A children’s oxygen chamber is a medical device designed to saturate the tissues of the body with oxygen at increased pressure (hyperbaric oxygenation). The oxygen chamber allows you to effectively fight the manifestations of hypoxia (lack of oxygen). Moreover, it has a complex therapeutic effect in many pathological conditions and chronic diseases.
The principle of operation of the children’s oxygen chamber
The treatment procedure consists in finding the patient for a certain time in a special chamber, the atmosphere of which is saturated with a large amount of oxygen under pressure. As a result, much more oxygen is bound to the blood, and increased oxygenation of all tissues and organs is achieved.
During the treatment session, the patient lies in a relaxed state inside the chamber, if desired, you can even sleep.
Indications
The most effective pressure chamber in a sanatorium in the treatment of diseases of the heart and blood vessels, including:
hypertension , coronary heart disease ;
Similarly, atherosclerosis;
chronic venous insufficiency;
Furthermore, rehabilitation after heart attacks, strokes.
In addition, children’s oxygen chamber treatment will help with the following conditions
A pronounced therapeutic effect is also common in patients with:
Pathologies of the nervous system.
Diseases of the stomach and intestines
Acceleration of recovery after injuries and surgical interventions.
Children’s oxygen chamber saturation of the blood helps to normalize the processes of hormone production and metabolism. Therefore, treatment in a pressure chamber is easy to recommend for patients with thyroid disorders and other hormonal problems.
Contraindications for children’s oxygen chamber
Treatment in a pressure chamber is not suitable for patients with:
Serious lung pathologies (air cysts, abscesses).
Moreover, Violations of the patency of the Eustachian tubes.
Acute respiratory diseases.
Similarly, Severe purulent infections.
Oncological diseases.
It is important to consider that a small percentage of people are sensitive to oxygen. In addition, treatment in a pressure chamber is also contraindicated for such patients.
Effects of hyperbaric oxygenation
Treatment in chambers can effectively relieve fatigue, normalize muscle tone, increase efficiency and improve the state of immunity.
The majority of patients show normalization of blood pressure, restoration of heart rhythm. In most cases, the effects of chronic stress, fatigue and insomnia completely eliminate.
Oxygen also has a beneficial effect on the condition of the skin. The inclusion of children’s oxygen chamber provides treatment of dermatological diseases. Similarly, it allows you to quickly achieve a complete cure.
Due to the fact that oxygen is an active oxidant, it effectively binds and removes toxins that accumulate in the intercellular space when it is lacking.
The positive Impact of children’s oxygen chamber
The positive effects of hyperbaric oxygenation have a cumulative effect and persist for a long time after the completion of the course of sanatorium treatment.
The doctor noted that the oxygenation procedure has a very good healing effect. Inpatients receive a pressure chamber free of charge, taking into account the treatment protocols. Indications for its use are very diverse - cardiovascular diseases, diseases of the nervous system and gastrointestinal tract, diabetes mellitus, infertility, pregnancy, eye diseases, chronic gynecological diseases and others.
What are some contradictions?
However, along with the mass of indications for undergoing this procedure, there are also children’s oxygen chamber contraindications. Oncological pathology, thyroid gland formation, and seizures are severe forms of hypertension and acute respiratory diseases. Hence, all these factors will not allow the patient to undergo HBO.
Generally, you can nourish the body with oxygen at absolutely any age, from the smallest to the elderly. The program of the passage is selected individually by the doctor. Usually it is five to eight procedures, the maximum is ten, - added Professionals.
Every month in the department of hyperbaric oxygenation of the regional clinical hospital, an average of 300-320 procedures is easy to perform. About 40 people get their share of health.
Is children’s oxygen chamber good to lose weight?
We add that those who wish to lose weight will also be able to breathe in children’s oxygen chamber. Such an event favorably contributes to the process if you connect the main components to it - sports and proper nutrition. Moreover, this service is not important in the program of state guarantees for free provision of medical care.
Possible complications
In very rare cases, when using faulty, outdated equipment, with a negligent attitude to the procedure, complications are possible
damage to lung tissue;
Similarly, tympanic membrane injury;
convulsions;
After the session, the normal state is a slight dizziness, slight congestion in the ears. An experienced specialist of the Modern chambers sanatorium conducts treatment procedures taking into account contraindications. Therefore, the risk of complications is minimized.
Modern chambers have a modern safe oxygen chamber. Similarly, the chamber does not require special safety conditions. Moreover, it comes with emergency release buttons, a personnel call button, there is no noise isolation. Furthermore, the patient, being in the pressure chamber, can communicate with others in a calm voice if desired.
Therapeutic effects and indications for prescription
Before answering the question of what diseases oxygen treatment od prescription, you should pay attention to what the pressure chamber is useful for. Positive processes after using it include:
acceleration of metabolism;
improved tissue regeneration;
elimination of congestion, edema;
improving the functioning of internal organs;
Moreover, quick recovery after suffering diseases of an infectious nature.
The sessions in the pressure chamber help to reduce the use of medications, shorten the duration of treatment, strengthen the immune system, and prevent the development of complications.
How is the children’s oxygen chamber session going?
Generally, pressurized air therapy is easy. It is allowed to take a book and a tablet with you into the cell. Instead of doing any work, you can sleep. No special preparation is important prior to placement in the camera. You cannot go through the procedure hungry and immediately after eating; it is very well to visit the toilet.
Conclusion
As soon as a child is placed in a pressure chamber, the nurse turns on the children’s oxygen chamber to increase the pressure and supply oxygen. At the time of its change, so that the ears do not feel strongly, it is good to blow out the ears (like on an airplane) or suck up lollipop. For the same purpose, it is also good to make swallowing movements more often.
Long-term hyperbaric oxygen chamber therapy is an option for people who suffer from chronic oxygen deficiency (hypoxemia). This means that there is too little oxygen bound to the red blood cells in their arterial blood. It is to adequately supply the organs and cells of the body with this vital element.
OXYGEN CHAMBER THERAPY IN A NUTSHELL:
Long-term oxygen therapy is good for people with chronic oxygen deficiency. Such hypoxemia (lack of oxygen in the blood) is mainly comes by severe lung diseases such as COPD or pulmonary fibrosis.
Chronic hypoxemia can have a number of causes. First and foremost are serious lung diseases such as
the chronic obstructive pulmonary disease (COPD),
Pulmonary emphysema ,
the pulmonary fibrosis,
the cystic fibrosis (CF)
or recurrent pulmonary embolism.
Diseases that hinder the breathing process are paralysis of the respiratory muscles or narrowing of the chest. Moreover, it is due to deformation of the ribs or the spine, can lead to a chronic lack of oxygen.
But not only diseases of the respiratory organs can cause a chronic lack of oxygen, but also heart and cardiovascular diseases. These include pulmonary hypertension, the so-called cor pulmonale (lung heart) and severe chronic heart failure.
