Hyperbaric therapy

The low breathing resistance of helium—oxygen mixtures is of therapeutic advantage for patients suffering from asthma and other obstmctive respitatory difficulties. The mixtures have also been used for hyperbaric therapy. 

In addition to antidotal therapy, administration of 100% oxygen can help with cyanide detoxification, possibly by affecting the binding of cyanide to cytochrome oxidase (13). Hyperbaric therapy may be considered, but only after standard treatment has failed, or if the patient has concurrent carbon monoxide poisoning (13). 

Hyperbaric medicine The prefix hyper-means above or excessive, and a bar is a unit of pressure equal to 100 kPa, roughly normal atmospheric pressure. Thus, the term hyperbaric refers to pressure that is greater than normal. Patients receiving hyperbaric therapy are exposed to pressures greater than the pressure of the atmosphere at sea level. 

Hyperbaric therapy uses 100% oxygen at pressure to help heal wounds and infections, and to treat carbon monoxide poisoning. A hyperbaric chamber has a volume of 1510 L. How many kilograms of Oi gas are needed to give an oxygen pressure of 2.04 atm at 25 °C (8.5, 8.6)... 

Rusyniak DE, Kirk MA, May JD, Kao LW, Brizendine EJ, Welch JL, Cordell WH, Alonso RJ. Hyperbaric oxygen therapy in acute ischemic stroke results of the hyperbaric oxygen in acute ischemic stroke trial pilot study. Stroke 2003 34 571-574. 

There is no proven antidote for hydrogen sulfide poisoning. Treatment consists of supportive measures such as evaluating and supporting airway, breathing, and circulation (ATSDR 1994). Sodium nitrite may or may not be an effective antidote, but if proper precautions in administration are observed, intravenous administration of sodium nitrite may help some hydrogen sulfide poisoned persons (Hall 1996 Hall and Rumack 1997). Hyperbaric oxygen therapy is controversial, but it may be effective for patients not treated successfully by other measures (ATSDR 1994). 

Smilkstein MJ, Bronstein AC, Pickett HM, et al. 1985. Hyperbaric oxygen therapy for severe hydrogen sulfide poisoning. J Emerg Med 3 27-30. 

Continue oxygen therapy until patient is asymptomatic and blood carbon monoxide levels are below 10%. For individuals with blood carbon monoxide levels above 40%, consider transfer to a hyperbaric facility. 

Oxygen is used for the correction of hypoxia and as a diluent or carrier gas for vapors and gases, primarily anesthetic agents. The use of oxygen at increased pressure is termed hyperbaric oxygen therapy. This therapy is used in diverse conditions such as multiple sclerosis, traumatic spinal cord injury, cerebrovascular accidents, bone graft, fractures, and leprosy. However, there are no available authentic data, as there are no well-controlled clinical trials. 

Supportive therapy 100% oxygen or hyperbaric oxygen Oxygen Potentiates the efficacy of nitrite-thiosulfate therapy... 

Thom, S.R., Keim, L.W. (1989). Carbon monoxide poisoning a review. Epidemiology, pathophysiology, clinical findings, and treatment options including hyperbaric oxygen therapy. J. Toxicol. Clin. Toxicol. 27 141-56. 

Blood gases and serum electrolytes should be monitored and corrected as needed (Hall and Rumack, 1986 Vogel et al, 1981). Blood cyanide levels can confirm exposure, but due to the time needed to get the results, they are not clinically useful. Provide supplemental oxygen with assisted ventilation as indicated. Animal study results for hyperbaric oxygen therapy have been questionable (Way et al, 1972). Acidosis (pH <7.1) should be corrected with intravenous sodium bicarbonate, but acidosis may not resolve until after the administration of antidotes (Hall and Rumack, 1986). Benzodiazepines or barbiturates can be used to control seizures. 

Tibbies P M, Edelsberg J S1996 Hyperbaric-oxygen therapy. New England Journal of Medicine 334 1642-1648... 

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