soft" chambers that can operate at between 0.3 and 0.5 bars (4.4 and 7.3 psi) above atmospheric pressure.[63] Hard chambers and soft chambers should not be considered equivalent in regards to efficacy and safety as they are different in many aspects.

A hard chamber may consist of

  • a pressure vessel that is generally made of steel, aluminium with the view ports (windows) made of acrylic;
  • one or more human entry hatches—small and circular or wheel-in type hatches for patients on gurneys;
  • the airlock that allows human entry—a separate chamber with two hatches, one to the outside and one to the main chamber, which can be independently pressurized to allow patients to enter or exit the main chamber while it is still pressurized and a small airlock for medicines, instruments, and food;
  • glass ports or closed-circuit television that allows technicians and medical staff outside the chamber to monitor the patient inside the chamber;
  • an intercom or walkie-talkie allowing two-way communication;
  • a carbon dioxide scrubber—consisting of a fan that passes the gas inside the chamber through a soda lime canister;
  • a control panel outside the chamber to open and close valves that control air flow to and from the chamber, and regulate oxygen to helmets or masks.

A soft chamber may consist of

  • a urethane-coated, nylon-bonded flexible acrylic pressure vessel with steel-weld technology;
  • a full-length dual zipper-sealed opening;
  • an over-pressure valve, if oxygen is fed into a small mask and expired gas has to be circulated toward the end of the chamber and out through the pressure regulators.

Oxygen supply

A recompression chamber for a single diving casualty

In today's larger multiplace chambers, both patients and medical staff inside the chamber breathe from either "oxygen hoods" – flexible, transparent soft plastic hoods with a seal around the neck similar to a space suit helmet – or tightly fitting oxygen masks, which supply pure oxygen and may be designed to directly exhaust the exhaled gas from the chamber. During treatment patients breathe 100% oxygen most of the time to maximise the effectiveness of their treatment, but have periodic "air breaks" during which they breathe room air (21% oxygen) to minimize the risk of oxygen toxicity. The exhaled gas must be removed from the chamber to prevent the build up of oxygen, which could present a fire risk. Attendants may also breathe oxygen to reduce their risk of decompression sickness. The pressure inside a hard chamber is increased by opening valves allowing high-pressure air to enter from storage cylinders, which are filled by an air compressor. A soft chamber may be pressurised directly from a compressor.

Smaller "monoplace" chambers can only accommodate the patient, and no medical staff can enter. The chamber may be pressurised with pure oxygen or compressed air. If pure oxygen is used, no oxygen breathing mask or helmet is needed, but the cost of using pure oxygen is much higher than that of using compressed air. If compressed air is used then an oxygen mask or hood is needed as in a multiplace, hard chamber. In monoplace chambers that are compressed with pure oxygen a mask is available to provide the patient with "air breaks," periods of breathing normal air (21% oxygen), in order to reduce the risk of hyperoxic seizures. In soft chambers, using compressed air and a mask supplying 96% oxygen, no air breaks are necessary as there is negligible risk of oxygen toxicity because of relatively low oxygen partial pressures and the short duration of treatment.

Treatments

Initially, HBOT was developed as a treatment for diving disorders involving bubbles of gas in the tissues, such as decompression sickness and gas embolism. The chamber cures decompression sickness and gas embolism by increasing pressure, reducing the size of the gas bubbles and improving the transport of blood to downstream tissues. The high concentrations of oxygen in the tissues are beneficial in keeping oxygen-starved tissues alive, and have the effect of removing the nitrogen from the bubble, making it smaller until it consists only of oxygen, which is re-absorbed into the body. After elimination of bubbles, the pressure is gradually reduced back to atmospheric levels.

Protocol

The slang term, at some facilities, for a cycle of pressurization inside the HBOT chamber is "a dive". An HBOT treatment for longer-term conditions is often a series of 20 to 40 dives, or compressions. Again, these dives last for about an hour and can be administered via a hard, high-pressure chamber or a soft, low-pressure chamber - the major difference being per-dive "dose" of oxygen. Many conditions do quite well with the lower dose, lower cost-per-hour, soft chambers.

Emergency HBOT for decompression illness follows treatment schedules laid out in treatment tables. Most cases employ a recompression to 2.8 bars (41 psi) absolute, the equivalent of 18 metres (60 ft) of water, for 4.5 to 5.5 hours with the casualty breathing pure oxygen, but taking air breaks every 20 minutes to reduce oxygen toxicity. For extremely serious cases resulting from very deep dives, the treatment may require a chamber capable of a maximum pressure of 8 bars (120 psi), the equivalent of 70 metres (230 ft) of water, and the ability to supply heliox as a breathing gas.[64]

U.S. Navy treatment charts are used in Canada and the United States to determine the duration, pressure, and breathing gas of the therapy. The most frequently used tables are Table 5 and Table 6. In the UK the Royal Navy 62 and 67 tables are used.

