         |
 |
|
Preliminary research done is France and also at Duke University has shown that hyperbaric oxygen, if applied very early in poisoning, will significantly protect the liver from damage in carbon tetrachloride ingestion. Hydrogen Sulfide Poisoning There have been sporadic reports in the literature, including recent ones from Australia, which tend to show that hydrogen sulfide poisoning is benefited by HBO2. Hydrogen sulfide attacks cytochrome A3 oxidase (the same cytochrome, which is attacked by cyanide) and it may be that it is at that site that hyperbaric oxygen acts. Sickle Cell Crisis There have been anecdotal reports showing dramatic relief of sickle cell crisis with hyperbaric oxygen. Original work done at Duke University showed that sickle cell forms of the erythrocyte were markedly reduced under hyperbaric conditions. However, there has been no large-scale study to confirm its overall usefulness clinically. Spinal Cord Injury Animal work carried out by Yeo and Kelly and Lassiter have shown that HBO2 can prevent permanent injury in non-transecting lesions of the spinal cord when applied within four hours of injury. However, in the clinical setting, it is typically very difficult to get the patient to a chamber within four hours of injury. Myers, at the University of Maryland (Gamache, et al, 1981) treated a number of these patients experimentally but the majority could not be treated within the first four hours or "golden period." The mechanism seems to be that hyperbaric oxygen will block the edema which starts the cord swelling. This in turn crushes off the blood supply. In Myers' series, some patients, when treated late, returned to a plateaued level of function within 3 months as opposed to one year for control patients. Closed Head Injury For some years the Undersea and Hyperbaric Medical Society approved treatment of cerebral edema based on dog studies. However, the methods used in those studies did not approximate what happens to patients in closed head trauma. For this reason, cerebral edema was withdrawn from the approved list. However, work currently being carried on by Rockswold (Rockswold, et al, 1985) tends to show that those patients with a Glasgow coma score of 4, 5 or 6 have a survival rate which may be double that of the controls and also that the quality of life following recovery from the injury is vastly improved. As yet, Rockswold has not treated enough patients for statistical significance. Purpura Fulminans This often-fatal disease, which appears secondary to pneumococcal pneumonia and meningococcemia, has been shown to respond to hyperbaric oxygen. The disease is most common in children, and fingers, toes and even limbs may be lost to peripheral ischemia. Two cases of purpura fulminans induced by pneumococcus have been reported in the literature and there have been six unpublished cases induced by the meningococcus. All of these cases survived. Intra-Abdominal and Intra-Cranial Abscesses There have been anecdotal reports of patients with cerebral abscess who have recovered following HBO2 treatment. Prior to being placed in the chamber, they were pursuing a downhill course and were nearly moribund. Similarly, the Russians have done a study of peritoneal abscesses (Kindwall, 1987) which has shown enhanced survival in humans. There are also animal studies, which show hyperbaric oxygen to be of benefit. Mesenteric Thrombosis Normally this is a surgical disease where one operates to remove dead bowel. However, often too much bowel appears to be infarcted to be compatible with survival. Some of these patients were subsequently treated for three days b.i.d. in a hyperbaric chamber and appeared to have more viable bowel after treatment. Operation then became possible. Central Retinal Artery Occlusion A large series of occluded central retinal arteries have been reported from Japan (Miyake, 1986). Approximately 50% of these patients will respond to hyperbaric treatment. This treatment is experimental but it is advantageous to try it as there is little other to offer these patients. Patients who have a totally dead retina, evidenced by being unable to tell the difference between light and dark, do not respond to hyperbaric oxygen. Cystoid Macular Edema This is a disease of the eye found in patients who have had their lenses removed for cataract with placement of a plastic replacement lens. Between 0.5% and 3% of these patients will develop edema of the macula with degeneration. There is nothing that can be offered in the way of treatment for these patients. However, recently a study was done in Denver (Pfoff & Thom, 1986). It was found that the first five patients had 100% success in clearing up their vision. One patient improved from 20/400 to 20/40. Results seemed to be permanent in that the treatment was stopped after three weeks and the eyes remained stable for 1-1/2 years. Bell's Palsy This is an idiopathic paralysis of the face which typically occurs in young adults. Most cases will clear spontaneously in six months. However, some patients never completely recover. Steroids are the only treatment currently used and results are inconclusive as to their benefit. Racic (Racic, et al, 1985) studied 20 patients who cleared up in 15 days or less with twice daily treatment at 2.8 ATA for one hour. This rapid remission is unheard of in the usual clinical case. A larger study of 79 patients, completed by Racic, et al, was published by the Undersea and Hyperbaric Medical Society in 1997. The abstract of this study can be found in the Research Studies section of this site or by clicking on the following link: https://hbotoday.com/treatment/clinical/researchstudies Leprosy The Mycobacterium leprae is sensitive to high partial pressures of oxygen. There have been reports in the literature that six treatments carried out over a three-day period have produced permanent remission (Wilkinson, et al, 1969). As leprosy is a tremendous financial burden in much of the world, further research must be carried out to define what role, if any, hyperbaric oxygen may play in this disorder. Source: Clinical Hyperbaric Medicine. Eric P. Kindwall, M.D. Lyme Disease | Stroke and Traumatic Brain Injury Brown Recluse (Loxosceles reclusa) Spider Bite | Other Research Areas Telephone: Email: Chico Hyperbaric Center Web Site Developed & Hosted by Access Now 2000. Copyright © 1999-2001. All Rights Reserved. # |
|