Hyperbaric oxygen chamber Helps in oxy gen deficiency
Chronic oxygen deficiency can also have sequelae - especially in the cardiovascular system - which further impair the restricted oxygen supply. This vicious circle is easy to break with long-term o hyperbaric oxygen chamber therapy.
The benefits of LTOT are famous in various scientific studies, especially in connection with COPD. The results show that long-term oxygen therapy significantly increases the life expectancy of patients.
Positive effects have also showed with regard to physical performance and quality of life. With long-term oxygen therapy, it is often possible to achieve significantly improved physical activity again.
Signs and consequences of a chronic lack of oxygen
Almost all organs and cells in our body depend on a constant supply of oxygen-rich blood. If there is a persistent deficiency because the lungs no longer absorb enough oxygen, this can have far-reaching effects on the body. The first signs of a chronic lack of oxygen are usually
Fatigue,
Fatigue and
a drop in physical performance.
In the case of severe undersupply, even minor stresses lead to shortness of breath and exhaustion. That is why you need domestic hyperbaric oxygen chamber.
How does hyperbaric oxygen chamber impact blood circulation?
To compensate for the lack of oxygen, the right ventricle pumps more blood into the pulmonary arteries. This causes hypertension in the lungs, which leads to a thickening of the vascular walls.
Moreover, it makes it even more difficult to absorb oxygen from the air we breathe into the blood. As a result of the pulmonary hypertension, the muscles of the right ventricle are increasingly overloading, which can then lead to right heart failure.
Another mechanism for adapting to the lack of oxygen - similar to high-altitude training for competitive athletes - is to produce more red blood cells. Medically, one speaks of polyglobulia. The excessive number of red bulbs worsens the flow properties of the blood and thus additionally hinders the transport of oxygen.
What is the goal of long-term hyperbaric oxygen chamber therapy?
Chronic hypoxemia leads to mechanisms that further exacerbate the lack of oxygen and have serious consequences in other organs. The aim of long-term hyperbaric oxygen chamber therapy is to break this vicious circle and improve the physical performance and quality of life of the sick.
How do you clarify the need for long-term oxygen therapy?
The diagnostic criterion for such a chronic oxygen deficiency is that the so-called arterial oxygen partial pressure (PaO2) under resting conditions during a stable illness phase of four weeks is at least three times at a value of 55 mmHg (millimeters of mercury) or below. In people with COPD and comorbidities such as cor pulmonale, the limit is 60 mmHg.
How does hyperbaric oxygen chamber maintain oxygen pressure?
The arterial oxygen partial pressure comes by a blood gas analysis. A blood sample takes from an artery or from the earlobe.. The result is available after just a few minutes.
After the chronic hypoxemia comes out, the doctor can prescribe long-term oxygen therapy. The aim is to increase the oxygen supply in the body to at least 60 mmHg or more by administering additional oxygen. In order to achieve this, the necessary oxygen flow rates, which can later be set on the oxygen device, must be precisely determine at the beginning of the therapy.
How is long-term oxygen therapy carried out?
Studies show that long-term oxygen therapy only has the desired success if it comes out for at least 16 hours a day. The general principle is: the longer, the better. Therefore, if possible, treatment should aim at 24 hours per day.
However, this means that the people who receive hyperbaric oxygen chamber connect to a device that supplies the oxygen for the entire day, or at least large parts of it. There are various systems for this: Stationary ones for the home, but also mobile, portable oxygen devices that are relatively small and light and give those affected a lot of freedom of movement.
Typically, an LTOT is easy to check with the help of concentrators or as liquid oxygen; steel pressure cylinders are rarely common.
Which is the best hyperbaric oxygen chamber?
Which system or which combination of devices is best suited for the individual requirements of the individual patient is good to discuss with the treating specialist. The oxygen usually checks through the nose, although there are also various application systems here.
People on long-term oxygen therapy should have regular check-ups from their pulmonologist. The guideline recommends every three months.
What are the risks and side effects of long-term oxygen therapy?
Especially at high flow rates, the LTOT can dry out the nasal mucous membranes. However, this is easy to counter by connecting a humidifier and taking appropriate care measures.
Apart from that, long-term hyperbaric oxygen chamber therapy is in principle free of side effects, even after years of use, if the patient consistently adheres to the oxygen flow rates prescribed by the doctor. That means
on the one hand, never to interrupt the treatment on your own,
on the other hand, the amount of oxygen must not be increased above a predetermined maximum value even in the case of shortness of breath.
Because a prolonged overdose of the drug oxygen can have serious consequences. Too much oxygen can be just as harmful as too little.
According to the WHO, there are currently about 50 million people living with dementia in the world, of which Alzheimer's disease is the most common type.
As we all know, hyperbaric oxygen can solve the symptoms of ischemia and hypoxia or the problem of ischemia and hypoxia during the development of the disease. Today, let's talk about the application of hyperbaric oxygen therapy in Alzheimer's disease.
Alzheimer's disease is the most common type of dementia, accounting for 60-80% of elderly patients. Although the exact cause of Alzheimer's disease has not yet been discovered, there are several risk factors related to the disease including age, gender, socioeconomic factors, education, head injury, sleep, high blood pressure, and genetic factors.
Complications related to Alzheimer's disease, such as cardiovascular disease, stroke, cerebral ischemia are all related to acute and chronic hypoxia. Therefore, the cognitive decline in Alzheimer's disease patients may be related to hypoxia.
A clinical study of 42 patients with Alzheimer’s disease, 11 patients with amnestic mild cognitive impairment and 30 patients in the control group showed that 40 minutes of hyperbaric oxygen per day for 20 consecutive days can significantly improve recognition know function. Compared with patients in the control group, hyperbaric oxygen significantly improved the simple mental state score and the Montreal cognitive score of patients with Alzheimer's disease, as well as the ability of daily living scale score. Hyperbaric oxygen can also protect mitochondrial integrity, and prevent mitochondrial-related apoptosis pathways.
A similar clinical study involved a 58-year-old female patient with Alzheimer's disease that got worse 8 months before hyperbaric oxygen therapy. The patient received 1.15 ATA hyperbaric oxygen therapy for 50 minutes, 5 days a week. After 21 hyperbaric oxygen treatments, patients reported improved levels and improved performance in crossword puzzles and daily activities. After completing 40 hyperbaric oxygen treatments, the patient reported enhanced memory, reduced disorientation, improved tremor, and increased local and overall brain metabolism by 6.5-38%. In addition, combined with standard drug therapy, hyperbaric oxygen (96 times in total) maintained the patient's symptomatic and functional level for 22 months.
However, studies have also shown that a course of hyperbaric oxygen therapy can only temporarily improve the cognitive impairment of patients with Alzheimer's disease, and the effect is not permanent. Multi-course hyperbaric oxygen therapy may have long-term effects on the cognitive health of patients with Alzheimer's disease. When stop the treatment, the side effects associated with hyperbaric oxygen are mild and reversible, like claustrophobia, headache, reversible myopia, and epilepsy. Serious complications, such as irreversible nuclear cataracts and oxygen poisoning, are extremely rare.