The Undersea and Hyperbaric Medical Society (UHMS) publishes a report that compiles the latest research findings and contains information regarding the recommended duration and pressure of the longer-term conditions.[65]

Home and out-patient clinic treatment

An example of mild portable hyperbaric chamber. This 40-inch-diameter (1,000 mm) chamber is one of the larger chambers available for home.

There are several sizes of portable chambers, which are used for home treatment. These are usually referred to as "mild personal hyperbaric chambers", which is a reference to the lower pressure (compared to hard chambers) of soft-sided chambers. Food and Drug Administration (FDA) approved chambers for use with room air are available in the USA and may go up to 4.4 pounds per square inch (psi) above atmospheric pressure,[citation needed] which equals 1.3 atmospheres absolute (ATA), equivalent to a depth of 10 feet of sea water. In the US, these "mild personal hyperbaric chambers" are categorized by the FDA as CLASS II medical devices and requires a prescription in order to purchase one or take treatments.[66] Personal hyperbaric chambers are only FDA approved to reach 1.3 ATA.[citation needed] While hyperbaric chamber distributors and manufacturers cannot supply a chamber in the US with any form of elevated oxygen delivery system, a physician can write a prescription to combine the two modalities, as long as there is a prescription for both hyperbarics and oxygen.[citation needed] The most common option (but not approved by FDA) some patients choose is to acquire an oxygen concentrator which typically delivers 85–96% oxygen as the breathing gas. Due to the high circulation of air through the chamber, the total concentration of oxygen in the chamber never exceeds 25% as this can increase the risk of fire. [citation needed] Oxygen is never fed directly into soft chambers but is rather introduced via a line and mask directly to the patient. FDA approved oxygen concentrators for human consumption in confined areas used for HBOT are regularly monitored for purity (+/- 1%) and flow (10 to 15 liters per minute outflow pressure). An audible alarm will sound if the purity ever drops below 80%. Personal hyperbaric chambers use 120 volt or 220 volt outlets. Ranging in size from 21 inches up to 40 inches in diameter these chambers measure between 84 in (7 ft) to 120 in (10 ft) in length.[citation needed] The soft chambers are approved by the FDA for the treatment of altitude sickness, but are commonly used for other "off-label" purposes.[citation needed]

Possible complications and concerns

There are risks associated with HBOT, similar to some diving disorders. Pressure changes can cause a "squeeze" or barotrauma in the tissues surrounding trapped air inside the body, such as the lungs,[67] behind the eardrum,[68][69] inside paranasal sinuses,[68] or trapped underneath dental fillings.[70] Breathing high-pressure oxygen may cause oxygen toxicity.[71] Temporarily blurred vision can be caused by swelling of the lens, which usually resolves in two to four weeks.[72][73]

There are reports that cataract may progress following HBOT.[74] Also a rare side effect has been blindness secondary to optic neuritis (inflammation of the optic nerve).[citation needed]

Effects of Pressure

Patients inside the chamber may notice discomfort inside their ears as a pressure difference develops between their middle ear and the chamber atmosphere.[75] This can be relieved by the Valsalva maneuver or by "jaw wiggling". As the pressure increases further, mist may form in the air inside the chamber and the air may become warm. Increased pressure may also cause ear drums to rupture, resulting in severe pain.

To reduce the pressure, a valve is opened to allow air out of the chamber. As the pressure falls, the patient’s ears may "squeak" as the pressure inside the ear equalizes with the chamber. The temperature in the chamber will fall. The speed of pressurization and de-pressurization can be adjusted to each patient's needs.

Contraindications

The only absolute contraindication to hyperbaric oxygen therapy is untreated tension pneumothorax.[67] Also, the treatment may raise the issue of Occupational health and safety (OHS), which has been encountered by the therapist.[76][clarification needed]

Patients should not undergo HBO therapy if they are taking or have recently taken the following drugs:

  • Doxorubicin (Adriamycin) – A chemotherapeutic drug.
  • Cisplatin – Also a chemotherapeutic drug.
  • Disulfiram (Antabuse) – Used in the treatment of alcoholism.
  • Mafenide acetate (Sulfamylon) – Suppresses bacterial infections in burn wounds

The following are relative contraindications -- meaning that special consideration must be made by specialist physicians before HBO treatments begin:

