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Transcutaneous oximetry values in chronic ulcer patients during Hyperbaric treatment at 1.4 ATA compared to 2 ATA. 慢性溃疡患者在 1.4 ATA 和 2 ATA 高压氧仓治疗期间的经皮血氧饱和度值对比。
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2024-01-01
Ram A Sack, Yoav Yechezkel Pikkel, Ortal Leitner Shemy, Yitzhak Ramon, Yehuda Ullmann, Assaf A Zeltzer

Chronic wounds have a significant impact on a patient's quality of life. Different pathologies, such as poor blood supply and tissue breakdown, may lead to inadequate oxygenation of the wound. Hyperbaric oxygen (HBO2) is a widely used treatment for an increasing number of medical practices. A new so-called "hyperbaric treatment" trend has emerged. The use of low-pressure, soft-sided, or inflatable chambers represents a growing trend in hyperbaric medicine. Used in professional settings as well as directly marketed to individuals for home use, they are promoted as equivalent to clinical hyperbaric treatments provided in medical centers. However, these chambers are pressurized to 1.3 atmospheres absolute (ATA) on either air or with an oxygen concentrator, both generate oxygen partial pressures well below those used in approved hyperbaric centers for UHMS-approved indications. A total of 130 consecutive patients with chronic ulcers where tested. TcPO2 was measured near the ulcer area while the patient was breathing 100% O2 at 1.4 ATA for five and 10 minutes. The average TcPO2 at 1.4 ATA after 10 minutes of O2 breathing was 161 mmHg (1-601 mmHg, standard deviation 137.91), compared to 333 mmHg in 2 ATA (1-914±232.56), p < 0.001. Each electrode tested was also statistically significant, both after five minutes of O2 breathing and after 10 minutes. We have not found evidence supporting the claim that 1.4 ATA treatment can benefit a chronic ulcer patient. The field of HBO2 is constantly evolving. We have discovered new ways to treat previously incurable ailments. Nevertheless, it is important to note that new horizons must be examined scientifically, supported by evidence-based data. The actual effect of 1.4 ATA on many ailments is yet to be determined.

慢性伤口会严重影响患者的生活质量。血液供应不足和组织破坏等不同病理情况可能会导致伤口供氧不足。高压氧(HBO2)是越来越多医疗实践中广泛使用的一种治疗方法。一种新的所谓 "高压氧治疗 "趋势已经出现。使用低压、软边或充气室代表了高压氧医学日益增长的趋势。在专业环境中使用以及直接销售给个人在家中使用,它们被宣传为等同于医疗中心提供的临床高压氧治疗。然而,这些高压氧舱使用空气或氧气浓缩器加压到 1.3 个绝对大气压 (ATA),两者产生的氧分压都远远低于经批准的高压氧中心用于 UHMS 批准的适应症的氧分压。共有 130 名连续的慢性溃疡患者接受了测试。在溃疡区域附近测量 TcPO2,当时患者呼吸 1.4 ATA 的 100% 氧气,时间分别为 5 分钟和 10 分钟。呼吸氧气 10 分钟后,1.4 ATA 的平均 TcPO2 为 161 mmHg(1-601 mmHg,标准偏差 137.91),而 2 ATA 为 333 mmHg(1-914±232.56),P < 0.001。测试的每个电极在氧气呼吸 5 分钟后和 10 分钟后也都有统计学意义。我们没有发现证据支持 1.4 ATA 治疗能使慢性溃疡患者受益的说法。HBO2 领域在不断发展。我们发现了治疗以前无法治愈的疾病的新方法。尽管如此,重要的是要注意,必须以循证数据为支持,对新领域进行科学研究。1.4 ATA 对许多疾病的实际效果还有待确定。
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引用次数: 0
In-field use of I-VED electrical impedance sensor for assessing post-dive decompression stress in humans. 现场使用 I-VED 电阻抗传感器评估人体潜水减压后的压力。
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2024-01-01
Sotiris P Evgenidis, Konstantinos Zacharias, Virginie Papadopoulou, Sigrid Theunissen, Costantino Balestra, Thodoris D Karapantsios

Purpose: Ultrasound imaging is commonly used in decompression research to assess venous gas emboli (VGE) post-dive, with higher loads associated with increased decompression sickness risk. This work examines, for the first time in humans, the performance of a novel electrical impedance spectroscopy technology (I-VED), on possible detection of post-dive bubbles presence and arterial endothelial dysfunction that may be used as markers of decompression stress.