Although hyperbaric oxygen therapy is not widely used in Alzheimer's disease, and domestic Alzheimer's disease related guidelines have not included hyperbaric oxygen therapy, more and more basic and clinical studies have confirmed hyperbaric oxygen therapy's value and advantages. Although the FDA has approved 14 kinds of clinical applications of hyperbaric oxygen, it is still necessary to conduct more clinical studies to study the most effective hyperbaric oxygen treatment plan for patients with Alzheimer's disease.
28-year-old Xiao Tao is a middle school teacher. In order to prepare for the city's key teacher exams, she actively prepared lessons during the day and immersed herself in studying at night. After a month of hard work, she greeted the exam with confidence. But just a week before the exam, she suddenly found that she was not in good condition, a little dizzy, and a little nauseous, mainly because her left ear could not hear clearly. On the day after the exam, she went to the hospital to see a doctor, trying to solve the ear trouble. Unexpectedly, the hospital diagnosed him with sudden deafness.
The doctor said that in fact, sudden deafness occurs at all ages. There are many causes, such as fatigue, noise, hyperlipidemia, hyperglycemia, viral infection, emotional agitation, nervousness, and excessive fatigue. The doctor recommended Xiao Tao to do hyperbaric oxygen therapy and give drugs to nourish nerves and improve circulation. After a course of treatment (10 days), Xiao Tao's symptoms were relieved a lot. After the second course of treatment, my tinnitus disappeared and my hearing was basically restored.
At the same time as drug treatment, hyperbaric oxygen showed its skills:
It can quickly increase the oxygen content of human arterial blood, increase the diffusion distance of blood oxygen in the capillaries, increase the oxygen partial pressure content in the inner ear and perilymph, improve the hypoxic state in the capillaries, and restore their functions;
Improving local hypoxia can also constrict local blood vessels, reduce capillary permeability, reduce exudation, and improve edema caused by hypoxia in the inner ear;
Improve blood rheology, reduce the specific volume of blood cells, thereby reducing blood viscosity, improve inner ear circulation and tissue metabolism, and promote the recovery of auditory hair cells and nerve endings.
The incidence of sudden deafness in my country has been on the rise in recent years, and it is a common phenomenon for young people to suffer from sudden deafness. The cause of sudden deafness is complex, and many pathogenic factors may cause it. Hyperbaric oxygen is an important measure for the comprehensive treatment of sudden deafness. Clinical practice has proved that the combined treatment of hyperbaric oxygen with drugs is more effective than drug treatment alone, and the early use of hyperbaric oxygen has a better effect than the late use. Experts believe that even with early delays, hyperbaric oxygen therapy should not be given up. Even European and American experts suggest that hyperbaric oxygen can be used as a remedy when conventional treatment is not effective.
I believe that many people who do hyperbaric oxygen for the first time will ask a variety of questions. After all, this kind of treatment is relatively new. However, the questions raised by some people are too novel and alternative. Today these questions are all answered in detail for you.
1. How high is the pressure of hyperbaric oxygen?
People call pressure exceeding 1 atm high pressure, and breathing oxygen under high-pressure environment is called hyperbaric oxygen. Conventional treatment pressures are 0.06Mpa, 0.08Mpa, 0.10Mpa, 0.15Mpa and so on. Under normal circumstances, doctors will choose different pressures according to different conditions. For example, when rescuing patients with carbon monoxide poisoning, the pressure will be higher; for chronic diseases, the pressure will be relatively low. In addition, different pressures will be selected according to adults and children.
2. How long does each treatment take?
Complete hyperbaric oxygen therapy is mainly divided into three stages, namely boosting, stabilizing and inhaling oxygen, and decompressing. Generally, the whole course of hyperbaric oxygen treatment takes about 90 to 120 minutes.
3. Is hyperbaric oxygen treatment according to the course of treatment?
Hyperbaric oxygen treatment is generally once a day, usually 10 days as a course of treatment, but the treatment time for different diseases is not the same. Acute and mild cases can be less than one course of treatment; chronic diseases and severe cases can reach more than 5 courses, but every 1-2 course should be intermittent for several days. It can be seen that, for patients with different symptoms, the doctor will instruct the patient to perform hyperbaric oxygen therapy according to the course of treatment.
4. Can normal people do hyperbaric oxygen?
Hyperbaric oxygen is a way to treat diseases. However, is it not possible to do hyperbaric oxygen if there is no disease? of course not! For normal people, hyperbaric oxygen therapy can also be performed under certain circumstances. For example, after high-intensity exercise, muscle soreness, and extreme fatigue, hyperbaric oxygen therapy can effectively relieve the body's soreness and fatigue. If the brain is used excessively in work and study, hyperbaric oxygen therapy can also relieve headache and dizziness symptoms, improve memory and maintain energy. Hyperbaric oxygen therapy also has cosmetic effects such as delaying skin aging, whitening and removing acne.
5. Do you need an empty stomach for hyperbaric oxygen?
No! Hyperbaric oxygen has the function of lowering blood sugar, so doing hyperbaric oxygen treatment will consume some physical strength. Therefore, before undergoing hyperbaric oxygen therapy, you must eat a normal diet.
6. Is it cold in the hyperbaric chamber?
In the hyperbaric oxygen chamber, the temperature change with the pressure. As the temperature in the cabin is required during hyperbaric oxygen treatment, air conditioning is necessary for the hyperbaric oxygen chamber. National standard: 24-28℃±2℃ in summer; 18-22℃±2℃ in winter.
7. Do hyperbaric oxygen inhalation with the nose or mouth?
You can breathe as you normally do in the hyperbaric oxygen chamber. The doctor recommends: Breathing with your mouth and nose at the same time can alleviate dry mouth and tongue during oxygen inhalation. However, if you are suffering from rhinitis, it is recommended to breathe through your mouth.
8. Is it addictive to always do hyperbaric oxygen?
Is oxygen a drug???
9. Does hyperbaric oxygen dangle?
The hyperbaric oxygen chamber is firmly placed on the ground without shaking.
How oxygen therapy is beneficial in cancer treatment?
We have already talked here on the blog about how physicians use oxygen therapy in the treatment of respiratory diseases, such as pulmonary emphysema. But for taking this treatment, physicians need special Hyperbaric Oxygen Chambers.
Did you know that it can be a great ally, too, in cancer treatment?
What is oxygen therapy?
Oxygen therapy is a therapeutic method for respiratory complications and shortness of breath, which works by replacing oxygen until it is at the level above 90%, the right to health.
Expert physicians can use oxygen cylinders or concentrators to do this treatment.
How can you complete treatment using oxygen therapy?