  • Cardiac disease
  • Upper respiratory infections – These conditions can make it difficult for the patient to equalise their ears or sinuses, which can result in what is termed ear or sinus squeeze.
  • High fevers – In most cases the fever should be lowered before HBO treatment begins.
  • Emphysema with CO2 retention – This condition can lead to pneumothorax during HBO treatment.
  • History of thoracic (chest) surgery – This is rarely a problem and usually not considered a contraindication. However, there is concern that air may be trapped in lesions that were created by surgical scarring. These conditions need to be evaluated prior to considering HBO therapy.
  • Malignant disease: Cancers thrive in blood rich environments but may be suppressed by high oxygen levels. HBO treatment of individuals who have cancer presents a problem, since HBO both increases blood flow via angiogenesis and also raises oxygen levels. Taking an anti-angiogenic supplement may provide a solution.[77][78] A study by Feldemier, et al. and recent NIH funded study on Stem Cells by Thom, et al., indicate that HBO is actually beneficial in producing stem/progenitor cells and the malignant process is not accelerated.[79]
  • Middle ear barotrauma is always a consideration in treating both children and adults in a hyperbaric environment because of the necessity to equalise pressure in the ears.
  • Pregnancy is a relative contraindication to both SCUBA diving and hyperbaric oxygen treatments. In cases where a pregnant woman has carbon monoxide poisoning there is evidence that lower pressure (2.0 ATA) HBOT treatments are not harmful to the fetus, and that the risk involved is outweighed by the greater risk of the untreated effects of CO on the fetus (neurologic abnormalities or death.)[80][81]

Neuro-rehabilitation

A father and his son inside a hyperbaric oxygen chamber.

A 2004 systematic review of HBOT in traumatic brain injury identified 2 randomized controlled trials and 5 observational studies that met evaluated functional health outcomes. The studies ranged from fair to poor in quality. None adequately reported adverse events, the most serious reported being seizures, pulmonary symptoms, and neurologic deterioration. The review concluded that was insufficient evidence to prove the effectiveness or ineffectiveness, including risks and benefits of HBOT for TBI. In one RCT, the HBOT group had reduced mortality compared to the control group but much higher levels of disability. Another, smaller, study found no difference in mortality. The observational studies were weak in quality and did not provide enough evidence of clinical improvement following HBOT treatment.[82]

Evidence in a 2005 systematic review of the evidence for HBOT in the treatment of stroke showed no benefit to the treatment, though the generalizability of the finding was limited due to the wide variety in stage and type of stroke, and the treatment given. Good quality studies were recommended to determine if HBOT provides any benefit in stroke.[83] Another review that examined the effectiveness of HBOT in acute stroke. It found no evidence that HBOT improved clinical outcomes at 6 months, but further study was recommended.[45]

A systematic review of HBOT for cerebral palsy was published in 2007. Two randomized controlled trials and four observational studies were identified.[84] The best evidence from a randomized controlled trial (the Collet study) found that HBOT and slightly pressurized room air resulted in similar improvements in motor function of about 5–6% compared to baseline.[84][85] Neuropsychological tests also showed no difference between HBOT and room air. Based on caregiver report, those who received room air had significantly better mobility and social functioning.[84][85] Several methodological concerns about the study were raised. Another trial found no difference between a HBOT and a no treatment group.[84] Some low quality observational studies of HBOT reported similar improvements in motor function. Children receiving HBOT were reported to experience seizures and the need for tympanostomy tubes to equalize ear pressure, though the incidence was not clear. Future research was recommended to determine the efficacy of pressurized room air and non-pressurized oxygen compared with standard treatments.[84]

A review of 12 randomized studies using HBOT with multiple sclerosis suggested that there is no clinically significant benefit from the administration of HBOT. The review proposed that more trials for selected subgroups of MS and for prolonged treatments may be worthwhile, but that routine use of HBOT in the treatment of MS was not recommended.[86] The 2004 Cochrane review concluded that further "trials are not, in our view, justified".[56]

