Thursday, May 3, 2012
Friday, August 12, 2011
Hyperbarics for Frostbites
There's one I have never written about before.
I am not a great mountain climber, or researcher of the Antarctica
nor do I live in Alaska or Iceland.
But here is some interesting excerpt from an article about Hyperbaric Oxygen
for the treatment of frostbites.
I am not a great mountain climber, or researcher of the Antarctica
nor do I live in Alaska or Iceland.
But here is some interesting excerpt from an article about Hyperbaric Oxygen
for the treatment of frostbites.
"Ledinham first reported the use of HBO for the treatment of frostbite in 1963. Other studies have reported considerable success with the use of HBO for frostbite injuries.
Whether local circulatory effects decrease cellular damage or tissue viability, it appears that an increase in local tissue oxygen tension through the use of HBO improves the viability of tissue and allows vascular and cellular regeneration to occur. The immediate effect of HBO is hyperoxygenation of ischemic tissues, resulting from increased amounts of dissolved oxygen in plasma directly in proportion to the partial pressure of inhaled oxygen. Hyperoxia can be of great benefit through numerous mechanisms: improvement of oxygen delivery and preservation of tissue viability in ischemic areas; vasoconstriction with reduction in local edema with preservation of oxygenation; prevention of ischemic/reperfusion injury syndrome; enhancement of host response to local infections; and enhancement of the wound healing process through stimulation of angiogenesis and tissue growth and support. These processes can improve the local circulation and viability of damaged tissues, even when HBO treatments are started 2 weeks or more after the injury. The ideal time to initiate HBO for frostbite is during the rewarming period because of the reperfusion component of the injury."[1]
This is a lot of medical jargon, but in my books i understand enough to be sure
that I would get some treatments if I ever were unfortunate enough to acquire
a frostbite.
Wednesday, July 27, 2011
Spider Bites
It's been a while since I have posted something, but I will be
less lazy now again.
One of my friends told me he had been bitten by a Brown Recluse spider,
and that the bite wound looks nasty. He is of course already under the
care of a MD in his hometown. Nevertheless I was of course curious
about what's out there in regards to hyperbarics and spider bites. Here is
what I found:
"Hyperbaric oxygen. Hyperbaric oxygen therapy has been used successfully in the management of necrotic wounds, but not in all cases. It is thought to be useful in the treatment of brown recluse spider bites through two different mechanisms. First, the hypoxic nature of nonhealing wounds suggests a strong relationship between healing and oxygen supply. Sheffield and Dunn showed that wound oxygen tension is elevated with hyperbaric treatments. The second mechanism of action directly involves the venom, possibly inactivating its necrotizing component. Sphingomyelinase-D digests the intercellular matrix, allowing the venom to spread; hypothetically, hyperbaric oxygen therapy denatures the sphingomyelinase-D. One study disputes this theory; however, the sphingomyelinase-D was not tested at clinical levels. Controlled animal and human studies are still needed to conclusively demonstrate the efficacy of hyperbaric oxygen therapy."1
"The effect of hyperbaric oxygen in decreasing the size of necrotic skin lesions resulting from brown recluse envenomation has also been studied. One study using white rabbits showed an earlier reepithelization of the necrotic ulcers when these rabbits were treated with hyperbaric oxygen twice daily. Treatments were initiated at 72 hours after injection of venom. Maynor et al speculated that hyperbaric oxygen inactivated sphingomyelinase D by the disruption of sulfhydryl groups. Hyperbaric oxygen has also been postulated to decrease wound damage secondary to brown recluse envenomation in at least two additional ways. It has been speculated that wound damage is decreased in part because of the pulmonary sequestration of neutrophils. Hyperbaric oxygen therapy also increases the production of collagen by fibroblasts, thereby facilitating wound healing. Beilman et al found that guinea pig models which had hyperbaric oxygen therapy as pretreatment had significantly smaller areas of necrosis when compared with control animals or animals given dapsone as pretreatment."2
Not everything absolutely conclusive, but good enough for me to tell my friend to throw some hyperbaric treatments into his protocol.
Looks like that Brown Recluse venom is real nasty, so every little thing that can help
on top of regular doctors protocols in my opinion should be welcome, especially
in those bite cases where it comes to complications with the wound.
1) http://www.o-wm.com/content/brown-recluse-spider-bites-a-complex-problem-wound-a-brief-review-and-case-study?page=0,3
2) http://www.medscape.com/viewarticle/405814_7
less lazy now again.