In addition to cancer treatments that aim to fight the tumor itself, such as chemotherapy and radiation therapy, other professionals such as psychologists and nutritionists play a very important role in the whole process.
Oxygen may also be part of such treatments and complementary aims to increase the defense of the organism. Further, it also helps to prevent the spread of the problem and the emergence of metastases.
Treatment with supplemental oxygen is able to increase the body's ability to recover. Moreover, therapy performed in Hyperbaric Oxygen Chambers eliminates disease-causing microorganisms that can aggravate the condition of cancer patients.
Thus, oxygen therapy works by making, the immune system stronger, killing bacteria, fungi, parasites, and viruses together with cells from deficient and diseased tissues. In addition, it increases the ability of healthy cells to multiply in the body.
What are the effects of oxygen therapy on the body?
Among the effects that oxygen therapy is able to promote in favor of the cancer patient are:
- Stimulation of the production of leukocytes, cells that have the function of defending the organism;
- Increased dissociation between oxygen and hemoglobin, which facilitates the oxygenation of cells;
- The antineoplastic action (anticancer), which inhibits the growth of new tissues such as tumors;
The antiviral action
- Increased flexibility and effectiveness of erythrocytes (red blood cells), responsible for transporting oxygen from the lungs to the tissues;
The increase in the production of "interferon" and tumor necrosis factor, substances that the body uses to fight infections and cancer;
The improvement of tissue oxygenation provides quality of life for patients undergoing cancer treatment.
What is Hyperbaric Oxygenation (HBO)?
This is a procedure in which pure oxygen is inhaled in a Hyperbaric Oxygen Chamber with atmospheric pressure up to 3 times higher than normal in order to improve the natural healing powers of the body.
Hyperbaric medicine significantly helps in the treatment of diseases such as neurology, treatment of infectious diseases, oncology, radiation therapy, rheumatology, etc.
Originally developed for the treatment of decompression sickness in people who ascend to the surface in spacesuits from great depths and need to restore normal pressure balance, hyperbaric oxygen therapy has found numerous medical applications for the treatment of various diseases.
Breathe deeply into your chest and focus on your breathing to take control of your health.
Is oxygen essential for normal cellular metabolism?
Oxygen is essential for normal cellular metabolism. Hypobaric oxygen therapy is expanding the spectrum of research into medical clarification. Furthermore, most celebrities use and prefer Hyperbaric Oxygen Chamber treatment as an anti-aging treatment.
In addition, professional athletes use it to accelerate injury healing. Additionally, it is elderly to relieve chronic symptoms or treat potential brain damage.
What are the top 9 benefits of Hyperbaric Oxygen Therapy?
Optimization of microcirculation
Activation and improvement of the lymphatic system
Activating drainage systems to release toxins
Improving blood circulation in general
Improving heart function
Anti-inflammatory effect on subcutaneous adipose tissue
Accelerates the recovery process for postoperative patients
Accelerates healing time for minor and serious sports injuries
Accelerated recovery after intense training and professional sports
Have you ever wondered why a person breathes?
The function of respiration is necessary in order to enrich the blood with oxygen, which will subsequently deliver it to all corners of our body. Each cell, enriched with oxygen, will receive the energy necessary for its work and remove unnecessary carbon dioxide.
Oxygen is a vital element. If a person can live without food for about a month, without food and water - up to a week, then without oxygen, life lasts an average of 5 minutes (for trained divers, no more than 20 minutes). Oxygen deficiency is detrimental to tissues, organs, and the body as a whole.
Why you need oxygen therapy treatment?
The fact is that oxygen is responsible for the production of energy in the body. Therefore, when a person lacks oxygen - for example, when breathing problems or when there is a lack of oxygen in the air - he becomes lethargic, apathetic, he lacks energy.
Moreover, it lacks the truest sense of the word.
Hyperbaric Oxygen Chambers
continues to be consumed but does not re-enter, its insignificant reserves are depleted, oxygen deficiency in tissues and organs grows very quickly, and blood supply is disrupted.
What are the healing properties of oxygen?
The Hyperbaric Oxygen Chamber presented in our Center was made in South Korea. It belongs to the new generation of premium pressure chambers. When creating this pressure chamber, the latest achievements of scientists from South Korea were used.
It is this South Asian country that is recognized as one of the best in the world in terms of medical technology. It is recommended to visit the pressure chamber both for general health improvement of the body and for aesthetic purposes.
Who can take sessions of oxygenation of body tissues?
First of all, oxygen recovery is indicated for cardiovascular diseases and circulatory problems, as well as for any chronic diseases. You will have to treat these diseases with experts in Hyperbaric Oxygen Chamber.
Compensation for the lack of fresh air contributes to:
Effect of hyperbaric oxygen therapy on the correction of hypoxia in severe COVID-19 patients:
A case report
Zhong xiaoling, tao xiaolan, tang yanchao, Chen ruiyong
China journal of maritime medicine and high-pressure medicine, 2020, 27: network prepublication.
The following contents are protected, shall not be reproduced without authorization, offenders will be corrected!
Progressive hypoxemia is the focus and difficulty of the supportive treatment of severe COVID - 19 (Novel Coronavirus Pneumonia (NCP). It is the main indicator of the classification of light, severe and critical type in the diagnosis and treatment scheme of pneumonia infected by a novel coronavirus (hereinafter referred to as the guidelines) promulgated by the national health commission. Oxygen therapy is the main means of NCP supportive treatment. All atmospheric oxygen treatments have been listed in the guidelines, including nasal catheters, masks, noninvasive and invasive mechanical ventilation, and extracorporeal oxygenation (ECMO) [1]. However, the application of hyperbaric oxygen therapy (HBOT) has not been reported. HBOT inhales 100% oxygen at a pressure of more than one atmosphere to cure diseases [2]. It is the most effective oxygen therapy method known. However, there has been no report on the use of HBOT in the correction of NCP hypoxemia. In a case of severe NCP in wuhan Yangtze river shipping general hospital, atmospheric pressure and high flow oxygen supply were unable to control the continuous decrease of blood oxygen saturation. Based on the analysis of HBOT principle, HBOT is tried for the first time. It was found that the effect of HBOT in the treatment of progressive severe hypoxemia was very obvious. Now the case is reported in detail as follows.
