Hiperbaric oxigen therapy. Historical perspective, physiological mechanisms and clinical applications
Keywords:
Hyperbaric, oxygen, history, physiology, therapy, applicationsAbstract
Hyperbaric oxygen therapy (HBOT) is defined as a treatment
mode which involves the breathing of pure oxygen (100% O2) at
an ambient pressure higher than the atmospheric one measured at the sea level.
The treatments are performed with the patients breathing pure
oxygen, entirely enclosed in sealed chambers, pressurized with
air (multiplace chambers) or with oxygen (monoplace chambers),
at a pressure greater than one atmosphere.
Multiple physiological mechanisms, which are activated as a
result of hyperbaric oxygenation (mechanical effect of increased
pressure, toxic gas increased wash out, hyperoxygenation, vasoconstriction, fibroblast proliferation, angiogenesis, leukocyte
oxidative bacterial killing, toxin inhibition, bacteriostasis, bacterial
killing, antibiotic synergy) explain the many beneficial effects of
HBOT in several pathological conditions, caused, worsened or perpetuated by hypoxia or gas bubbles trapped in the body, such as:
decompression sickness, air embolus syndrome, carbon monoxide
intoxication and acute cyanide poisoning, clostridial gas gangrene,
necrotizing soft-tissue infections, chronic osteomyelitis, chronic
wounds, radiation-induced injury, crush injuries, compartment
syndrome, graft and flap salvage, oedema, sepsis, acute burns,
severe blood loss anemia, and many others.
The present work provides an overview concerning some
historical aspects, physiological effects, clinical applications, and
secondary effects of HBOT.
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