One of my friends told me he had been bitten by a Brown Recluse spider,
and that the bite wound looks nasty. He is of course already under the
care of a MD in his hometown. Nevertheless I was of course curious
about what's out there in regards to hyperbarics and spider bites. Here is
what I found:
"Hyperbaric oxygen. Hyperbaric oxygen therapy has been used successfully in the management of necrotic wounds, but not in all cases. It is thought to be useful in the treatment of brown recluse spider bites through two different mechanisms. First, the hypoxic nature of nonhealing wounds suggests a strong relationship between healing and oxygen supply. Sheffield and Dunn showed that wound oxygen tension is elevated with hyperbaric treatments. The second mechanism of action directly involves the venom, possibly inactivating its necrotizing component. Sphingomyelinase-D digests the intercellular matrix, allowing the venom to spread; hypothetically, hyperbaric oxygen therapy denatures the sphingomyelinase-D. One study disputes this theory; however, the sphingomyelinase-D was not tested at clinical levels. Controlled animal and human studies are still needed to conclusively demonstrate the efficacy of hyperbaric oxygen therapy."1
"The effect of hyperbaric oxygen in decreasing the size of necrotic skin lesions resulting from brown recluse envenomation has also been studied. One study using white rabbits showed an earlier reepithelization of the necrotic ulcers when these rabbits were treated with hyperbaric oxygen twice daily. Treatments were initiated at 72 hours after injection of venom. Maynor et al speculated that hyperbaric oxygen inactivated sphingomyelinase D by the disruption of sulfhydryl groups. Hyperbaric oxygen has also been postulated to decrease wound damage secondary to brown recluse envenomation in at least two additional ways. It has been speculated that wound damage is decreased in part because of the pulmonary sequestration of neutrophils. Hyperbaric oxygen therapy also increases the production of collagen by fibroblasts, thereby facilitating wound healing. Beilman et al found that guinea pig models which had hyperbaric oxygen therapy as pretreatment had significantly smaller areas of necrosis when compared with control animals or animals given dapsone as pretreatment."2
Not everything absolutely conclusive, but good enough for me to tell my friend to throw some hyperbaric treatments into his protocol.
Looks like that Brown Recluse venom is real nasty, so every little thing that can help
on top of regular doctors protocols in my opinion should be welcome, especially
in those bite cases where it comes to complications with the wound.
1) http://www.o-wm.com/content/brown-recluse-spider-bites-a-complex-problem-wound-a-brief-review-and-case-study?page=0,3
2) http://www.medscape.com/viewarticle/405814_7
Thursday, May 19, 2011
Contraindications
Hey,
it's been a while life is keeping me busy.
This will be a short post but nevertheless important.
Of course even Hyperbaric Oxygen has contraindications.
There is absolute ones (= No no) and relative ones:
Absolute Contraindications:
Relative Contraindications:
Here is what i have to say about some of the relative one's:
In case of Number 3 this is unfortunate because I believe Hyperbaric
Oxygen can actually help, but the problem is that you might not
be able to equalize your ear pressure which occurs during inflation
and deflation of the chamber.
For Number 2: I have seen claustrophobic people going into
Hyperbaric Oxygen chambers, but it is more rare that they will be
able to complete a full session and if they do it usually requires
attended sessions. Rule of thumb is if they want to come out just
let them out don't try to talk them into remaining in the chamber
or make them wrong in any way because they will never come back
and so deprive themselves of the possible benefits.
Numbers 1 and 4 I would probably not put in.
Number 5 i might have to come back to you. I don't see a problem
there but I might be wrong I'll let you know in a later post.
Have a great week :)
(1)
it's been a while life is keeping me busy.
This will be a short post but nevertheless important.
Of course even Hyperbaric Oxygen has contraindications.
There is absolute ones (= No no) and relative ones:
Absolute Contraindications:
- Bleomycin Exposure (This is a chemo agent)
- Undrained pneumothorax
- Concurrent chemotherapy/radiation therapy
- Pressure-sensitive implanted medical device (eg, automatic implantable cardiac defibrillator, pacemaker, dorsal column stimulator, insulin pump)
- and of course if the Patient refuses.(1)
Relative Contraindications:
- Severe chronic obstructive pulmonary disease/asthma
- Severe claustrophobia
- Chronic sinusitis/upper respiratory infection
- History of spontaneous pneumothorax
- High fever/dehydration (1)
Here is what i have to say about some of the relative one's:
In case of Number 3 this is unfortunate because I believe Hyperbaric
Oxygen can actually help, but the problem is that you might not
be able to equalize your ear pressure which occurs during inflation
and deflation of the chamber.
For Number 2: I have seen claustrophobic people going into
Hyperbaric Oxygen chambers, but it is more rare that they will be
able to complete a full session and if they do it usually requires
attended sessions. Rule of thumb is if they want to come out just
let them out don't try to talk them into remaining in the chamber
or make them wrong in any way because they will never come back
and so deprive themselves of the possible benefits.
Numbers 1 and 4 I would probably not put in.
