Introduction: Cerebral radiation necrosis is rarely encountered in pediatric patients. This case report describes a child with cerebral radiation necrosis who was successfully treated using corticosteroids, bevacizumab, and hyperbaric oxygenation.
Case report: A 3-year-old boy developed progressive extremity weakness six months after the completion of radiation therapy for the treatment of a neuroepithelial malignancy. Treatment with corticosteroids and bevacizumab was initiated, but his symptoms did not improve, and he was then referred for hyperbaric oxygen therapy. After completing 60 hyperbaric treatments, he experienced significant improvements in mobility, which remained stable over the next year.
Discussion: Cerebral radiation necrosis typically presents in children with symptoms of ataxia or headache. Corticosteroids and bevacizumab are common treatments, but hyperbaric oxygen therapy has also been studied as a therapeutic modality for this condition. When considering the use of hyperbaric oxygenation in pediatric patients, careful attention to treatment planning and patient safety can reduce the risks of adverse events such as middle ear barotrauma and confinement anxiety.
Conclusion: In addition to other available pharmacologic therapies, hyperbaric oxygenation should be considered for the treatment of pediatric patients with cerebral radiation necrosis.
{"title":"Treatment of pediatric cerebral radiation necrosis using hyperbaric oxygenation.","authors":"Kelly Johnson-Arbor","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cerebral radiation necrosis is rarely encountered in pediatric patients. This case report describes a child with cerebral radiation necrosis who was successfully treated using corticosteroids, bevacizumab, and hyperbaric oxygenation.</p><p><strong>Case report: </strong>A 3-year-old boy developed progressive extremity weakness six months after the completion of radiation therapy for the treatment of a neuroepithelial malignancy. Treatment with corticosteroids and bevacizumab was initiated, but his symptoms did not improve, and he was then referred for hyperbaric oxygen therapy. After completing 60 hyperbaric treatments, he experienced significant improvements in mobility, which remained stable over the next year.</p><p><strong>Discussion: </strong>Cerebral radiation necrosis typically presents in children with symptoms of ataxia or headache. Corticosteroids and bevacizumab are common treatments, but hyperbaric oxygen therapy has also been studied as a therapeutic modality for this condition. When considering the use of hyperbaric oxygenation in pediatric patients, careful attention to treatment planning and patient safety can reduce the risks of adverse events such as middle ear barotrauma and confinement anxiety.</p><p><strong>Conclusion: </strong>In addition to other available pharmacologic therapies, hyperbaric oxygenation should be considered for the treatment of pediatric patients with cerebral radiation necrosis.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"50 4","pages":"421-424"},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kubra Canarslan-Demir, Kubra Ozgok-Kangal, Ayse Saatci-Yasar, Mehmet Akif Erdol, Bayram Koc
During hyperbaric oxygen (HBO2) therapy in humans, there are changes in cardiovascular physiology due to high pressure and hyperoxygenation. Peripheral vasoconstriction, bradycardia, and a decrease in cardiac output are observed during HBO2 therapy. These physiological effects of HBO2 therapy on the cardiovascular system are tolerated in healthy people. However, patients with underlying cardiac disease may experience severe problems during HBO2 therapy, such as pulmonary edema and death. In addition, cardiac complications may occur in patients with diabetes mellitus (DM). Therefore, HBO2 therapy may negatively affect cardiovascular physiology in patients with DM. The present study aimed to examine the cardiovascular effects of HBO2 therapy in diabetic patients. The findings of NT-ProBNP, troponin I, and electrocardiography (ECG) of diabetic patients who applied to the Ministry of Health University Gülhane Training Research Underwater and Hyperbaric Medicine Clinic were compared before and after the first HBO2 therapy session. When ECG findings were analyzed at the end of a session of HBO2 exposure, a statistically significant increase was observed in the QTc and QTc dispersion measurements (p≺0.001 and p = 0.02, respectively). In cardiac enzymes, there was a statistically significant increase in troponin I values after an HBO2 therapy session, but no statistically significant change was observed in Pro-BNP (p = 0.009, p = 0.3, respectively). Short-term exposure to HBO2 therapy had statistically significant changes in troponin I, QT, and QTc in patients with DM, which did not reach clinical significance. Despite very little evidence of cardiac dysfunction, we recommend caution in using HBO2 therapy in patients with DM and emphasize the need for further investigation of these measurements.