Methods: I-VED signals were recorded in scuba divers who performed standardized pool dives before and at set time points after their dives at 35-minute intervals for about two hours. Two distinct frequency components of the obtained signals, Low-Pass Frequency-LPF: 0-0.5 Hz and Band-Pass Frequency-BPF: 0.5-10 Hz, are extracted and respectively compared to VGE presence and known flow-mediated dilation trends for the same dive profile for endothelial dysfunction.

Results: Subjects with VGE counts above the median for all subjects were found to have an elevated average LPF compared to subjects with lower VGE counts, although this was not statistically significant (p=0.06), as well as significantly decreased BPF standard deviation post-dive compared to pre-dive (p=0.008).

Conclusions: I-VED was used for the first time in humans and operated to provide qualitative in-vivo electrical impedance measurements that may contribute to the assessment of decompression stress. Compared to ultrasound imaging, the proposed method is less expensive, not operator-dependent and compatible with continuous monitoring and application of multiple probes. This study provided preliminary insights; further calibration and validation are necessary to determine I-VED sensitivity and specificity.

目的:在减压研究中,超声波成像通常用于评估潜水后静脉气体栓塞(VGE),较高的负荷会增加减压病的风险。这项研究首次在人体中研究了一种新型电阻抗光谱技术(I-VED)的性能,该技术可用于检测潜水后气泡的存在和动脉内皮功能障碍,可作为减压压力的标记:方法:对潜水员进行 I-VED 信号记录,这些潜水员在潜水前和潜水后的设定时间点进行了标准化的泳池潜水,间隔时间为 35 分钟,持续约两小时。从获得的信号中提取两个不同的频率成分,即低通频-LPF:0-0.5 Hz 和带通频-BPF:0.5-10 Hz,并分别与 VGE 的存在和已知的同一潜水情况下血流介导的扩张趋势进行比较,以确定内皮功能障碍:结果:与 VGE 数量较少的受试者相比,VGE 数量高于所有受试者中位数的受试者的平均 LPF 升高,尽管这在统计学上并不显著(p=0.06),而且与潜水前相比,潜水后的 BPF 标准偏差显著降低(p=0.008):I-VED首次用于人体,并可提供定性的体内电阻抗测量,有助于减压压力的评估。与超声波成像相比,所提议的方法成本更低、不依赖于操作者,并且可进行连续监测和应用多个探头。这项研究提供了初步的见解;要确定 I-VED 的灵敏度和特异性,还需要进一步的校准和验证。
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引用次数: 0
Decompression sickness followed by diabetic ketoacidosis and sepsis shock: an unusual case report. 减压病后继发糖尿病酮症酸中毒和败血症休克:一个不寻常的病例报告。
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2024-01-01
Anwei Liu, Xiaogan Hou, Jing Nie, Qiang Wen, Zhiguo Pan

Decompression sickness (DCS) is caused by abrupt changes in extracorporeal pressure with varying severity. Symptoms range from mild musculoskeletal pain to severe organ dysfunction and death, especially among patients with chronic underlying disease. Here, we report an unusual case of a 49-year-old man who experienced DCS after a dive to a depth of 38 meters. The patient's symptoms progressed, starting with mild physical discomfort that progressed to disturbance of consciousness on the second morning. During hospitalization, we identified that in addition to DCS, he had also developed diabetic ketoacidosis, septic shock, and rhabdomyolysis. After carefully balancing the benefits and risks, we decided to provide supportive treatment to sustain vital signs, including ventilation support, sugar-reducing therapy, fluid replacement, and anti-infection medications. We then administered delayed hyperbaric oxygen (HBO2) when his condition was stable. Ultimately, the patient recovered without any sequelae. This is the first case report of a diver suffering from DCS followed by diabetic ketoacidosis and septic shock. We have learned that when DCS and other critical illnesses are highly suspected, it is essential to assess the condition comprehensively and focus on the principal contradiction.