See also

References

  1. ^ a b Gesell, Laurie B. (Chair and editor) (2008). Hyperbaric Oxygen Therapy Indications. The Hyperbaric Oxygen Therapy Committee Report (12 ed.). Durham, NC: Undersea and Hyperbaric Medical Society. ISBN 0-930406-23-0. {{cite book}}: |author= has generic name (help)
  2. ^ Jørgensen TB, Sørensen AM, Jansen EC (2008). "Iatrogenic systemic air embolism treated with hyperbaric oxygen therapy". Acta Anaesthesiol Scand. 52 (4): 566–568. doi:10.1111/j.1399-6576.2008.01598.x. PMID 18339163. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  3. ^ Thom SR; Bhopale VM; Velazquez OC (2006). "Stem cell mobilization by hyperbaric oxygen". American Journal of Physiology - Heart. 290 (4): H1378–H1386. doi:10.1152/ajpheart.00888.2005. PMC 233328. {{cite journal}}: Invalid |display-authors=3 (help); Unknown parameter |author-separator= ignored (help); Unknown parameter |month= ignored (help)
  4. ^ "Indications for hyperbaric oxygen therapy". Undersea & Hyperbaric Medical Society. 2011. Retrieved 21 August 2011.
  5. ^ Textbook of Hyperbaric Medicine KK Jane, 5th Edition, 2010
  6. ^ Undersea and Hyperbaric Medical Society. "Air or Gas Embolism". Retrieved 2011-08-21.
  7. ^ Undersea and Hyperbaric Medical Society. "Carbon Monoxide". Retrieved 2011-08-21.
  8. ^ Piantadosi CA (2004). "Carbon monoxide poisoning". Undersea Hyperb Med. 31 (1): 167–77. PMID 15233173. Retrieved 2008-05-19.
  9. ^ Undersea and Hyperbaric Medical Society. "Cyanide Poisoning". Retrieved 2011-08-21.
  10. ^ Hall AH, Rumack BH (1986). "Clinical toxicology of cyanide". Ann Emerg Med. 15 (9): 1067–1074. doi:10.1016/S0196-0644(86)80131-7. PMID 3526995. {{cite journal}}: Unknown parameter |month= ignored (help)
  11. ^ Takano T, Miyazaki Y, Nashimoto I, Kobayashi K (1980). "Effect of hyperbaric oxygen on cyanide intoxication: in situ changes in intracellular oxidation reduction". Undersea Biomed Res. 7 (3): 191–7. PMID 7423657. Retrieved 2008-05-19. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  12. ^ Undersea and Hyperbaric Medical Society. "Clostridal Myositis and Myonecrosis (Gas gangrene)". Retrieved 2011-08-21.
  13. ^ Hart GB, Strauss MB (1990). "Gas Gangrene - Clostridial Myonecrosis: A Review". J. Hyperbaric Med. 5 (2): 125–144. Retrieved 2008-05-16.
  14. ^ Zamboni WA, Riseman JA, Kucan JO (1990). "Management of Fournier's Gangrene and the role of Hyperbaric Oxygen". J. Hyperbaric Med. 5 (3): 177–186. Retrieved 2008-05-16.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  15. ^ Undersea and Hyperbaric Medical Society. "Crush Injury, Compartment syndrome, and other Acute Traumatic Ischemias". Retrieved 2011-08-21.
  16. ^ Bouachour G, Cronier P, Gouello JP, Toulemonde JL, Talha A, Alquier P (1996). "Hyperbaric oxygen therapy in the management of crush injuries: a randomized double-blind placebo-controlled clinical trial". J Trauma. 41 (2): 333–9. PMID 8760546. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  17. ^ Undersea and Hyperbaric Medical Society. "Decompression Sickness or Illness and Arterial Gas Embolism". Retrieved 2011-08-21.
  18. ^ Brubakk, A. O. (2003). Bennett and Elliott's physiology and medicine of diving, 5th Rev ed. United States: Saunders Ltd. p. 800. ISBN 0-7020-2571-2. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  19. ^ Acott, C. (1999). "A brief history of diving and decompression illness". South Pacific Underwater Medicine Society Journal. 29 (2). ISSN 0813-1988. OCLC 16986801. Retrieved 2008-03-18.
  20. ^ Undersea and Hyperbaric Medical Society. "Enhancement of Healing in Selected Problem Wounds". Retrieved 2011-08-21.
  21. ^ Zamboni WA, Wong HP, Stephenson LL, Pfeifer MA (1997). "Evaluation of hyperbaric oxygen for diabetic wounds: a prospective study". Undersea Hyperb Med. 24 (3): 175–9. PMID 9308140. Retrieved 2008-05-16. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  22. ^ Kranke P, Bennett M, Roeckl-Wiedmann I, Debus S (2004). Kranke, Peter (ed.). "Hyperbaric oxygen therapy for chronic wounds". Cochrane Database Syst Rev (2): CD004123. doi:10.1002/14651858.CD004123.pub2. PMID 15106239.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  23. ^ Abidia A; Laden G; Kuhan G; et al. (2003). "The role of hyperbaric oxygen therapy in ischaemic diabetic lower extremity ulcers: a double-blind randomised-controlled trial". Eur J Vasc Endovasc Surg. 25 (6): 513–518. doi:10.1053/ejvs.2002.1911. PMID 12787692. {{cite journal}}: Unknown parameter |author-separator= ignored (help); Unknown parameter |month= ignored (help)