{"title":"Analysis of the cardiovascular effects of hyperbaric oxygen therapy in diabetic patients.","authors":"Kubra Canarslan-Demir, Kubra Ozgok-Kangal, Ayse Saatci-Yasar, Mehmet Akif Erdol, Bayram Koc","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>During hyperbaric oxygen (HBO2) therapy in humans, there are changes in cardiovascular physiology due to high pressure and hyperoxygenation. Peripheral vasoconstriction, bradycardia, and a decrease in cardiac output are observed during HBO2 therapy. These physiological effects of HBO2 therapy on the cardiovascular system are tolerated in healthy people. However, patients with underlying cardiac disease may experience severe problems during HBO2 therapy, such as pulmonary edema and death. In addition, cardiac complications may occur in patients with diabetes mellitus (DM). Therefore, HBO2 therapy may negatively affect cardiovascular physiology in patients with DM. The present study aimed to examine the cardiovascular effects of HBO2 therapy in diabetic patients. The findings of NT-ProBNP, troponin I, and electrocardiography (ECG) of diabetic patients who applied to the Ministry of Health University Gülhane Training Research Underwater and Hyperbaric Medicine Clinic were compared before and after the first HBO2 therapy session. When ECG findings were analyzed at the end of a session of HBO2 exposure, a statistically significant increase was observed in the QTc and QTc dispersion measurements (p≺0.001 and p = 0.02, respectively). In cardiac enzymes, there was a statistically significant increase in troponin I values after an HBO2 therapy session, but no statistically significant change was observed in Pro-BNP (p = 0.009, p = 0.3, respectively). Short-term exposure to HBO2 therapy had statistically significant changes in troponin I, QT, and QTc in patients with DM, which did not reach clinical significance. Despite very little evidence of cardiac dysfunction, we recommend caution in using HBO2 therapy in patients with DM and emphasize the need for further investigation of these measurements.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"50 4","pages":"425-431"},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Microtia reconstruction with autologous costal cartilage framework grafting is challenging because the three-dimensional structure of the ear is highly complex, and meeting the high aesthetic demands of patients can be difficult. If the skin flap overlying the framework is thinned to achieve a smooth and accentuated outline, a poor blood supply in the thin skin flap may lead to skin necrosis, exposure of the framework, and poor surgical results. Hyperbaric oxygen (HBO2) therapy can promote the healing of complex wounds and flaps. This study sought to determine the effectiveness of HBO2 therapy for the prevention of postoperative complications after framework grafting in microtia reconstruction.
Methods: We retrospectively evaluated postoperative complications and compared outcomes in pediatric patients who underwent costal cartilage grafting for microtia reconstruction at our institution between 2011 and 2015, according to whether or not they received postoperative HBO2 therapy. HBO2 therapy was applied once daily for a total of 10 sessions starting on the first postoperative day.
Results: During the study period, eight patients received HBO2 therapy after costal cartilage grafting, and 12 did not. There was no significant difference in the incidence of postoperative ulcers. However, the incidence of framework exposure was lower, and the healing time was shorter in patients who received HBO2 therapy than in those who did not.
Discussion: HBO2 therapy can be used safely in pediatric patients to reduce postoperative complications and improve the aesthetic outcome of microtia reconstruction. After costal cartilage grafting, HBO2 therapy should be considered as adjuvant therapy.