Case data
Tang xx, male, 69 years old, was hospitalized with fever for half a day. On the night of January 22, 2020, he felt chills and fever without obvious cause, with a body temperature of 37.8. Previous hypertension, 2016 atherosclerotic coronary heart disease, acute myocardial infarction, coronary stent implantation. Nucleic acid test was positive on admission, and CT showed typical pulmonary imaging changes. Methylamydron was given 40mg, two times /d (5d), 20g/ d (5d) of immunoglobulin, 3g/ d of ceftriaxone sodium, and 0.2g, 3 time /d continuous low flow oxygen intake through nasal catheter. The temperature returned to normal on the third day. Panting after the activity on the 5th day, chest CT examination indicated that the patchy infection foci in both lungs were more advanced than before, and the lung affected area (+++) was given oxygen inhalation mask with high flow. On the 14th day, the patient had fever again, and his body temperature was 38℃. Reexamination of chest CT showed diffuse large flaky infection foci in both lungs and lung involvement areas (++++). The lowest oxygen partial pressure was 37mmHg, the lowest oxygen saturation of blood (SO2) was 66%, and the highest oxygen content was 88%. After another course of drug treatment, the patient's temperature returned to normal. But breathing is difficult, hypoxemia aggravates. Suggest ventilator machine treatment, the patient does not cooperate. On the 21st day of onset (February 11), hyperbaric oxygen therapy was given, from 9:00-10:35 every day. Only antibiotic treatment and oxygen mask were reserved for clinical use. All clinical records and examination results from admission to 17 February were collected. Clinical examination and monitoring were carried out by routine hospital methods, which are not described here.
HBOT program
HBOT was conducted in the hyperbaric oxygen department of the Yangtze River shipping general hospital. The exposure time of high pressure was from 9:00-10:35 am every day. According to the requirements of infection control of severe infectious diseases, a series of infection control measures were designed, such as pollution area division, patient transfer route, strengthened disinfection of pressurized cabin and hygiene management. The patient enters the pressurized treatment chamber through a special channel, takes off the mask and puts on the respirator. After giving first-level oxygen, the pressure is increased. Constant pressure to 2.0ATA for 15min and constant pressure for 60min. Maintain continuous ventilation in pressurized cabin during pressure stabilization. Then decompression to atmospheric pressure at a constant speed for 20min. Open the cabin door, the patient takes off the mask to stop the first-level oxygen intake, puts on the mask, and walks out of the cabin through a special channel. During the high pressure exposure process of HBOT in this patient, there is no medical companion cabin, but a secondary cabin is provided. If necessary, medical staff can be transferred to the treatment cabin for medical treatment at any time after pressurization. The patient received oxygen throughout the whole course, with a total oxygen time of 95min and an oxygen dose of 216UPTD.
Results analysis
1-Clinical manifestations:
As shown in FIG. 1, the patient still felt dyspnea and chest pain after high flow oxygen inhalation in the supine position before treatment, accompanied by obvious gastrointestinal symptoms. After the first HBOT, dyspnea, chest pain and gastrointestinal symptoms were significantly improved. After the second treatment, the gastrointestinal symptoms basically disappeared. After the fourth treatment, oxygen was given by nasal catheter daily, but the chief complaint of dyspnea after the operation remained. At the time of writing, HBOT patients were continuing the routine HBOT treatment once a day.
Figure 1 Patient symptom change and schedule of oxygen therapy
2- Monitoring results of finger pulse SO2:
When the patient was admitted to the hospital, his general condition was ok. After receiving active medication, his respiratory symptoms did not relieve. As can be seen from figure 2, SO2 in patients had the lowest rise in the morning and the highest rise at night. The highest value on day 13 (February 4) was 92%, which was classified as severe according to the medical guidelines. On day 19 (February 9), the lowest SO2 was 66% and the highest SO2 was 86% under the condition of oxygen mask, presenting respiratory distress. Mechanical ventilation support has been recommended, which can be diagnosed as critical illness.
Figure 2 Monitoring results of SO2 hyperoxygenation in bed mask (flow rate 5 ~ 8min/L)
FIG. 3 shows that the SO2 before entering the cabin is significantly lower than that before when oxygen is absorbed by the mask of the ward (at 08:00). After the first HBOT came out of the cabin, SO2 was increased to 90%, indicating that the correction effect of the treatment process on hypoxemia was very obvious. However, the results at 08:00, before entering the cabin and at 12:00 all showed a significant gradual increase with the treatment. The SO2 immediately after the first treatment was 90%, followed by more than 93%. After the first 4 times of treatment, after returning to the ward (at 12:00) and lying on the back under the oxygen state, the SO2 dropped back significantly compared with that out of the cabin. After the 5th time (February 15), there was no return to the landing at 12:00 compared with the time after exiting the capsule.
Figure 3 Changes of SO2 before and after HBOT treatment
Figure 4 shows that despite the active drug treatment before February 10, the mean SO2 of the patients was still decreasing day by day (P<0.05). The downward trend was reversed immediately after the treatment, and the mean value on February 11 was significantly higher than that on February 10 (P<0.05), and it increased day by day. After the 5th treatment (February 15), the normal range was basically restored.
Figure 4 The change of the daily mean of SO2 under the condition of oxygen absorption
3-Arterial blood gas analysis results:
Due to various reasons, the patient did not reexamine the blood gas after the first treatment except the blood gas. As shown in table 1, the partial oxygen pressure (PO2) before HBOT decreased progressively, which was consistent with the chief complaint and symptoms of dyspnea of the patient. Before the first HBOT (on the 19th day of admission), it was 37mmHg. Reexamination on the day after treatment has been restored to 69mmHg.
Table 1 Results of arterial blood gas test
4-Hematological examination results:
Due to various reasons, some hematology was not reviewed after treatment. Only before and after comparisons are provided here. As shown in table 2, the lymphocyte count and lymphocyte percentage were consistent with the clinical manifestations and decreased significantly before treatment. Review results after 2 treatments (12 February) showed a significant rebound.
Table 2 Results of blood routine examination
The results of coagulation function test are shown in table 3. Fibrinogen (FIB) was significantly increased on the 7th day after admission (January 28), fibrinogen degradation product (FDP) was significantly increased on the 10th day, and d-dimer (d-d) was further found to be significantly increased on the morning blood test on the 21st day. HBOT was started on the same day. After 7 treatments, FIB, d-d and FDP were significantly reduced, lymphocyte count and albumin were significantly increased, and total bilirubin and direct bilirubin returned to the normal range.
Table 3 The patient's clotting test results
5-CT scan results:
As shown in figure 5, chest CT scan of the patient on February 7 showed multiple specular soft tissue density shadows in both lungs, smooth trachea, thickened vascular texture in both lungs, and multiple flaky high-density shadows in both lungs. The severity of double lung infection was compared with the imaging results on February 3. On February 18, chest CT was re-examined after 8 HBOT sessions, and multiple soft tissue density shadows and flaky high density shadows in both lungs were reduced, but still significant.