  24. ^ Kalani M, Jörneskog G, Naderi N, Lind F, Brismar K (2002). "Hyperbaric oxygen (HBO) therapy in treatment of diabetic foot ulcers. Long-term follow-up". J. Diabetes Complicat. 16 (2): 153–158. doi:10.1016/S1056-8727(01)00182-9. PMID 12039398.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  25. ^ Chen, J (2003). "The Effects of Hyperbaric Oxygen Therapy on Diabetic Retinopathy". Investigative Ophthalmology & Visual Science. 44 (5): 4017–B720.
  26. ^ Chang, Yun-Hsiang; et al. (006). "Hyperbaric oxygen therapy ameliorates the blood–retinal barrier breakdown in diabetic retinopathy". Clinical & Experimental Ophthalmology. 34 (6): 584–589. doi:10.1111/j.1442-9071.2006.01280.x. PMID 16925707. {{cite journal}}: Check date values in: |date= (help)
  27. ^ Basile C, Montanaro A, Masi M, Pati G, De Maio P, Gismondi A (2002). "Hyperbaric oxygen therapy for calcific uremic arteriolopathy: a case series". J. Nephrol. 15 (6): 676–80. PMID 12495283.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  28. ^ Undersea and Hyperbaric Medical Society. "Severe Anemia". Retrieved 201-08-21. {{cite web}}: Check date values in: |accessdate= (help)
  29. ^ Hart GB, Lennon PA, Strauss MB. (1987). "Hyperbaric oxygen in exceptional acute blood-loss anemia". J. Hyperbaric Med. 2 (4): 205–210. Retrieved 2008-05-19.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  30. ^ Undersea and Hyperbaric Medical Society. "Intracranial Abscess". Retrieved 2011-08-21.
  31. ^ Lampl LA, Frey G, Dietze T, Trauschel M. (1989). "Hyperbaric Oxygen in Intracranial Abscesses". J. Hyperbaric Med. 4 (3): 111–126. Retrieved 2008-05-19.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  32. ^ Undersea and Hyperbaric Medical Society. "Necrotizing Soft Tissue Infections". Retrieved 2011-08-21.
  33. ^ Escobar SJ, Slade JB, Hunt TK, Cianci P (2005). "Adjuvant hyperbaric oxygen therapy (HBO2) for treatment of necrotizing fasciitis reduces mortality and amputation rate". Undersea Hyperb Med. 32 (6): 437–43. PMID 16509286. Retrieved 2008-05-16.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  34. ^ Undersea and Hyperbaric Medical Society. "Refractory Osteomyelitis". Retrieved 2011-08-21.
  35. ^ Mader JT, Adams KR, Sutton TE (1987). "Infectious diseases: pathophysiology and mechanisms of hyperbaric oxygen". J. Hyperbaric Med. 2 (3): 133–140. Retrieved 2008-05-16.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  36. ^ Kawashima M, Tamura H, Nagayoshi I, Takao K, Yoshida K, Yamaguchi T (2004). "Hyperbaric oxygen therapy in orthopedic conditions". Undersea Hyperb Med. 31 (1): 155–62. PMID 15233171. Retrieved 2008-05-16.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  37. ^ Undersea and Hyperbaric Medical Society. "Hyperbaric Oxygen Treatments for Complications of radiation Therapy". Retrieved 2011-08-21.
  38. ^ Zhang, L. D. (1990). "Distribution of lesions in the head and neck of the humerus and the femur in dysbaric osteonecrosis". Undersea Biomed. Res. 17 (4): 353–8. ISSN 0093-5387. OCLC 2068005. PMID 2396333. Retrieved 2008-04-06. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  39. ^ Lafforgue P (2006). "Pathophysiology and natural history of avascular necrosis of bone". Joint Bone Spine. 73 (5): 500–7. doi:10.1016/j.jbspin.2006.01.025. PMID 16931094. {{cite journal}}: Unknown parameter |month= ignored (help)
  40. ^ Undersea and Hyperbaric Medical Society. "Skin Grafts and Flaps Compromised". Retrieved 2011-08-21.
  41. ^ McFarlane RM, Wermuth RE (1966). "The use of hyperbaric oxygen to prevent necrosis in experimental pedicle flaps and composite skin grafts". Plast. Reconstr. Surg. 37 (5): 422–430. doi:10.1097/00006534-196605000-00008. PMID 5327032. {{cite journal}}: Unknown parameter |month= ignored (help)