{"title":"Efficacy of hyperbaric oxygen after microtia reconstruction using costal cartilage: A retrospective case-control study.","authors":"Naoki Murao, Akihiko Oyama, Yuhei Yamamoto, Emi Funayama, Kosuke Ishikawa, Taku Maeda","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Microtia reconstruction with autologous costal cartilage framework grafting is challenging because the three-dimensional structure of the ear is highly complex, and meeting the high aesthetic demands of patients can be difficult. If the skin flap overlying the framework is thinned to achieve a smooth and accentuated outline, a poor blood supply in the thin skin flap may lead to skin necrosis, exposure of the framework, and poor surgical results. Hyperbaric oxygen (HBO2) therapy can promote the healing of complex wounds and flaps. This study sought to determine the effectiveness of HBO2 therapy for the prevention of postoperative complications after framework grafting in microtia reconstruction.</p><p><strong>Methods: </strong>We retrospectively evaluated postoperative complications and compared outcomes in pediatric patients who underwent costal cartilage grafting for microtia reconstruction at our institution between 2011 and 2015, according to whether or not they received postoperative HBO2 therapy. HBO2 therapy was applied once daily for a total of 10 sessions starting on the first postoperative day.</p><p><strong>Results: </strong>During the study period, eight patients received HBO2 therapy after costal cartilage grafting, and 12 did not. There was no significant difference in the incidence of postoperative ulcers. However, the incidence of framework exposure was lower, and the healing time was shorter in patients who received HBO2 therapy than in those who did not.</p><p><strong>Discussion: </strong>HBO2 therapy can be used safely in pediatric patients to reduce postoperative complications and improve the aesthetic outcome of microtia reconstruction. After costal cartilage grafting, HBO2 therapy should be considered as adjuvant therapy.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"50 4","pages":"413-419"},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hayden W Hess, Zachary J Schlader, Blair D Johnson, Riana R Pryor, David Hostler
Background: We tested the hypotheses that self-paced aerobic exercise performance is reduced following four hours of cold-water immersion when breathing air and further reduced when breathing 100% oxygen (O2). Nine healthy adults (four women; age 24 ± 3 years; body fat 17.9 ± 6.4%; VO2max 48±9 mL • kg • minute⁻¹) completed three visits: a no-immersion control trial and two experimental trials consisting of a four-hour cold-water immersion (20.1±0.3°C) either breathing air (FIO2 = 0.21) or O2 (FIO2 = 1.0). During the no-immersion control trial and following immersion in the experimental trials, subjects first completed a 60-minute ruck-march carrying 20% of body mass in a rucksack, immediately followed by an unweighted, self-paced 5-km time trial on a motorized treadmill. Core temperature, heart rate, and rating of perceived exertion were recorded every 1,000 meters during the 5-km time trial. Data are presented mean± SD. Time trial performance was reduced following immersion in both the 100% O2 trial (32±6 minutes; p=0.01) and air trial (32±5 minutes; p=0.01) compared to the control trial (28± 4 minutes). However, there was no difference between the 100% O2 and air trials (p=0.86). Heart rate, core temperature, and rating of perceived exertion increased during the time trial (time effect: p≺0.01), but were not different between trials (trial effect: p≥0.33). These findings suggest that prolonged cold-water immersion attenuates self-paced aerobic exercise performance, but does not appear to be further affected by breathing gas type.