减压病(DCS)是由不同严重程度的体外压力骤变引起的。症状从轻微的肌肉骨骼疼痛到严重的器官功能障碍和死亡不等,尤其是患有慢性基础疾病的患者。在此,我们报告了一例不同寻常的病例,一名 49 岁的男子在潜入 38 米深的水下后出现了 DCS。患者的症状不断加重,从轻微的身体不适开始,到第二天早上出现意识障碍。住院期间,我们发现除了 DCS 之外,他还出现了糖尿病酮症酸中毒、脓毒性休克和横纹肌溶解症。在仔细权衡利弊后,我们决定采取支持性治疗来维持生命体征,包括通气支持、降糖治疗、液体补充和抗感染药物。在病情稳定后,我们又对他进行了延迟高压氧(HBO2)治疗。最终,患者康复,没有留下任何后遗症。这是第一例潜水员因 DCS 而引发糖尿病酮症酸中毒和脓毒性休克的病例报告。我们认识到,当高度怀疑 DCS 和其他危重疾病时,必须全面评估病情,集中精力解决主要矛盾。
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引用次数: 0
Pneumothorax during manned chamber operations: A summary of reported cases. 载人舱手术中的气胸:报告病例摘要
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2024-01-01
Richard E Clarke, Keith Van Meter

In-chamber pneumothorax has complicated medically remote professional diving operations, submarine escape training, management of decompression illness, and hospital-based provision of hyperbaric oxygen therapy. Attempts to avoid thoracotomy by combination of high oxygen partial pressure breathing (the concept of inherent unsaturation) and greatly slowed rates of chamber decompression proved successful on several occasions. When this delicate balance designed to prevent the intrapleural gas volume from expanding faster than it contracts proved futile, chest drains were inserted. The presence of pneumothorax was misdiagnosed or missed altogether with disturbing frequency, resulting in wide-ranging clinical consequences. One patient succumbed before the chamber had been fully decompressed. Another was able to ambulate unaided from the chamber before being diagnosed and managed conventionally. In between these two extremes, patients experienced varying degrees of clinical compromise, from respiratory distress to cardiopulmonary arrest, with successful resuscitation. Pneumothorax associated with manned chamber operations is commonly considered to develop while the patient is under pressure and manifests during ascent. However, published reports suggest that many were pre-existing prior to chamber entry. Risk factors included pulmonary barotrauma-induced cerebral arterial gas embolism, cardiopulmonary resuscitation, and medical or surgical procedures usually involving the lung. This latter category is of heightened importance to hyperbaric operations as an iatrogenically induced pneumothorax may take as long as 24 hours to be detected, perhaps long after a patient has been cleared for chamber exposure.

