Several beneficial mechanisms are associated with hyperbaric medicine. Either alone, or more commonly in combination with other medical and surgical procedures, these mechanisms serve to enhance the healing process of treatable conditions.
1. HYPEROXYGENATION: Hyperbaric oxygen treatment provides immediate support to poorly perfused tissue in areas of compromised blood flow. The elevated pressure within the hyperbaric oxygen chamber produces a 10-15-fold increase in plasma oxygen concentration. What this means is that arterial oxygen values increase from 30 mm Hg to 1,500 or even 2,000 mm Hg. Oxygen diffuses four times as far from the capillaries. Any hyperbaric doctor would agree, however, that this form of hyperbaric oxygen treatment is only a temporary measure, it will often serve to buy time and maintain tissue viability until corrective measures can be implemented or a new blood supply established.
2. NEOVASCULARIZATION: The development of a new blood supply system is an indirect and delayed response to hyperbaric medicine procedures. Major injuries, surgery, radiation, refractory osteomyelitis, ulcerations, and diseases can damage or destroy portions of the circulatory system and the tissue supported by that blood supply. To rebuild healthy new capillaries requires the building blocks—new fibroblast cells and collagen—once a blood supply is re-established, the body can regenerate damaged tissue. Hyperbaric oxygen treatment accelerates the processes, both of growing new capillaries (angiogenesis) and repairing tissues.
3. HYPEROXIA: By utilizing HBOT, the increased oxygen levels help kill harmful bacteria and inhibit the development and activity of toxins (particularly in Clostridial perfringens infections—gas gangrene). The extra oxygen also makes the body’s immune system function more effectively, increasing efficiency in destroying foreign organisms. Recent research has demonstrated a prolonged post-antibiotic effect when hyperbaric oxygen therapy is combined with tobramycin against Pseudomonas aeroginosa—HBOT boosts and prolongs the effectiveness of the medication.
4. DIRECT PRESSURE: Hyperbaric oxygen therapy utilizes the concept of Boyle’s Law, where pressure and volume are inversely proportional, is used to reduce the volume of intravascular or other free gas (within the body). This has been used for more than a century to reduce the blood and tissue gases released when a diver or patient undergoes a pressure reduction too quickly. Re-pressurization, with a more gradual return to normal pressures is an effective treatment for decompression sickness and cerebral arterial gas embolisms. Untreated decompression sickness results in significant illness and death and remains grossly under diagnosed.
5. Hyperoxia-induced VASOCONSTRICTION: With or without causing oxygen deprivation, a swollen circulatory system is probably less efficient in facilitating tissue healing. Hyperbaric oxygen therapy reduces blood vessel swelling, enabling blood to flow more freely through damaged tissues, bringing healing oxygen and nutrients and carrying away cellular debris. In intermediate compartment syndrome (caused by tissue swelling in a limited space), in injured extremities, and in the fluid accumulation associated with grafts, blood vessel swelling restricts blood flow. Studies have shown a significant decrease in fluid resuscitation requirements when hyperbaric oxygen treatment is added to standard burn wound management treatment—limiting the tremendous fluid loss associated with these injuries makes healing a lot faster.
6. ATTENUATION OF REPERFUSION INJURY: A traumatic incident causes immediate, recognizable, and often irreversible damage. Often, when blood flow is restored (reperfusion) after the initial damage, the body responds by sending out protective leukocytes (white blood cells). Recent theory is that these leukocytes react inappropriately, causing further damage to marginal tissues. mechanism of HBOT to be discovered. Hyperbaric oxygen appears to reduce this secondary, indirect injury by preventing such activation. The net effect of hyperbaric oxygen treatment is the preservation of marginal tissues that may otherwise be lost to ischemia-reperfusion injury.
Comments