{"title":"Aerobic exercise performance is reduced following prolonged cold-water immersion.","authors":"Hayden W Hess, Zachary J Schlader, Blair D Johnson, Riana R Pryor, David Hostler","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>We tested the hypotheses that self-paced aerobic exercise performance is reduced following four hours of cold-water immersion when breathing air and further reduced when breathing 100% oxygen (O2). Nine healthy adults (four women; age 24 ± 3 years; body fat 17.9 ± 6.4%; VO2max 48±9 mL • kg • minute⁻¹) completed three visits: a no-immersion control trial and two experimental trials consisting of a four-hour cold-water immersion (20.1±0.3°C) either breathing air (FIO2 = 0.21) or O2 (FIO2 = 1.0). During the no-immersion control trial and following immersion in the experimental trials, subjects first completed a 60-minute ruck-march carrying 20% of body mass in a rucksack, immediately followed by an unweighted, self-paced 5-km time trial on a motorized treadmill. Core temperature, heart rate, and rating of perceived exertion were recorded every 1,000 meters during the 5-km time trial. Data are presented mean± SD. Time trial performance was reduced following immersion in both the 100% O2 trial (32±6 minutes; p=0.01) and air trial (32±5 minutes; p=0.01) compared to the control trial (28± 4 minutes). However, there was no difference between the 100% O2 and air trials (p=0.86). Heart rate, core temperature, and rating of perceived exertion increased during the time trial (time effect: p≺0.01), but were not different between trials (trial effect: p≥0.33). These findings suggest that prolonged cold-water immersion attenuates self-paced aerobic exercise performance, but does not appear to be further affected by breathing gas type.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"50 4","pages":"359-372"},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: To investigate therapeutic effects of hydrogen-rich saline (HRS) combined with hyperbaric oxygen (HBO2) in an experimental rat model of acute lung injury (ALI). Methods: 40 Male Sprague-Dawley rats were randomly divided into sham, LPS, LPS + HBO2, LPS + HRS and LPS + HBO2 + HRS groups. ALI was induced by an intratracheal injection of LPS, then the rats were respectively given single agent treatment of HBO2 or HRS or HBO2 + HRS treatment. The treatments were continued for three days in an experimental rat model of ALI. At the end of the experiment, the lung pathological, inflammatory factors, and cell apoptosis in the pulmonary tissue were detected by Tunel method and cell apoptosis rate was calculated accordingly. Results: In the groups treated with HBO2 + HRS, pulmonary pathological data, wet-dry weight ratio and inflammatory factors of pulmonary tissues and aveolar lavage fluid were signficantly superiror to those of the sham group (p<0.05). Cell apoptosis detection revealed that no matter single agent treatment of HRS or HBO2, or combination treatment, could all alleviate cell apoptosis, and HRS combined with HBO2 treatment was obviously superior to single treatment (p<0.05). Conclusions: HRS or HBO2 single treatment could decrease inflammatory cytokines release in lung tissue, reduce accumulation of oxidative products and alleviate apoptosis of pulmoanry cells, then lead to positive therapeutic effects on ALI induced by LPS. Furthermore, HBO2 combined with HRS treatment presented a synergy effect on cell apoptosis decrease, and a declined trend in inflammatory cytokines release and related inflammatory products generation, compared with single treatment.
{"title":"Hyperbaric oxygen combined with hydrogen-rich saline protect against acute lung in rat model","authors":"Yin Chang, Qianyu Han, Xiao-chen Bao, Mingdong Wang, Yuxiang Jin, Siang Zhang, Xuewei Zhao, Yi-qun Fang, L. Xue","doi":"10.22462/01.01.2023.5","DOIUrl":"https://doi.org/10.22462/01.01.2023.5","url":null,"abstract":"Background: To investigate therapeutic effects of hydrogen-rich saline (HRS) combined with hyperbaric oxygen (HBO2) in an experimental rat model of acute lung injury (ALI). Methods: 40 Male Sprague-Dawley rats were randomly divided into sham, LPS, LPS + HBO2, LPS + HRS and LPS + HBO2 + HRS groups. ALI was induced by an intratracheal injection of LPS, then the rats were respectively given single agent treatment of HBO2 or HRS or HBO2 + HRS treatment. The treatments were continued for three days in an experimental rat model of ALI. At the end of the experiment, the lung pathological, inflammatory factors, and cell apoptosis in the pulmonary tissue were detected by Tunel method and cell apoptosis rate was calculated accordingly. Results: In the groups treated with HBO2 + HRS, pulmonary pathological data, wet-dry weight ratio and inflammatory factors of pulmonary tissues and aveolar lavage fluid were signficantly superiror to those of the sham group (p<0.05). Cell apoptosis detection revealed that no matter single agent treatment of HRS or HBO2, or combination treatment, could all alleviate cell apoptosis, and HRS combined with HBO2 treatment was obviously superior to single treatment (p<0.05). Conclusions: HRS or HBO2 single treatment could decrease inflammatory cytokines release in lung tissue, reduce accumulation of oxidative products and alleviate apoptosis of pulmoanry cells, then lead to positive therapeutic effects on ALI induced by LPS. Furthermore, HBO2 combined with HRS treatment presented a synergy effect on cell apoptosis decrease, and a declined trend in inflammatory cytokines release and related inflammatory products generation, compared with single treatment.","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"15 4","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72611062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Murao, A. Oyama, Yuhei Yamamoto, E. Funayama, K. Ishikawa, T. Maeda