Figure 5 CT comparison of the patients before treatment (Feb. 7) and after the 8th treatment (Feb. 18)
Discuss
The course of this case was characterized by persistent and progressive hypoxemia and pulmonary pathological changes. The lung is the main target organ of a novel coronavirus. Pneumonia is a major disease manifestation of a novel coronavirus infectious disease (COVID-19).Diffuse inflammatory changes and hypoxemia in lung tissue are the main clinical features of NCP. Huang et al. reported 41 NCP patients, 12 of whom had acute respiratory distress syndrome (ARDS) complications were ICU care, suggesting that progressive hypoxemia is an important pathological feature of NCP. Of the 27 patients treated with nasal catheter ventilation alone, only 1 (8%) ended up in ICU.However, 62% of patients who rose to require nasal catheter high flow oxygen or noninvasive mechanical ventilation eventually developed into critical care units (ICU) [3]. Chen NS et al reported a similar situation in the investigation of 99 cases of fluid diseases [4]. Hypoxemia is also one of the main causes of death of NCP. The NCP clinical guidelines also use the degree of hypoxemia as the main indicator of NCP clinical classification of light, severe and critical. The radiographic examination of this patient showed that the pulmonary parenchymal lesions were dominant and the respiratory tract was unobstructed. The results of arterial blood gas analysis showed that the PH value was not acidic but alkaline, suggesting that the damage of lung function was mainly caused by the gas exchange function. As a routine procedure, oxygen was administered through a nasal catheter at admission. However, with the development of lung histopathology, SO2 continued to decrease. Further conversion to oxygen mask did not reverse the continuous decline of SO2. The above results suggested that the existing atmospheric oxygen therapy could not meet the needs of the correction of hypoxemia associated with the pathological progress of lung tissues.
Hypoxemia is a decrease in blood oxygen levels, while hypoxia is a lack of oxygen in a tissue or organ or throughout the body. Hypoxemia is the cause of hypoxia, but not the only one. The ultimate in atmospheric oxygen therapy is ECMO. In theory, the application of ECMO can solve the pathogenesis of hypoxemia in patients. However, the clinical application of NCP in critical cases has limited effect, mainly because of the presence of concurrent multi-organ failure. For the lung as the main target organ of NCP, resulting in multiple organ failure such as systemic dysfunction, in addition to the role of virus and immune response, it is not excluded to be related to the persistence of universal hypoxia of systemic tissues and organs. From the air environment to the cells of the tissues and organs, the oxygen transport amount is affected by the oxygen partial pressure of respiratory gases, lung ventilation function, ventilation function (including the role of air and blood barrier and ventilation/perfusion ratio in gas exchange), blood carrying capacity, and tissue hemoperfusion. The difference in efficacy of existing oxygen therapy methods is related to their ability to intervene in these five steps (figure 6). The clinical selection of oxygen therapy should fully consider the influence of disease on each link and the pertinence of oxygen therapy.
Figure 6 The effect of different oxygen therapy on oxygen from the external environment to the process of tissue and organ
Oxygen debt (also known as exercise excess oxygen consumption) is the difference between oxygen demand and actual oxygen supply, and is commonly used in sports medicine [5]. The fever and strong immune response caused by virus infection will inevitably lead to the increase of metabolic rate and oxygen demand. At the same time, however, the persistent hypoxemia caused by lung histopathology of NCP reduces the oxygen supply of the lungs and lungs to the tissues and organs of the whole body. Therefore, when the NCP disease develops to a certain extent, there must be a gap between oxygen demand and oxygen supply, which can also be understood as a special "oxygen debt". Studies have found that under certain intensity of exercise load, preexisting lung diseases can lead to hypoxemia [6]. In this case, the SO2 before HBOT entered the cabin was significantly lower than that before under the condition of oxygen inhalation in the ward mask (at 08:00), which was caused by the fact that the patient could not absorb oxygen and increased a certain amount of activity during the process from the ward to the HBOT department. As a result, the oxygen intake decreased and the consumption increased, SO2 decreased. This phenomenon suggested that pathological changes in the lungs resulted in a serious imbalance between oxygen demand and oxygen supply in the patient. Arterial blood gas analysis before the first entry of HBOT on February 11 suggested that the blood lactic acid content was significantly increased (3.03mmol/L), suggesting that the patient was in a state of severe anaerobic metabolism.
HBOT based on gas physics characteristic, through the great increase in oxygen partial pressure, reach the cardiopulmonary function in the same condition, the increase of alveolar oxygen partial pressure, increase the blood oxygen tension, increase effective diffusion radius of tissue oxygen, increase oxygen transport capacity, so as to achieve correct hypoxia (1) valid thoroughly at the same time, improve the acidosis, and organize the cell vitality, enhance (2) after the reoxygenation of capillary endothelial cells, the capillary function can be restored and the exudation and edema caused by hypoxia can be blocked. (3) increase the effective diffusion radius of tissue oxygen, correct tissue hypoxia and increase tissue oxygen reserve [2]. The blood gas analysis results of this patient after the first time HBOT went out of the cabin showed that PO2 increased from 37.0mmHg before entering the cabin to 69.0mmHg, showing a good effect of HBOT correction, but there was an obvious gap with the normal value, and SO2 only increased to 90%. This state before entering the cabin can best reflect the degree of hypoxia of the patient's systemic tissues and organs. The ultimate goal of clinical oxygen therapy is to solve the hypoxia state of the body. This result suggested that the accumulation of "oxygen debt" in the early stage of the patient exceeded the ability of one HBOT to correct, which further reflected the imbalance of oxygen demand and oxygen supply in the patient's body.
After the patient left the capsule for 90 minutes (at 12:00), the oxygen saturation of the patient significantly decreased, indicating that the tissue oxygen reserve increased by the physical dissolution of HBOT was exhausted in a very short time. On the whole, however, the daily mean SO2 of HBOT patients increased steadily. Can't use HBOT residual oxygen explanation, the possible mechanism on the one hand is to provide the body's aerobic HBOT intermittent (before metabolism of anaerobic - aerobic metabolism in the treatment after - treatment of anaerobic metabolism), greatly improved the body tissue tolerance ability of anaerobic metabolism, mechanism of similar HBOT intermittent oxygen oxygen toxicity tolerance of [2]. In addition, for example, the significant increase of d-dimer, plasminogen and TDP in the hematological indicators of this patient suggested that the patient had existed a certain degree of disseminated intravascular coagulation (DIC) prior to HBOT, which can be secondary to viral infection. There were peripheral hemodynamic changes and perfusion disorders. The change of coagulation index in this patient also suggested the obvious role of HBOT in improving terminal circulation and improving oxygen supply to tissues. Whether DIC combined with persistent hypoxemia leads to ischemic loss and tissue edema of capillary endothelial cells in the peripheral circulation and whether it is a common phenomenon in patients with severe NCP requires more clinical studies and observations.
In this case, due to the lack of medical care in the cabin, oxygen was inhaled for 95min from the beginning of pressurization to the end of decompression. Oxygen poisoning has always been an important problem for many hyperbaric oxygen clinicians in the application of HBOT. The human body is adapted to the environment of 20kPa oxygen partial pressure under atmospheric air, and it will inevitably have an impact when exposed to HBOT's high pressure oxygen. Due to the necessity of breathing the mixed gas or oxygen with high pressure oxygen during diving, the diving program was designed by limiting the exposure dose of high pressure oxygen to avoid large lung type oxygen poisoning injury [2]. The high oxygen exposure dose of conventional HBOT is about 150 UPTD. In this case, the exposure dose was 216 UPTD, but still much less than 615 UPTD. This dose represents a reduction in lung capacity of approximately 1%, the safe limit for conventional high pressure oxygen exposure. Therefore, the patient's HBOT did not have to worry about the risk of pulmonary oxygen poisoning.