Number 5 i might have to come back to you. I don't see a problem
there but I might be wrong I'll let you know in a later post.
Have a great week :)
(1)
Kindwall EP. Contraindications and side effects to hyperbaric oxygen treatment.
In: Kindwall EP, editor. Hyperbaric medicine practice. Flagstaff, AZ:
Best Publishing, 1995
Friday, April 29, 2011
And about Wound Healing again
I know I keep stressing the relevance of hyperbaric treatments in wound healing.
That's why everytime I come across something that explains why it works
I want to post it here so you can see that it's actually not rocket science to
understand that hyperbaric oxygen is of extreme importance in wound healing.
The following quotation is a bit technical but right to the point:
That's why everytime I come across something that explains why it works
I want to post it here so you can see that it's actually not rocket science to
understand that hyperbaric oxygen is of extreme importance in wound healing.
The following quotation is a bit technical but right to the point:
"In wound healing, biochemical energy supply is a basic requirement. Oxygen is essential for the production of biological energy equivalents (e.g. adenosine triphosphate, ATP) in aerobic glycolysis, the citric acid cycle, and the oxidation of fatty acids. Therefore, sufficient oxygenation of tissue is a prerequisite for adequate energy levels, which are essential for proper cellular function.
In healing tissue, sufficient oxygenation is particularly relevant because of the increased energy demand for reparative processes such as cell proliferation, bacterial defence and collagen synthesis. The strictly oxygen-dependent NADPH-linked oxygenase represents a further highly important enzyme in wound healing; it catalyses the production of reactive oxygen species (ROS) such as peroxide anion (HO2 −), hydroxyl ion (HO−) and superoxide anion (O2−). ROS play a prominent role in oxidative bacterial killing and coregulate prevalent processes in wound healing such as cytokine release, cell proliferation and angiogenesis.Against this background, the crucial role of reduced oxygen supply in chronic wound pathogenesis becomes obvious. Chronic wounds are characterized by an insufficient repair process that precludes the establishment of a sustained anatomical and functional result in an appropriate length of time" (1)
Like I said a bit technical but still enough regular English in there to understand
the point.
(1)
From The British Journal of Dermatology
Oxygen in Acute and Chronic Wound Healing
Posted: 09/15/2010; The British Journal of Dermatology. 2010;163(2):257-268. © 2010 Blackwell Publishing
Thursday, April 14, 2011
Hyperbaric Oxygen and Diabetes
Every time I run into someone with advanced Diabetes, and
they already have the "red legs" or worse and having learned
that that problem has to do with hypoxia, which basically means
not enough Oxygen supply to the extremeties it of course occurs
to me that HBOT should be able to help with that. There is actually
a lot written on the WWW about this but I only post an excerpt
of one of the studies supporting this:
".....Animal and human studies support these findings. All cells require oxygen for aerobic metabolism and cellular energy production. Hunt and Van Winkle showed that a minimum PO2 of 30 mm Hg is required by cells for functioning. Hunt and Pai demonstrated that collagen synthesis for maintenance and healing is oxygen dependent, with an optimal PO2 of at least 50 to 100 mm Hg. Sheffield showed that HBOT can provide PO2 levels in excess of 1,000 mm Hg in ischemic areas. Nemiroff et al., in a randomized, prospective animal study of ischemic flaps, demonstrated markedly greater survival of ischemic tissue when treated with HBOT (p<0.05). Kihara et al., in their controlled study of ischemic neuropathy, demonstrated that “hyperbaric oxygenation will effectively rescue fibers from ischemic fiber degeneration” (p<0.05). The effectiveness of hyperbaric oxygen in clinical human studies is well documented, with acute ischemias arising from surgery and trauma having been particularly well studied. Bowersox et al., showed the effectiveness of HBOT in a large series of patients with ischemic flaps and grafts, as has Perrins. Shupak et al., demonstrated a doubling of the survival rate of ischemic limbs using HBOT. Hill et al., showed that even complex tissues, such as the ear, can survive severe post traumatic ischemia using HBOT........." (1)
And so on.
It looks to me that diabetic patients don't always need their feet
amputated but they could be rescued with Hyperbaric Oxygen.