腔内气胸使医学上的远程专业潜水作业、潜艇逃生训练、减压病管理和医院提供的高压氧治疗变得复杂。事实证明,通过高氧分压呼吸(固有不饱和概念)和大幅减慢腔内减压速度来避免开胸手术的尝试多次获得成功。当这种旨在防止胸腔内气体体积膨胀速度超过收缩速度的微妙平衡被证明是徒劳无益时,就需要插入胸腔引流管。气胸经常被误诊或漏诊,造成了严重的临床后果。一名患者在气室完全减压之前就已经死亡。另一名患者在被诊断为胸腔积气并接受常规治疗之前,还能在无人搀扶的情况下从气室中走出来。在这两个极端之间,患者经历了不同程度的临床损害,从呼吸窘迫到心肺骤停,但都抢救成功。与载人舱操作相关的气胸通常被认为是在患者处于压力下时发生的,并在上升过程中表现出来。然而,已发表的报告表明,许多气胸在进入舱室前就已存在。风险因素包括肺气压诱发的脑动脉气体栓塞、心肺复苏以及通常涉及肺部的内科或外科手术。后一类因素对高压氧手术更为重要,因为先天性诱发的气胸可能需要长达24小时才能被发现,也许是在病人被允许进入高压氧舱后很长时间才被发现。
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引用次数: 0
Transcutaneous oximetry values in chronic ulcer patients during Hyperbaric treatment at 1.4 ATA compared to 2 ATA 慢性溃疡患者在 1.4 ATA 和 2 ATA 高压氧仓治疗期间的经皮血氧饱和度值比较
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2023-12-14 DOI: 10.22462/587
Ram A. Sack, Y. Pikkel, Ortal Leitner-Shemi, Yitzhak Ramon, Yehuda Ullmann, Assaf A. Zeltzer
Chronic wounds have a significant impact on a patient’s quality of life. Different pathologies, such as poor blood supply and tissue breakdown, may lead to inadequate oxygenation of the wound. Hyperbaric oxygen (HBO2) is a widely used treatment for an increasing number of medical practices. A new so-called “hyperbaric treatment” trend has emerged. The use of low-pressure, soft-sided, or inflatable chambers represents a growing trend in hyperbaric medicine. Used in professional settings as well as directly marketed to individuals for home use, they are promoted as equivalent to clinical hyperbaric treatments provided in medical centers. However, these chambers are pressurized to 1.3 atmospheres absolute (ATA) on either air or with an oxygen concentrator, both generate oxygen partial pressures well below those used in approved hyperbaric centers for UHMS-approved indications. A total of 130 consecutive patients with chronic ulcers where tested. TcPO2 was measured near the ulcer area while the patient was breathing 100% O2 at 1.4 ATA for five and 10 minutes. The average TcPO2 at 1.4 ATA after 10 minutes of O2 breathing was 161 mmHg (1-601 mmHg, standard deviation 137.91), compared to 333 mmHg in 2 ATA (1-914±232.56), p < 0.001). Each electrode tested was also statistically significant, both after five minutes of O2 breathing and after 10 minutes. We have not found evidence supporting the claim that 1.4 ATA treatment can benefit a chronic ulcer patient. The field of HBO2 is constantly evolving. We have discovered new ways to treat previously incurable ailments. Nevertheless, it is important to note that new horizons must be examined scientifically, supported by evidence-based data. The actual effect of 1.4 ATA on many ailments is yet to be determined.
慢性伤口会严重影响患者的生活质量。血液供应不足和组织破坏等不同病理情况可能会导致伤口供氧不足。高压氧(HBO2)是越来越多医疗实践中广泛使用的一种治疗方法。一种新的所谓 "高压氧治疗 "趋势已经出现。使用低压、软边或充气室代表了高压氧医学日益增长的趋势。在专业环境中使用以及直接销售给个人在家中使用,它们被宣传为等同于医疗中心提供的临床高压氧治疗。然而,这些高压氧舱使用空气或氧气浓缩器加压到 1.3 个绝对大气压 (ATA),两者产生的氧分压都远远低于经批准的高压氧中心用于 UHMS 批准的适应症的氧分压。共有 130 名连续的慢性溃疡患者接受了测试。在溃疡区域附近测量 TcPO2,当时患者呼吸 1.4 ATA 的 100% 氧气,时间分别为 5 分钟和 10 分钟。氧气呼吸 10 分钟后,1.4 ATA 的平均 TcPO2 为 161 mmHg(1-601 mmHg,标准偏差 137.91),而 2 ATA 为 333 mmHg(1-914±232.56),p < 0.001)。测试的每个电极在氧气呼吸 5 分钟后和 10 分钟后也都有统计学意义。我们没有发现证据支持 1.4 ATA 治疗能使慢性溃疡患者受益的说法。HBO2 领域在不断发展。我们发现了治疗以前无法治愈的疾病的新方法。尽管如此,重要的是要注意,必须以循证数据为支持,对新领域进行科学研究。1.4 ATA 对许多疾病的实际效果还有待确定。
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引用次数: 0
Stroke on ECG: a cerebral T-wave change secondary to acute carbon monoxide poisoning 脑卒中心电图:继发于急性一氧化碳中毒的脑t波改变
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2023-08-28 DOI: 10.22462/630
Xin Xiao, MD, Xiuna Jing, MD, Yun Zhao, MD, Fei Yao, MD, Qing Sun, MD
In clinical management of carbon monoxide (CO) poisoning, serum cardiac enzyme biomarkers and electrocardiogram (ECG) are both highly recommended emergency check-ups to evaluate myocardial injuries. Medical imaging – including head CT or MRI – are not routine for CO poisoning emergency management. We herein report on a comatose patient who was diagnosed with cerebral infarction secondary to 24 hours previous acute CO poisoning, warned by a typical cerebral-type T waves on ECG in advance, and confirmed by a head MRI. Fortunately, the patient made a full recovery based on a timely treatment with medications and hyperbaric oxygen (HBO2) therapy. We would like to propose that a vital, stable, conscious CO poisoning patient who remains a higher risk for hemorrhagic or ischemic stroke should be closely monitored for potential neurological abnormalities, and a continuous ECG monitoring should be reinforced throughout the treatment. A head MRI or CT is a priority in evaluating the secondary cerebral stroke and should be arranged immediately in the event of an abnormal ECG or if unusual new symptoms are apparent.