In this case, CT reexamination after 8 HBOT showed that although the pulmonary lesions of the patient were significantly improved, the lesions were still obvious. However, the patient's SO2 remained in the normal range under the condition of oxygen inhalation by nasal catheter. Separation phenomenon in this lung pathological changes and SO2, prompt HBOT although not directly to clear effect to the disease (virus), but it provides powerful oxygen cure, as the direct cause of lung tissue pathology may lead to continuous hypoxemia, especially the state of the oxygen to body tissues and organs of oxygen debt continues to accumulate, and its important oxygen consumption of tissues and organs of the secondary injury, keep the function of the body is relatively good state, for the body against infection systemic function provides a good foundation.
To sum up, according to the pathological characteristics of NCP, HBOT has a clear mechanism of excellent action different from atmospheric oxygen therapy. Conventional HBOT has been widely used in clinical practice for decades and has a strong therapeutic capacity. On the premise of solving the transfer process sensing control, large-scale treatment of NCP patients can fundamentally solve the problem of supporting treatment of progressive hypoxia that cannot be contained by current atmospheric pressure oxygen therapy, so as to achieve the expected effect of reducing the critical disease rate and mortality. From the changes in the clinical manifestations and examination results of this patient, it can be seen that 1 HBOT can significantly improve the severe and critical NCP patients whose daily average SO2 is still lower than 80% under the condition of atmospheric pressure oronasal mask and high flow oxygen absorption, and 4 HBOT can basically correct the persistent hypoxemia in critically critical patients. According to the existing critical disease NCP stock in wuhan, in the use of clinical HBOT, measures and practices of combining HBOT with atmospheric oxygen therapy can be further explored to comprehensively improve the treatment efficiency of large Numbers of patients.
Reference
[1] national health commission, state administration of traditional Chinese medicine. Will be coronavirus pneumonia diagnosis and treatment scheme (trial version 5) [S/OL]. (2020-02-04) [2020-02-17].http://www.gov.cn/zhengce/zhengceku/2020-02/05/5474791/files/de44557832ad4be1929091dcbcfca891.pdf.
[2] gong jinhan, Ed. Diving medicine [M]. Beijing: people's military medical publishing house, 1985:550-561
[3] HuangCL WangYM, LiXW, et al. The Clinical features of patients infected with 2019 will be coronavirus in Wuhan, China [J]. Lancet, 2020395:497-506. The DOI: https://doi.org/10.1016/S0140-6736 (20), 30183-5.
[4] ChenNS ZhouM, DongX, et al. Epidemiological and clinical characteristics of 99 cases of 2019 will be coronavirus root in Wuhan, China: A descriptive study [J]. Lancet, 2020395, 507-513.doi:https://doi.org/10.1016/s0140-6736 (20), 30211-7.
[5] Wang J, wang h, zhu z x. research progress of classical oxygen debt theory [J]. Applied psychology, 1997 (02) : 55-57. (in Chinese)
[6] hopkinssr. Exercise induced arterial hypoxemia: the role of promise-induced inequality and pulmonary diffusion limitation[J]. Adv Exp Med Biol, 2006,588 :17-30.DOI:10.1007/978-0-387-34817-9_3.
Mountain Sickness is divided into Acute Mountain Sickness(AMS) and Chronic Mountain Sickness(CMS).
Acute Mountain Sickness generally refers to a variety of symptoms that occur within a few hours to a few days when entering a plateau (above 2500 meters above sea level) from the plain without adaptation or quickly entering a higher altitude area from the plateau. Acute Mountain Sickness can be further divided into: acute mountain sickness, High Altitude Pulmonary Edema(HAPE), High Altitude Cerebral Edema(HACE), and the severity gradually deepens. The initial acute mountain sickness manifests as headache, fatigue, loss of appetite, nausea and vomiting, dizziness, and insomnia, but it is not fatal. But if left untreated, it may develop into HAPE. And then may slowly developed into HACE. HACE may not occur until at least two days after the altitude is above 4000 meters. Symptoms include unstable gait, trunk ataxia, lethargy, confusion, and some mild fever. If proper treatment is not taken, the coma may develop rapidly and even die from a brain herniation within 24 hours.
Chronic Mountain Sickness refers to chronic diseases such as the cardiovascular and cerebrovascular, blood system and other chronic diseases of people who live and work above 3000 meters above sea level for a long time due to low oxygen.
The treatment of Mountain Sickness is mainly to use hyperbaric oxygen therapy to assist drug treatment, and if necessary, lower the altitude and leave the plateau environment.
The principle of hyperbaric oxygen therapy is that hyperbaric oxygen can quickly correct hypoxemia in the body, improve and eliminate the hypoxic state of tissues, especially brain tissue, reduce pulmonary artery pressure, improve ventilation function. Hyperbaric oxygen can also constrict blood vessels, reduce tissue edema, especially reduce blood flow to the brain, reduce cerebral edema, reduce intracranial pressure, improve brain function, and promote recovery.
Here is an example. The patient is a 48-year-old man. On June 3, 2020, he traveled to Tibet by car from Qinghai with his friend, and arrived in Lhasa(about 3,600 meters above sea level) in only two days .On the next day, he developed symptoms of confusion during the day. He lost consciousness that night and was immediately sent to a local hospital for hyperbaric oxygen and fluid infusion therapy, but he did not improve significantly. He was sent to the People's Hospital on June 9 and was diagnosed with HAPE and HACE. The doctor immediately sent him into a hyperbaric oxygen chamber for emergency treatment. After the first emergency hyperbaric oxygen treatment, the patient's consciousness improved significantly when he exited the cabin.
So how to prevent altitude sickness? The first choice expect drug prevention is hyperbaric oxygen therapy. Hyperbaric oxygen can better stimulate the body's endogenous protection mechanism, thereby reducing various adverse effects caused by entering the plateau. Secondly, the speed of entering the plateau cannot be too fast. And the way to prevent severe mountain sickness is to treat acute mountain sickness in time.
Warmly remind all friends that before going to the plateau, they must understand the relevant knowledge of plateau diseases, raise their awareness of danger, and be prepared to deal with it. After returning, hyperbaric oxygen can also be used to promote body recovery.
Transcutaneous pressure of Oximetry (tcpO2) is a non-invasive way of detecting the microcirculation of the skin and subcutaneous tissues, which can reflect the oxygen supply status of the capillary blood flow.
1. What is being tested?
What is tested is the amount of dissolved oxygen in the tissue: it refers to the oxygen dissolved in the blood in the tissue capillary network in a physical state, expressed in millimeters of mercury.
