Hyperbaric Oxygen Therapy (Hbo)

(Hyperbaric O2 therapy)

The hyperbaric oxygen therapy means the treatment with 100% O2 for several hours in a sealed chamber at a pressure of> 1 atm, which is gradually lowered to air pressure. For divers this therapy is used primarily for decompression sickness and arterial gas embolism. A short time until the start of treatment leads to a better outcome for the patient, but the therapy should within 48 hours after starting to emerge. Despite a serious injury therapy predicts a bad score. An untreated pneumothorax requiring a chest tube plant at the beginning of hyperbaric oxygen therapy.

Objectives of hyperbaric oxygen therapy for diving injuries are:

The hyperbaric oxygen therapy means the treatment with 100% O2 for several hours in a sealed chamber at a pressure of> 1 atm, which is gradually lowered to air pressure. For divers this therapy is used primarily for decompression sickness and arterial gas embolism. A short time until the start of treatment leads to a better outcome for the patient, but the therapy should within 48 hours after starting to emerge. Despite a serious injury therapy predicts a bad score. An untreated pneumothorax requiring a chest tube plant at the beginning of hyperbaric oxygen therapy. Objectives of hyperbaric oxygen therapy for diving injuries are: Increasing O2 solubility and release Increasing N2 washout Decreasing CO concentration Falling gas bubble size reduction of tissue ischemia for carbon monoxide poisoning are among the mechanisms to reduce the half-life of carboxyhemoglobin, which ischemia reduces and possibly mitochondrial function is improved. Hyperbaric O2 therapy is also used for other pathological disorders that are not related to diving into context (see table: Hyperbaric O2 therapy (HBO)). Hyperbaric O2 therapy (HBO) documents disturbances Good arterial gas embolism Clostridieninfektion decompression sickness ORN Slow-healing skin grafts Some Anemia (severe) with hemorrhagic shock burns Severe carbon monoxide poisoning Intracranial Abscess with actinomycosis necrotizing fasciitis rotation soft tissue injury heavy-treat osteomyelitis traumatic crush injury and compartment syndrome wound healing in ischemic limbs Acute Nierenarterien- or vein occlusion * Hyperbaric O2Therapie (hyperbaric oxygenation, HBO) is the main treatment for diving-related injuries and decompression sickness and arterial gas embolism. It is applied to other diseases, but it is in some applications more established than in others. Relative contraindications are chronic diseases of the lungs, problems with the sinuses, seizures and claustrophobia. Pregnancy is not a contraindication. In the US, you can find the nearest location of a pressure chamber via the Divers Alert Network at 919-684-9111 for emergencies and 919-684-2948 for other information; www.diversalertnetwork.org). Since HBO is relatively well tolerated should be started if any chance that they could contribute to the recovery; HBO may even still help if it is up to 48 hours started after the appearance on the surface. However, the success is generally low if> 48 hours started after onset of symptoms, with the exception of exposure to height (z. B. Fly) after diving, the therapy even a few days according to the amount of exposure to be successful in this case, could. In the pressure chambers are either more treatment courses with room for one or more patients on a stretcher and a nurse or a doctor or a treatment center with room for a single patient. Chambers with a place are indeed cheaper, but do not allow access to the patient during recompression; its use in critically ill patients in which an intervention may be necessary, can be risky. In popular diving areas the divers themselves, the medical staff, rescue workers and police officers should know where the nearest appropriate pressure chamber is located, how to most quickly and how best phone makes contact. Such information may be obtained also from the Divers Alert Network (919-684-9111; www.diversalertnetwork.org). The Undersea and Hyperbaric Medical Society (http://membership.uhms.org/) is another invaluable resource for general information on HBO. Guidelines for HBO pressure and duration of treatment is usually a specialist in the HBO unit decides. The treatments are carried out 1 or 2 times daily for 45 to 300 minutes until the symptoms subside; 5- to 10-minute air breaks are inserted in order to reduce the risk of O2 toxicity. The chamber pressure is usually kept between 2.5 and 3.0 atm, but patients can start life-threatening neurological symptoms due to gas embolism with an increase to 6 atm to rapidly compress the cerebral gas bubbles. Although HBO is usually performed with 100% O2 or compressed air may result in specific gas mixtures (eg. As in non-atmospheric proportions O2 or N2 / O2 Helium /) shall be displayed if the diver used an unusual gas mixture or when the depth or duration were exceptional dive. Appropriate guidelines for treatment are included in the US Navy Diving Manual. Patients with residual neurological deficits should receive repeated intermittent positive pressure treatment, it may take a few days until the maximum improvement is reached. Complications of Rekompressionstherapie The Rekompressionstherapie can cause similar problems as barotrauma, incl. Ear and Sinusbarotraumata. O2Toxizität can cause reversible myopia. Rarely pulmonary barotrauma, pulmonary O2 toxicity, hypoglycemia or seizures may occur. Sedatives and opioids may mask the symptoms and cause respiratory failure; they should be avoided or administered only in the slightest yet effective doses. Contraindications for hyperbaric oxygen therapy patients with pneumothorax requiring a chest tube in front of HBO. Relative contraindications: Obstructive disorders infections of the upper respiratory or sinus Severe heart failure, recent ear surgery or injury Fever claustrophobia seizure disorder breast surgery Summary An HBO should be arranged as soon as possible. not close them one Rekompressionstherapie based on the time of which has elapsed since the occurrence; However, with the exception of the amount of exposure after diving, the success rate of Rekompressionstherapie is low when it is started> 48 hours after symptom onset. If an unstable patient should get an HBO, a multi-person pressure chamber should be used. Patients with pneumothorax requiring a chest tube in front of HBO. For more information Divers Alert Network: 24-hour emergency hotline, 919-684-9111 SEA 00C: Office of the Director of Ocean Engineering Supervisor of Salvage and Diving Undersea and Hyperbaric Medical Society

Health Life Media Team

Leave a Reply