在一氧化碳(CO)中毒的临床处理中,血清心肌酶生物标志物和心电图(ECG)都是强烈推荐的紧急检查,以评估心肌损伤。医学成像——包括头部CT或核磁共振成像——不是一氧化碳中毒应急管理的常规方法。我们在此报告一例昏迷患者,诊断为继发于24小时前急性一氧化碳中毒的脑梗死,心电图上有典型的脑型T波提示,头部MRI证实。幸运的是,患者通过及时的药物治疗和高压氧(HBO2)治疗完全康复。我们建议对生命、稳定、意识清醒的一氧化碳中毒患者密切监测潜在的神经系统异常,并在整个治疗过程中加强连续心电图监测。头部MRI或CT是评估继发性脑卒中的优先选择,如果出现异常心电图或明显的异常新症状,应立即安排检查。
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引用次数: 0
Pneumothorax during manned chamber operations: A summary of reported cases 载人舱室操作期间的气胸:报告病例摘要
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2023-08-14 DOI: 10.22462/652
Richard E. Clarke, CHT-A, Keith Van Meter, MD
In-chamber pneumothorax has complicated medically remote professional diving operations, submarine escape training, management of decompression illness and hospital-based provision of hyperbaric oxygen therapy. Attempts to avoid thoracotomy by combination high oxygen partial pressure breathing (the concept of inherent unsaturation) and greatly slowed rates of chamber decompression proved successful on several occasions. When this delicate balance designed to prevent intrapleural gas volume expanding faster than it contracts proved futile, chest drains were inserted. The presence of pneumothorax was misdiagnosed or missed altogether with disturbing frequency resulting in wide-ranging clinical consequences. One patient succumbed before the chamber had been fully decompressed. Another was able to ambulate unaided from the chamber before being diagnosed and managed conventionally. In between these two extremes, patients experienced varying degrees of clinical compromise, from respiratory distress to cardiopulmonary arrest, with successful resuscitation. Pneumothorax associated with manned chamber operations has commonly been considered to develop while the patient was under pressure and manifest during ascent. Published reports suggest, however, that many were pre-existing prior to chamber entry. Risk factors included pulmonary barotrauma-induced cerebral arterial gas embolism, cardiopulmonary resuscitation and medical or surgical procedures usually involving the lung. This latter category is of heightened importance to hyperbaric operations as an iatrogenically induced pneumothorax may take as long as 24 hours to be detected, perhaps long after a patient has been cleared for chamber exposure.