Introduction: Microtia reconstruction with autologous costal cartilage framework grafting is challenging because the three-dimensional structure of the ear is highly complex, and meeting the high aesthetic demands of patients can be difficult. If the skin flap overlying the framework is thinned to achieve a smooth and accentuated outline, a poor blood supply in the thin skin flap may lead to skin necrosis, exposure of the framework, and poor surgical results. Hyperbaric oxygen (HBO2) therapy can promote the healing of complex wounds and flaps. This study sought to determine the effectiveness of HBO2 therapy for prevention of postoperative complications after framework grafting in microtia reconstruction. Methods: We retrospectively evaluated postoperative complications and compared outcomes in pediatric patients who underwent costal cartilage grafting for microtia reconstruction at our institution between 2011 and 2015 according to whether or not they received postoperative HBO2 therapy. HBO2 therapy was applied once daily for a total of 10 sessions starting on the first postoperative day. Results: During the study period, eight patients received HBO2 therapy after costal cartilage grafting and 12 did not. There was no significant difference in the incidence of postoperative ulcers. However, the incidence of framework exposure was lower and the healing time was shorter in patients who received HBO2 therapy than in those who did not. Discussion: HBO2 therapy can be used safely in pediatric patients to reduce postoperative complications and improve the aesthetic outcome of microtia reconstruction. After costal cartilage grafting, HBO2 therapy should be considered as adjuvant therapy.
{"title":"Efficacy of hyperbaric oxygen after microtia reconstruction using costal cartilage: A retrospective case-control study","authors":"N. Murao, A. Oyama, Yuhei Yamamoto, E. Funayama, K. Ishikawa, T. Maeda","doi":"10.22462/01.01.2023.46","DOIUrl":"https://doi.org/10.22462/01.01.2023.46","url":null,"abstract":"Introduction: Microtia reconstruction with autologous costal cartilage framework grafting is challenging because the three-dimensional structure of the ear is highly complex, and meeting the high aesthetic demands of patients can be difficult. If the skin flap overlying the framework is thinned to achieve a smooth and accentuated outline, a poor blood supply in the thin skin flap may lead to skin necrosis, exposure of the framework, and poor surgical results. Hyperbaric oxygen (HBO2) therapy can promote the healing of complex wounds and flaps. This study sought to determine the effectiveness of HBO2 therapy for prevention of postoperative complications after framework grafting in microtia reconstruction. Methods: We retrospectively evaluated postoperative complications and compared outcomes in pediatric patients who underwent costal cartilage grafting for microtia reconstruction at our institution between 2011 and 2015 according to whether or not they received postoperative HBO2 therapy. HBO2 therapy was applied once daily for a total of 10 sessions starting on the first postoperative day. Results: During the study period, eight patients received HBO2 therapy after costal cartilage grafting and 12 did not. There was no significant difference in the incidence of postoperative ulcers. However, the incidence of framework exposure was lower and the healing time was shorter in patients who received HBO2 therapy than in those who did not. Discussion: HBO2 therapy can be used safely in pediatric patients to reduce postoperative complications and improve the aesthetic outcome of microtia reconstruction. After costal cartilage grafting, HBO2 therapy should be considered as adjuvant therapy.","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"15 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82014868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Canarslan-Demir, Kubra Ozgok-Kangal, Ayse SAATCI-YASAR, M. A. Erdol, B. Koç
During hyperbaric oxygen (HBO2) therapy in humans there are changes in cardiovascular physiology due to high pressure and hyperoxygenation. Peripheral vasoconstriction, bradycardia and a decrease in cardiac output are observed during HBO2 therapy. These physiological effects of HBO2 therapy on the cardiovascular system are tolerated in healthy people. However, patients with underlying cardiac disease may experience severe problems during HBO2 therapy, such as pulmonary edema and death. Cardiac complications may occur in patients with diabetes mellitus (DM). Therefore, HBO2 therapy may have negative effects on cardiovascular physiology in patients with DM. The present study aimed to examine the cardiovascular effects of HBO2 therapy in diabetic patients. The findings of NT-ProBNP, troponin I, electrocardiography (ECG) of diabetic patients who applied to the Ministry of Health University Gülhane Training Research Underwater and Hyperbaric Medicine Clinic were compared before and after the first HBO2 therapy session. When ECG findings were analyzed at the end of a session of HBO2 exposure, a statistically significant increase was observed in the QTc, QTc dispersion measurements (p < 0.001, p = 0.015, respectively). In cardiac enzymes there was statistically significant increase in troponin I values after an HBO2 therapy session, but no statistically significant change was observed in Pro-BNP (p = 0.009, p = 0.300, respectively). Short-term exposure to HBO2 therapy had statistically significant changes in troponin I, QT and QTc in patients with DM, which did not reach clinical significance. Despite very little evidence of cardiac dysfunction, we recommend caution HBO2 therapy in patients with DM and the need for further investigation of these measurements.
