Professional Documents
Culture Documents
Dr Deepak Kumar
LADY HARDINGE MEDICAL COLLEGE
INTRODUCTION
• Hyperbaric oxygen therapy is defined as
administration of 100% oxygen to a patient
placed inside a chamber pressurized to greater
than 1 atmosphere.
Not Hyperbaric Therapy!!!
• Local application of pressurized oxygen to a part of the body
without completely enclosing the patient is not hyper baric
oxygen therapy
History
• Initial discovery
– 1662 Henshaw built first hyperbaric chamber
• English physician and clergyman Called the chamber
the “Domicilum”
Background
• Elemental Oxygen
– 1775 Discovered by Priestly (English)
• Surgical use
– 1870’s Fontaine & Bert (France)
• Prolong anesthesia
• Improved surgical outcomes
– Wound healing
• Decompression sickness
– 1910-30’s Drager, then Behnke & Shaw
• Reduced morbidity of decompression
• Studies of cardiopulmonary effects initiated
Physiology
• Cardiopulmonary
– Increase in PaO2
• Saturation of available hemoglobin molecules
– Hb 97% saturated at atmospheric pressure
– Maximization does NOT significantly increase O2 delivery
• Increase in dissolved O2
– PAO2 is 100mm Hg at atmospheric pressure
– Using 100% FiO2 at 3 atm up to 2000mm Hg
» Increase O2 from 3ml/L blood to to 60ml/L
» 20 times more O2 circulating in plasma
Mechanisms of Action
Pneumothorax
Complications..
• Lens deformation causes temporary myopia
• Exacerbation of other processes
– Dental abscess, sinusitis, laryngocele, etc.
• Claustrophobia, anxiety, etc.
• Oxygen toxicity
– Very rare, but may cause seizures
• Potential effects on tumor growth
– Controversial
Fire Risk
• Especially monoplace
– 100% oxygen
– Highly pressurized
– Enclosed space
• Rare… but not rare enough
– 50 deaths due to HBO2-related fires since 1980
– Must remove all flammable materials
– Fire safety protocol is essential
• Risk reduced in multiplace chambers
– Chamber pressurized
– O2 delivered individually via tight-fitting masks
– Attendants may enter in an emergency
Contraindications
• Absolute Contraindications
– Untreated Pneumothorax
– Bleomycin –cardiotoxicity
– Cisplatin- delayed wound healing
– Disulfiram- blocks superoxide dimutase
(SOD)
Absolute HBO Contraindications
Recent Bleomycin Use – recent is not established although a one year period
may be sufficient.