  42. ^ Undersea and Hyperbaric Medical Society. "Thermal Burns". Retrieved 2011-08-21.
  43. ^ Cianci P, Lueders H, Lee H, Shapiro R, Sexton J, Williams C, Green B (1988). "Adjunctive Hyperbaric Oxygen Reduces the Need for Surgery in 40–80% Burns". J. Hyperbaric Med. 3 (2): 97–101. Retrieved 2008-05-16.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  44. ^ Taylor RS, Simpson IN (2005). "Review of treatment options for lyme borreliosis". J Chemother. 17 (Suppl 2): 3–16. PMID 16315580. {{cite journal}}: Unknown parameter |month= ignored (help)
  45. ^ a b Bennett MH, Wasiak J, Schnabel A, Kranke P, French C (2005). Bennett, Michael H (ed.). "Hyperbaric oxygen therapy for acute ischaemic stroke". Cochrane Database Syst Rev (3): CD004954. doi:10.1002/14651858.CD004954.pub2. PMID 16034959.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  46. ^ Jain KK (1989). "Effect of Hyperbaric Oxygenation on Spasticity in Stroke Patients". J. Hyperbaric Med. 4 (2): 55–61. Retrieved 2008-08-06.
  47. ^ Singhal AB, Lo EH (2008). "Advances in emerging nondrug therapies for acute stroke 2007". Stroke. 39 (2): 289–291. doi:10.1161/STROKEAHA.107.511485. PMID 18187678. Retrieved 2011-09-16. {{cite journal}}: Unknown parameter |month= ignored (help)
  48. ^ Bennett MH, French C, Schnabel A, Wasiak J, Kranke P (2008). Bennett, Michael H (ed.). "Normobaric and hyperbaric oxygen therapy for migraine and cluster headache". Cochrane Database Syst Rev (3): CD005219. doi:10.1002/14651858.CD005219.pub2. PMID 18646121.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  49. ^ Eftedal OS, Lydersen S, Helde G, White L, Brubakk AO, Stovner LJ (2004). "A randomized, double blind study of the prophylactic effect of hyperbaric oxygen therapy on migraine". Cephalalgia. 24 (8): 639–644. doi:10.1111/j.1468-2982.2004.00724.x. PMID 15265052.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  50. ^ Fife WP, Fife CE (1989). "Treatment of Migraine with Hyperbaric Oxygen". J. Hyperbaric Med. 4 (1): 7–15. Retrieved 2008-08-06.
  51. ^ Rossignol DA; Rossignol LW; Smith S; et al. (2009). "Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial" (PDF). BMC Pediatrics. 9: 21. doi:10.1186/1471-2431-9-21. PMC 2662857. PMID 19284641. {{cite journal}}: Unknown parameter |author-separator= ignored (help); Unknown parameter |laydate= ignored (help); Unknown parameter |laysource= ignored (help); Unknown parameter |laysummary= ignored (help)CS1 maint: unflagged free DOI (link)
  52. ^ Doreen Granpeesheh, Jonathan Tarbox, Dennis R. Dixon, Arthur E. Wilke, Michael S. Allen (2009). "Randomized Trial of Hyperbaric Oxygen Therapy for Children with Autism". Research in Autism Spectrum Disorders. {{cite journal}}: Unknown parameter |laysummary= ignored (help)CS1 maint: multiple names: authors list (link)
  53. ^ Neubauer, Richard A (2001). "Hyperbaric Hyperbaric oxygenation for cerebral palsy". Lancet. 357 (9273): 2052–3. doi:10.1016/S0140-6736(00)05137-0. PMID 11441856.
  54. ^ Baechli H, Schmutz J, Mayr JM (2008). "Hyperbaric oxygen therapy (HBO) for the treatment of an epidural abscess in the posterior fossa in an 8-month-old infant". Pediatr Neurosurg. 44 (3): 239–242. doi:10.1159/000121383. PMID 18354266.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  55. ^ Suzuki H; Fujimura T; Shiomori T; et al. (2008). "Prostaglandin E1 versus steroid in combination with hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss". Auris Nasus Larynx. 35 (2): 192–197. doi:10.1016/j.anl.2007.06.003. PMID 17826927. {{cite journal}}: Unknown parameter |author-separator= ignored (help); Unknown parameter |month= ignored (help)
  56. ^ a b Bennett M, Heard R (2004). Bennett, Michael H (ed.). "Hyperbaric oxygen therapy for multiple sclerosis". Cochrane Database of Systematic Reviews (1): CD003057. doi:10.1002/14651858.CD003057.pub2. PMID 14974004.
  57. ^ Yoshida, Takahiro; et al. (2008). "Hyperbaric oxygen therapy for radiation-induced hemorrhagic cystitis". International Journal of Urology. 15 (7): 639–641. doi:10.1111/j.1442-2042.2008.02053.x. PMID 18643783. {{cite journal}}: Cite has empty unknown parameter: |coauthors= (help)