在人类高压氧(HBO2)治疗期间,由于高压和高氧,心血管生理学发生了变化。在HBO2治疗期间观察到外周血管收缩,心动过缓和心输出量减少。HBO2治疗对心血管系统的这些生理影响在健康人群中是可耐受的。然而,患有潜在心脏病的患者在HBO2治疗期间可能会遇到严重的问题,如肺水肿和死亡。糖尿病(DM)患者可能出现心脏并发症。因此,HBO2治疗可能会对糖尿病患者的心血管生理产生负面影响。本研究旨在探讨HBO2治疗对糖尿病患者心血管的影响。比较卫生部大学 lhane训练研究水下和高压氧医学诊所申请的糖尿病患者第一次HBO2治疗前后NT-ProBNP、肌钙蛋白I、心电图(ECG)的变化。当分析HBO2暴露结束时的心电图结果时,观察到QTc和QTc弥散度测量有统计学意义的增加(p < 0.001, p = 0.015)。心肌酶方面,HBO2治疗后肌钙蛋白I升高有统计学意义,而Pro-BNP变化无统计学意义(p = 0.009, p = 0.300)。短期暴露于HBO2治疗对DM患者肌钙蛋白I、QT、QTc的影响有统计学意义,但未达到临床意义。尽管很少有心功能障碍的证据,但我们建议糖尿病患者谨慎使用HBO2治疗,并需要进一步研究这些测量值。
{"title":"Analysis of the cardiovascular effects of hyperbaric oxygen therapy in diabetic patients","authors":"K. Canarslan-Demir, Kubra Ozgok-Kangal, Ayse SAATCI-YASAR, M. A. Erdol, B. Koç","doi":"10.22462/01.01.2023.6","DOIUrl":"https://doi.org/10.22462/01.01.2023.6","url":null,"abstract":"During hyperbaric oxygen (HBO2) therapy in humans there are changes in cardiovascular physiology due to high pressure and hyperoxygenation. Peripheral vasoconstriction, bradycardia and a decrease in cardiac output are observed during HBO2 therapy. These physiological effects of HBO2 therapy on the cardiovascular system are tolerated in healthy people. However, patients with underlying cardiac disease may experience severe problems during HBO2 therapy, such as pulmonary edema and death. Cardiac complications may occur in patients with diabetes mellitus (DM). Therefore, HBO2 therapy may have negative effects on cardiovascular physiology in patients with DM. The present study aimed to examine the cardiovascular effects of HBO2 therapy in diabetic patients. The findings of NT-ProBNP, troponin I, electrocardiography (ECG) of diabetic patients who applied to the Ministry of Health University Gülhane Training Research Underwater and Hyperbaric Medicine Clinic were compared before and after the first HBO2 therapy session. When ECG findings were analyzed at the end of a session of HBO2 exposure, a statistically significant increase was observed in the QTc, QTc dispersion measurements (p < 0.001, p = 0.015, respectively). In cardiac enzymes there was statistically significant increase in troponin I values after an HBO2 therapy session, but no statistically significant change was observed in Pro-BNP (p = 0.009, p = 0.300, respectively). Short-term exposure to HBO2 therapy had statistically significant changes in troponin I, QT and QTc in patients with DM, which did not reach clinical significance. Despite very little evidence of cardiac dysfunction, we recommend caution HBO2 therapy in patients with DM and the need for further investigation of these measurements.","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"91 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90703286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mirko Leonardelli, F. Mele, M. Calvano, Enrica Macorano, Stefano Duma, Giovanni De Gabriele, F. Introna
Introduction: In fatal accidents during scuba diving it is necessary to differentiate a death from primary drowning from a secondary drowning death primarily due to other etiopathogenetic factors. The inhalation of water can only be the end point of a series of events alone capable of causing the diver’s exitus. The aim of this study is demonstrate that even low-risk heart diseases in daily life become potentially fatal during scuba diving. Methods: In this case series we describe all cases of death in the course of diving that came to the observation of the Forensic Institute of the University of Bari over a period of 20 years (2000-2020). Judicial autopsy was performed on all subjects with