2. What is the principle of tcpO2?
There are many kinds of oxygen partial pressure sensors, and the electrochemical oxygen sensor is usually used. Insert two metal electrodes into the aqueous solution containing electrolyte, and apply an appropriate DC voltage to the electrodes. When detecting, fix the fixed ring of the electrode filled with electrolyte to the detecting part, heat the electrode to a certain temperature, then the electrode can continuously measure the oxygen pressure in the electrolyte. After the oxygen enters the human body, it finally reaches the capillaries, where the combined oxygen becomes free oxygen, which is used by the human body. Under normal circumstances, the amount of oxygen diffused to the surface of the skin is difficult to detect. However, when the skin is heated to 43-45°C, the capillaries reach the maximum expansion, the blood flow is the largest, and the flow velocity is the fastest. Most of the blood oxygen diffused to the skin surface can be detected.
3. Influencing factors
Influencing factors include environmental factors: temperature, humidity, atmospheric pressure, etc.; oxygen sensor sensitivity; own factors: smoking, body position, cleanliness of the detection part, thickness of the keratinized layer, degree of extension and more. Actual operating experience also has a greater impact on the test results. The decisive factor of tcpO2 is the capillary diffusion function and blood oxygen content.
4. The difference between TCPO2 and SO2
SO2 is the percentage of the volume of oxygenated hemoglobin in the blood to the total volume of hemoglobin, which can provide a non-invasive continuous blood oxygen monitoring for the clinic. But it has certain limitations. Anemia, local hypoxia and high oxygen saturation cannot truly reflect the body’s oxygen status.
TCPO2 can non-invasively continuously monitor the oxygen dynamic changes of the tissue capillary network, and will not be affected by the above limitations.
5. The difference between TCPO2 and blood gas analysis
Blood gas analysis is an invasive blood oxygen detection method, which cannot be continuously monitored, nor can it detect the oxygen supply of local tissues. Compared with blood gas analysis, transcutaneous oxygen partial pressure monitoring is a non-invasive, continuous, and real-time detection method.
6. The scope of application of transcutaneous oxygen partial pressure measurement
Transcutaneous partial pressure of oxygen has more and more applications, and it has been approved for hyperbaric oxygen therapy, non-healing wounds, peripheral vascular disease/limb ischemia, amputation range determination, vascular reconstruction evaluation, burns, Raynaud’s/vibration syndrome, Skin flap monitoring and other clinical application fields. It has broad application prospects in the field of critically ill rescue.
7. The clinical value of TCPO2
In clinical applications, in addition to the absolute value of the monitoring results, it is more important to observe the dynamic changes in order to better guide the clinical use of drugs, the definition of surgical sites, and the evaluation of clinical efficacy.
8. The significance of TCPO2 in the subject of hyperbaric oxygen
The core of hyperbaric oxygen therapy is to increase the oxygen partial pressure and oxygen content of the tissue. Transcutaneous oxygen partial pressure measurement can monitor the exact value of tissue oxygen partial pressure at any time during hyperbaric oxygen treatment in real time.As a basic research, transcutaneous oxygen partial pressure measurement can help formulate a more reasonable hyperbaric oxygen treatment plan.
9. Preparation before the test
The indoor temperature should be normal; the body surface temperature should be tested when the body temperature is comfortable；clean the skin before testing.；drinking alcohol, smoking, drinking caffeine beverages, and taking certain drugs are prohibited.
10. Selection of test site
The percutaneous oxygen sensor must avoid large arteriovenous blood vessels, usually at the bend of the upper arm elbow joint, under the clavicle and lower abdomen (depending on the situation in special cases).
11. The main points in the test
The electrochemical characteristics of the sensor are relative values and must be calibrated before use.
The sensor must be in complete contact with the skin and isolated from air, otherwise it will affect the measured value.
After the sensor is attached to the skin, the reading value generally enters a stable state after 10-20 minutes.
Generally, the normal value change law is that the value decreases first after being isolated from the air, which can be used as a criterion for judging whether the sensor is fixed.
Although TCPO2 is a non-invasive, quantitative and continuous method, but because the skin is continuously heated during the test, the continuous time is generally not more than 4 hours, and it is recommended to change the position in 2 hours.
article: Beijing Qiumanshi Medical Technology Co., Ltd.
He Ruifeng, Li Qinglong, Bi Kexu (technical guidance);
Department of Hyperbaric Oxygen, Beijing Haidian Hospital
Hyperbaric oxygen therapy is a physical therapy that exposes the body to an environment higher than the standard atmospheric pressure (usually 1.4 ATA) and allows the patient to inhale 100% oxygen concentration to increase the oxygen content in the body to achieve the treatment of diseases.
As early as 1887, hyperbaric oxygen was used as one of the methods to treat clinical diseases and achieved curative effects. At present, hyperbaric oxygen has been widely used in the treatment and assistance of many acute and chronic diseases. Recently, in the field of sports medicine, it has been found that hyperbaric oxygen has a certain effect on the treatment of sports injuries and the recovery of sports fatigue, including acute muscles strains, sprains of joints and ligaments, and chronic overuse injuries.
The famous Brazilian football player Neymar was kicked down by his opponent and left the field injured. In order to return to the court as soon as possible, he would undergo hyperbaric oxygen therapy every other day. His personal physical trainer stated that Neymar's rehabilitation process has been accelerated with the assistance of hyperbaric oxygen therapy. As early as the 2016 European Cup, Cristiano Ronaldo used hyperbaric oxygen for adjuvant treatment after injury to the medial collateral ligament of the left knee joint.
Sports injuries generally include three stages of development: acute inflammation, tissue organization, and functional remodeling. The basic principle of hyperbaric oxygen therapy is to increase the oxygen in the blood and distribute the oxygen to the tissues and organs of the whole body under the action of the pressure gradient, improve the ischemic and hypoxic state of the tissues and organs, reduce the permeability of the blood vessel wall, and reduce exudation and edema, the reduction of edema will reduce the tension of local soft tissues, which is conducive to the smooth flow of blood circulation. Oxygen is indispensable in the period of organizational organization and function remodeling.
The traditional methods of recovery from exercise fatigue mainly include active activities, passive relaxation, nutritional supplements and water baths. In addition, hyperbaric oxygen may also have a positive effect on preventing and relieving fatigue after exercise.
In a suitable high-pressure environment, by increasing the oxygen concentration inhaled to increase the content of dissolved oxygen in the blood, the oxygen content and oxygen storage in the tissue are correspondingly increased, which can effectively improve, alleviate and correct the body's hypoxia. At present, the effect of hyperbaric oxygen on sports injury and physical recovery after exercise is gradually being recognized by coaches and athletes. In the future, it is hoped that hyperbaric oxygen can be more widely used in sports medicine and mass fitness to benefit athletes and fitness groups.
Author: Beijing Sport University School of Medicine and Rehabilitation
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