  58. ^ Noyer, Charles M.; et al. (2004). "Hyperbaric oxygen therapy for perineal Crohn's disease". The American Journal of Gastroenterology. 94 (2): 318–321. doi:10.1111/j.1572-0241.1999.00848.x. PMID 10022622. {{cite journal}}: Cite has empty unknown parameter: |coauthors= (help); Unknown parameter |author-separator= ignored (help)
  59. ^ Atug, Ozlen; et al. (2008). "Hyperbaric Oxygen Therapy Is as Effective as Dexamethasone in the Treatment of TNBS-E-Induced Experimental Colitis". Digestive Diseases and Sciences. 53 (2): 481–485. doi:10.1007/s10620-007-9956-4. PMID 17934837. {{cite journal}}: Cite has empty unknown parameter: |coauthors= (help)
  60. ^ Butler, Glenn; Michaels, Julio Chávarri; Al-Waili, Noori; Finkelstein, Michael; Allen, Michael; Petrillo, Richard; Carrey, Zev; Kolanuvada, Bangaruraju; Lee, Bok Y; Riera, Alfonso Gonzales; Michaels, Cesar Chávarri; Urteaga, Gary (2009). "Therapeutic effect of hyperbaric oxygen in psoriasis vulgaris: two case reports and a review of the literature". Journal of Medical Case Reports. 3: 7023. doi:10.4076/1752-1947-3-7023. PMC 2737769. PMID 19830133.
  61. ^ Ustundag, Aylin; et al. (2008). "Evaluation of the potential genotoxic effects of hyperbaric oxygen therapy". Toxicology Letters. 180 (Suppl 1): S142. doi:10.1016/j.toxlet.2008.06.792. PMID 18573318. {{cite journal}}: More than one of |pages= and |page= specified (help)
  62. ^ Mortensen, Christian Risby (2008). "Hyperbaric oxygen therapy". Current Anaesthesia & Critical Care. 19 (5–6). Elsevier: 333–337. doi:10.1016/j.cacc.2008.07.007. {{cite journal}}: Cite has empty unknown parameter: |coauthors= (help)
  63. ^ www.oxyhealth.com. "Portable Hyperbaric Chambers | Hyperbaric Oxygen Chamber | Hyperbaric Oxygen". Oxyhealth.com. Retrieved 2010-09-25.
  64. ^ U.S. Navy Supervisor of Diving (2008). "20". U.S. Navy Diving Manual (PDF). SS521-AG-PRO-010, revision 6. U.S. Naval Sea Systems Command. pp. 37–49. Retrieved 2009-06-29. {{cite book}}: Unknown parameter |vol= ignored (|volume= suggested) (help)
  65. ^ "Undersea and Hyperbaric Medical Society". Uhms.org. Retrieved 2011-08-21.
  66. ^ "Product Classification, Chamber, Hyperbaric". United States Food and Drug Administration. Retrieved 2011-08-22.
  67. ^ a b Broome JR, Smith DJ (1992). "Pneumothorax as a complication of recompression therapy for cerebral arterial gas embolism". Undersea Biomed Res. 19 (6): 447–55. PMID 1304671. Retrieved 2008-05-23. {{cite journal}}: Unknown parameter |month= ignored (help)
  68. ^ a b Fitzpatrick DT, Franck BA, Mason KT, Shannon SG (1999). "Risk factors for symptomatic otic and sinus barotrauma in a multiplace hyperbaric chamber". Undersea Hyperb Med. 26 (4): 243–7. PMID 10642071. Retrieved 2008-05-23.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  69. ^ Fiesseler FW, Silverman ME, Riggs RL, Szucs PA (2006). "Indication for hyperbaric oxygen treatment as a predictor of tympanostomy tube placement". Undersea Hyperb Med. 33 (4): 231–5. PMID 17004409. Retrieved 2008-05-23.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  70. ^ Stein, L (2000). "Dental Distress. The 'Diving Dentist' Addresses the Problem of a Diving-Related Toothache" (PDF). Alert Diver (January/ February): 45–48. Retrieved 2008-05-23.
  71. ^ Smerz, R.W. (2004). "Incidence of oxygen toxicity during the treatment of dysbarism". Undersea and Hyperbaric Medicine. 31 (2): 199–202. PMID 15485081. Retrieved 2008-04-30.
  72. ^ Butler FK (1995). "Diving and hyperbaric ophthalmology". Surv Ophthalmol. 39 (5): 347–366. doi:10.1016/S0039-6257(05)80091-8. PMID 7604359.
  73. ^ Butler FK, White E, Twa M (1999). "Hyperoxic myopia in a closed-circuit mixed-gas scuba diver". Undersea Hyperb Med. 26 (1): 41–5. PMID 10353183. Retrieved 2008-05-23.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  74. ^ Gesell LB, Adams BS, and Kob DG (2000). "De Novo Cataract Development Following A Standard Course Of Hyperbaric Oxygen Therapy". Undersea Hyperb Med abstract. 27 (supplement). Retrieved 2008-06-01.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  75. ^ Lehm Jan P, Bennett Michael H (2003). "Predictors of middle ear barotrauma associated with hyperbaric oxygen therapy". South Pacific Underwater Medicine Society Journal. 33: 127–133. Retrieved 2009-07-15.
