Hyperbaric Oxygen

Hyperbaric Oxygen means delivering the oxygen above atmospheric pressure which is 760 mmHg (or 1 atm). Special hyperbaric chambers are made for providing hyperbaric Oxygen, which are very expensive.

Hyperbaric Oxygen Uses

A. Poisonings:

  • Carbon monoxide poisoning (half life of CO at 1 atm is 214 minutes which can be reduced to 19 minutes at 2.5 atm).
  • Cyanide poisoning.

B. Gas bubble diseases:

  • Decompression sickness.
  • Air embolism.

C. Ischemia:

  • Crush injuries.
  • Ischemic ulcers.
  • Radiation necrosis.

D. Infections:

  • Clostridial.
  • Mucormycosis.
  • Refractory osteomyelitis.

E. Others:

  • Oxygen support during lung lavage.
  • Burns.
  • Cerebral edema.

Hyperbaric Oxygen Toxicity

1. Pulmonary: ARDS

2. CNS: Seizures preceded by facial numbness, twitching, unpleasant olfactory or gustatory sensations at common in Hyperbaric Oxygen toxicity.

3. Eye: Myopia, nuclear cataract and retrolental fibroplasia (in neonates)

4. Avascular necrosis of bone.

5 Barotrauma

Safe Levels of Hyper baric Oxygen and Therapy Schedule

Hyperbaric Oxygen Toxicity depends on 3 factors:

i Pressure,

ii. Time of exposure and

iii. Oxygen concentration.

Pulmonary effects can be seen at 2 atm while CNS symptoms manifest above 2 atm.

• Patients with chronic diseases are usually given 2 hours at 2 atm once a day

• Patients with decompression sickness are given 100% oxygen at 2-8 atm followed by 1-9 atm interspersed by periods of 5-15 minutes of air breathing.

• Gas embolism patients can be given air at 6 atm followed by 100% oxygen at2-8 and 1-9 atm. The exact safe levels of hyperbaric oxygen are not defined but not more than 2-8 atm should be used with 100% oxygen but with air (21 %021 up to 6 atm can be used safely and one therapy schedule at a time should be of less than 2 hours.

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