舱内气胸使医学远程专业潜水操作、潜艇逃生训练、减压病管理和医院提供高压氧治疗变得复杂。通过联合高氧分压呼吸(固有不饱和的概念)和大大降低腔室减压率来避免开胸的尝试在一些情况下证明是成功的。当这种旨在防止胸腔内气体体积扩张快于收缩的微妙平衡被证明无效时,胸腔引流管被插入。气胸的存在被误诊或漏诊,其频率令人不安,导致广泛的临床后果。一名患者在腔室完全减压前死亡。另一名患者在接受常规诊断和治疗之前能够在没有帮助的情况下从腔室行走。在这两个极端之间,患者经历了不同程度的临床妥协,从呼吸窘迫到心肺骤停,并成功复苏。与载人舱内手术相关的气胸通常被认为是在病人处于压力下时发生的,并在上升过程中表现出来。然而,发表的报告显示,许多在进入密室之前就已经存在了。危险因素包括肺气压损伤引起的脑动脉气体栓塞、心肺复苏和通常涉及肺的医疗或外科手术。后一种情况对于高压氧手术尤为重要,因为医源性气胸可能需要长达24小时才能被发现,甚至可能在患者已清除腔室暴露后很长时间才被发现。
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引用次数: 0
Medical and surgical management of pneumothorax in diving and hyperbaric chambers 潜水舱和高压氧舱气胸的内科和外科治疗
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2023-08-14 DOI: 10.22462/651
Richard E. Clarke, CHT-A, Keith Van Meter, MD
The presence of a pneumothorax within a pressurized chamber represents unique diagnostic and management challenges. This is particularly the case in the medical and geographic remoteness of many chamber locations. Upon commencing chamber decompression unvented intrapleural air expands. If its initial volume and/or degree of chamber pressure reduction is significant enough a tension pneumothorax will result. Numerous reports chronicle failure to diagnose and manage in-chamber pneumothorax with resultant morbidity and one fatal outcome. Such cases have occurred in both medically remote and clinically based settings. This paper reviews pneumothorax and tension pneumothorax risk factors and clinical characteristics. It suggests primary medical management using the principal of oxygen-induced inherent unsaturation in concert with titrated chamber decompression designed to prevent intrapleural air expanding any faster than it contracts. Should this conservative approach prove unsuccessful, and surgical venting becomes necessary or otherwise immediately indicated, interventional options are reviewed.
加压腔内气胸的存在代表了独特的诊断和管理挑战。在医疗和地理位置偏远的许多分舱地点尤其如此。开始腔室减压后,无通气胸膜内空气扩张。如果它的初始体积和/或腔压降低的程度足够显著,就会导致张力性气胸。许多报告慢性诊断和处理失败的室内气胸导致发病率和一个致命的结果。此类病例既发生在医疗偏远地区,也发生在临床环境中。本文就气胸和张力性气胸的危险因素及临床特点作一综述。它建议使用氧诱导的固有不饱和原理进行初级医疗管理,并配合滴定腔减压,以防止胸膜内空气扩张速度超过收缩速度。如果这种保守方法不成功,手术通气成为必要或立即需要,则重新考虑介入治疗方案。
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引用次数: 0
Hyperbaric oxygen (HBO2) therapy in thermal burn injury revisited. Pressure does matter. Review. 高压氧(HBO2)治疗热烧伤的再探讨。压力确实很重要。审查。
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2023-08-14 DOI: 10.22462/617
Christian Smolle M.D., Daniel Auinger M.D., Jörg Lindenmann M.D, Josef Smolle M.D., Freyja-Maria Smolle-Juettner M.D., Lars-Peter Kamolz M.D.
Throughout more than five decades a multitude of experimental and clinical studies has shown predominantly positive, but also controversial results on the efficacy of hyperbaric oxygen (HBO2) therapy in burns. Aim of the study was to define a common denominator or constellations, respectively, linked to the effects of HBO2 in burns with special focus on dosage parameters. Based on original work since 1965, species, number of individuals, type of study, percentage of total body surface area (TBSA), region, depth of burn, causative agent, interval between burn and first HBO2 session, pressure, duration of individual session, number of HBO2 sessions per day, cumulative number of HBO2 sessions and type of chamber were assessed. Out of 47 publications included, 32 were animal trials, four were trials in human volunteers and 11 clinical studies. They contained 94 experiments whose features were processed for statistical evaluation. 64 (67.4%) showed a positive outcome, 16 (17.9%) an ambiguous one and 14 (14.7%) a negative outcome. The only factor independently influencing the results was pressure with ATA (atmospheres absolute) lower than 3 ATA being significantly associated with better outcome (p=0.0005). There is a dire need for well-designed clinical studies in burn centers equipped with hyperbaric facilities to establish dedicated treatment protocols.