  76. ^ CAMJ (2008). "Fracture of the maxillary bone during hyperbaric oxygen therapy". Retrieved 17 December 2008.
  77. ^ Takenaka S, Arimura T, Higashi M, Nagayama T, Ito E (1980). "Experimental study of bleomycin therapy in combination with hyperbaric oxygenation". Nippon Gan Chiryo Gakkai Shi. 15 (5): 864–75. PMID 6159432. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  78. ^ Stubbs JM, Johnson EG, Thom SR (2005). "Trends Of Treating Patients, That Have Received Bleomycin Therapy In The Past, With Hyperbaric Oxygen Treatment (Hbot) And A Survey Of Considered Absolute Contraindications To Hbot". Undersea Hyperb Med abstract. 32 (supplement). Retrieved 2008-05-23.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  79. ^ Feldmeier J, Carl U, Hartmann K, and Sminia P. (2003). "Hyperbaric Oxygen: Does it promote growth or recurrence of malignancy?". Undersea and Hyperbaric Medicine. 30 (1): 1–18. PMID 12841604. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  80. ^ Van Hoesen KB, Camporesi EM, Moon RE, Hage ML, Piantadosi CA (1989). "Should hyperbaric oxygen be used to treat the pregnant patient for acute carbon monoxide poisoning? A case report and literature review". JAMA. 261 (7): 1039–43. doi:10.1001/jama.1989.03420070089037. PMID 2644457. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  81. ^ Elkharrat D; Raphael JC; Korach JM; et al. (1991). "Acute carbon monoxide intoxication and hyperbaric oxygen in pregnancy". Intensive Care Med. 17 (5): 289–92. doi:10.1007/BF01713940. PMID 1939875. {{cite journal}}: Unknown parameter |author-separator= ignored (help)
  82. ^ McDonagh M, Helfand M, Carson S, Russman BS (2004). "Hyperbaric oxygen therapy for traumatic brain injury: a systematic review of the evidence". Arch Phys Med Rehabil. 85 (7): 1198–204. doi:10.1016/j.apmr.2003.12.026. PMID 15241774. Retrieved 2011-09-16. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  83. ^ Carson S, McDonagh M, Russman B, Helfand M (2005). "Hyperbaric oxygen therapy for stroke: a systematic review of the evidence". Clin Rehabil. 19 (8): 819–33. doi:10.1191/0269215505cr907oa. PMID 16323381. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  84. ^ a b c d e McDonagh MS, Morgan D, Carson S, Russman BS (2007). "Systematic review of hyperbaric oxygen therapy for cerebral palsy: the state of the evidence". Dev Med Child Neurol. 49 (12): 942–7. doi:10.1111/j.1469-8749.2007.00942.x. PMID 18039243. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  85. ^ a b Collet JP; Vanasse M; Marois P; et al. (2001). "Hyperbaric oxygen for children with cerebral palsy: a randomised multicentre trial. HBO-CP Research Group". Lancet. 357 (9256): 582–6. doi:10.1016/S0140-6736(00)04054-X. PMID 11558483. {{cite journal}}: Unknown parameter |author-separator= ignored (help); Unknown parameter |month= ignored (help)
  86. ^ Bennett M, Heard R (2010). "Hyperbaric oxygen therapy for multiple sclerosis". CNS Neurosci Ther. 16 (2): 115–24. doi:10.1111/j.1755-5949.2009.00129.x. PMID 20415839. {{cite journal}}: Unknown parameter |month= ignored (help)

Further reading

  • Kindwall, Eric P; Whelan, Harry T (2008). Hyperbaric Medicine Practice, 3rd Edition. Flagstaff, AZ: Best Publishing Company. ISBN 978-1-930536-49-4.
  • Mathieu, Daniel (2006). Handbook on Hyperbaric Medicine. Berlin: Springer. ISBN 1-4020-4376-7.
  • Neubauer, Richard A; Walker, Morton (1998). Hyperbaric Oxygen Therapy. Garden City Park, NY: Avery Publishing Group. ISBN 0-89529-759. {{cite book}}: Check |isbn= value: length (help)
  • Jain, KK; Baydin, SA (2004). Textbook of hyperbaric medicine. Cambridge, MA: Hogrefe & Huber. ISBN 0-88937-277-2.
  • Harch, Paul G; McCullough, Virginia (2010). The Oxygen Revolution. Long Island City, NY: Hatherleigh Press. ISBN 1-57826-326-3.
Retrieved from "https://en.wikipedia.org/w/index.php?title=Hyperbaric_medicine&oldid=493056788"