(1) http://www.achm.org/index.php/General/Medicare-Accepted-Indications/Acute-Peripheral-Arterial-Insufficiency.html
they already have the "red legs" or worse and having learned
that that problem has to do with hypoxia, which basically means
not enough Oxygen supply to the extremeties it of course occurs
to me that HBOT should be able to help with that. There is actually
a lot written on the WWW about this but I only post an excerpt
of one of the studies supporting this:
".....Animal and human studies support these findings. All cells require oxygen for aerobic metabolism and cellular energy production. Hunt and Van Winkle showed that a minimum PO2 of 30 mm Hg is required by cells for functioning. Hunt and Pai demonstrated that collagen synthesis for maintenance and healing is oxygen dependent, with an optimal PO2 of at least 50 to 100 mm Hg. Sheffield showed that HBOT can provide PO2 levels in excess of 1,000 mm Hg in ischemic areas. Nemiroff et al., in a randomized, prospective animal study of ischemic flaps, demonstrated markedly greater survival of ischemic tissue when treated with HBOT (p<0.05). Kihara et al., in their controlled study of ischemic neuropathy, demonstrated that “hyperbaric oxygenation will effectively rescue fibers from ischemic fiber degeneration” (p<0.05). The effectiveness of hyperbaric oxygen in clinical human studies is well documented, with acute ischemias arising from surgery and trauma having been particularly well studied. Bowersox et al., showed the effectiveness of HBOT in a large series of patients with ischemic flaps and grafts, as has Perrins. Shupak et al., demonstrated a doubling of the survival rate of ischemic limbs using HBOT. Hill et al., showed that even complex tissues, such as the ear, can survive severe post traumatic ischemia using HBOT........." (1)
And so on.
It looks to me that diabetic patients don't always need their feet
amputated but they could be rescued with Hyperbaric Oxygen.
(1) http://www.achm.org/index.php/General/Medicare-Accepted-Indications/Acute-Peripheral-Arterial-Insufficiency.html
Thursday, April 7, 2011
Does HBOT make cancer grow faster?
Every once and a while somebody will ask me
if it is true that someone should not seek
Hyperbaric Oxygen treatments if they have cancer.
Supposedly the additional oxygen would make the cancer
grow faster.
I could not really answer this question, so I did a little
research and here is one article I came up with:
(Bold print done by me)
"The Issue of Carcinogenesis
An issue that frequently arises when considering a patient for hyperbaric oxygen who also carries a cancer diagnosis is what does HBO2 do to growth or potential recurrence of the malignancy. In a publication from 1994, Feldmeier and his colleagues reviewed the discoverable literature related to this issue. An overwhelming majority of both clinical reports and animal studies reviewed in this paper showed no enhancement of cancer growth.
A small number of reports actually showed a decrease in growth or rates of metastases. In 2001 at the Consensus Conference jointly sponsored by the European Society of Therapeutic Radiology and Oncology (ESTRO) and the European Committee for Hyperbaric Medicine (ECHM), Feldmeier updated this material. In this review, Feldmeier emphasized the differences known in tumor and wound healing angiogenesis. Each has similar but distinctly different processes operational. He showed that there are significant differences between tumors and wounds in the growth and inhibition factors, which modulate angiogenesis. He summarized the literature demonstrating that tumors, which are hypoxic, are less responsive to treatment, less subject to cellular death by apoptosis and more prone to aggressive growth and lethal metastases. Fears that hyperbaric oxygen may promote malignant growth are not supported by scientific evidence, and clinicians should not refuse to consider a patient for hyperbaric oxygen who has had a history of malignancy." 1
1 http://rubicon-foundation.org/dspace/bitstream/123456789/3998/1/15233169.pdf
Page 9
if it is true that someone should not seek
Hyperbaric Oxygen treatments if they have cancer.
Supposedly the additional oxygen would make the cancer
grow faster.
I could not really answer this question, so I did a little
research and here is one article I came up with:
(Bold print done by me)
"The Issue of Carcinogenesis
An issue that frequently arises when considering a patient for hyperbaric oxygen who also carries a cancer diagnosis is what does HBO2 do to growth or potential recurrence of the malignancy. In a publication from 1994, Feldmeier and his colleagues reviewed the discoverable literature related to this issue. An overwhelming majority of both clinical reports and animal studies reviewed in this paper showed no enhancement of cancer growth.
A small number of reports actually showed a decrease in growth or rates of metastases. In 2001 at the Consensus Conference jointly sponsored by the European Society of Therapeutic Radiology and Oncology (ESTRO) and the European Committee for Hyperbaric Medicine (ECHM), Feldmeier updated this material. In this review, Feldmeier emphasized the differences known in tumor and wound healing angiogenesis. Each has similar but distinctly different processes operational. He showed that there are significant differences between tumors and wounds in the growth and inhibition factors, which modulate angiogenesis. He summarized the literature demonstrating that tumors, which are hypoxic, are less responsive to treatment, less subject to cellular death by apoptosis and more prone to aggressive growth and lethal metastases. Fears that hyperbaric oxygen may promote malignant growth are not supported by scientific evidence, and clinicians should not refuse to consider a patient for hyperbaric oxygen who has had a history of malignancy." 1
1 http://rubicon-foundation.org/dspace/bitstream/123456789/3998/1/15233169.pdf
Page 9
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