在过去的50多年里,大量的实验和临床研究表明,高压氧(HBO2)治疗烧伤的疗效主要是积极的,但也有争议的结果。该研究的目的是定义一个公分母或星座,分别与烧伤中HBO2的影响有关,特别关注剂量参数。根据1965年以来的原始研究,评估了物种、个体数量、研究类型、总体表面积百分比(TBSA)、区域、烧伤深度、病原体、烧伤与第一次HBO2发作间隔、压力、个体发作持续时间、每天HBO2发作次数、累计HBO2发作次数和腔室类型。在纳入的47份出版物中,32份是动物试验,4份是人类志愿者试验,11份是临床研究。它们包含94个实验,其特征经过处理以进行统计评估。阳性64例(67.4%),不明确16例(17.9%),阴性14例(14.7%)。唯一独立影响结果的因素是ATA(绝对大气压)低于3ata的压力与更好的结果显著相关(p=0.0005)。迫切需要在配备高压氧设备的烧伤中心进行精心设计的临床研究,以建立专门的治疗方案。
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引用次数: 0
Bubble rupture & viability of red blood cells under resonant acoustic standing waves 共振声驻波作用下红细胞的气泡破裂与活力
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2023-08-10 DOI: 10.22462/575
Edwin López Ramos, Manuel Rivera Bengoechea, Silvina Cancelos Mancini, Carlos Marín Martín
Objective: The presentation of a novel prospective treatment for scenarios where bubble presence in the bloodstream poses a clinical risk. The method relies on generating resonant acoustic standing waves within a limb to non-invasively accelerate dissolution of bubbles present in the bloodstream via bubble rupture. Additionally, a preliminary assessment of the effects of the resonant acoustic waves and bubble rupture events on red blood cell viability is provided. Methods: Two semicircular piezoelectric (PZT) transducers electrically connected to each other were assembled around a small-girth segment of a rear thigh removed from a swine specimen. When driven at the frequency of electric resonance, this swine thigh and PZT transducer arrangement generates resonant acoustic standing waves within the swine thigh. Consequently, mechanical resonance of the system was non-invasively established by monitoring the electric response of the PZT to the applied frequency. The resonant acoustic field generated was used for the detection and rupture of bubbles that travel through a simulated blood vessel installed across the swine thigh. Two sets of experiments were carried out using this methodology, one with the artificial blood vessel filled with saline solution and one with defibrinated sheep blood. For the latter case, a preliminary hematologic assessment was done with red blood cell counts. Conclusion: Resonant acoustic standing waves effectively rupture bubbles of 300µm to 900µm within a simplified swine thigh model. The average dissolved gas content was 44% due to resonant acoustic waves at powers above 20W. No significant effect on red blood cell counts was observed.
目的:介绍一种新的前瞻性治疗方案,其中气泡存在于血液中构成临床风险。该方法依靠在肢体内产生共振声驻波,通过气泡破裂非侵入性地加速血液中气泡的溶解。此外,对共振声波和气泡破裂事件对红细胞活力的影响进行了初步评估。方法:两个半圆形压电(PZT)换能器彼此电连接组装在一个小周长段后大腿从猪标本中取出。当以谐振频率驱动时,这种猪大腿和PZT换能器布置在猪大腿内产生共振声驻波。因此,通过监测PZT对施加频率的电响应,可以无创地建立系统的机械共振。所产生的共振声场被用于检测和破裂气泡,这些气泡穿过安装在猪大腿上的模拟血管。采用该方法进行了两组实验,一组是盐水填充的人工血管,另一组是去纤羊血。对于后一种情况,初步的血液学评估是用红细胞计数完成的。结论:在简化的猪大腿模型中,共振声驻波可以有效地破裂300µm至900µm的气泡。在功率大于20W的谐振声波作用下,平均溶解气体含量为44%。对红细胞计数无明显影响。
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Undersea and Hyperbaric Medicine
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