ancillary execution of histological and toxicological investigations. Results: The results of the medicolegal investigations carried out in the complex identified heart failure with acute myocardial infarction as the cause of death in four cases characterized by severe myocardiocoronarosclerosis, a primary drowning in a subject without previous pathological substrate in one case, and a terminal atrial fibrillation induced by acute dynamic heart failure due to functional overload of the right ventricle in one case Conclusion: Our study demonstrates that lethal events during diving are often related to the presence of unrecognized or subclinical cardiovascular diseases. Such deaths could be prevented and avoided if a greater regulatory sensitivity to the prevention and control of diving was encouraged, considering both the inherent risks of this activity and the possible unrecognized or underestimated pathologies.
{"title":"Lethal event in scuba diving with self-contained breathing apparatus: a forensic study","authors":"Mirko Leonardelli, F. Mele, M. Calvano, Enrica Macorano, Stefano Duma, Giovanni De Gabriele, F. Introna","doi":"10.22462/01.01.2023.10","DOIUrl":"https://doi.org/10.22462/01.01.2023.10","url":null,"abstract":"Introduction: In fatal accidents during scuba diving it is necessary to differentiate a death from primary drowning from a secondary drowning death primarily due to other etiopathogenetic factors. The inhalation of water can only be the end point of a series of events alone capable of causing the diver’s exitus. The aim of this study is demonstrate that even low-risk heart diseases in daily life become potentially fatal during scuba diving. Methods: In this case series we describe all cases of death in the course of diving that came to the observation of the Forensic Institute of the University of Bari over a period of 20 years (2000-2020). Judicial autopsy was performed on all subjects with ancillary execution of histological and toxicological investigations. Results: The results of the medicolegal investigations carried out in the complex identified heart failure with acute myocardial infarction as the cause of death in four cases characterized by severe myocardiocoronarosclerosis, a primary drowning in a subject without previous pathological substrate in one case, and a terminal atrial fibrillation induced by acute dynamic heart failure due to functional overload of the right ventricle in one case Conclusion: Our study demonstrates that lethal events during diving are often related to the presence of unrecognized or subclinical cardiovascular diseases. Such deaths could be prevented and avoided if a greater regulatory sensitivity to the prevention and control of diving was encouraged, considering both the inherent risks of this activity and the possible unrecognized or underestimated pathologies.","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"27 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79134702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Yanagida, Daisuke Watanabe, Takahiro Yoshida, T. Nakagawa, A. Mizushima, K. Miura
Renal abscess (RA) is a collection of infective fluid in or around the renal parenchyma. It typically occurs in immunocompromised patients including those with diabetes mellitus (DM), poor nutritional status, or steroid administration. We herein report a case of RA associated with DM in which hyperbaric oxygen (HBO2) therapy greatly contributed to the resolution of this disease. The patient was an 85-year-old man with poorly controlled type 2 DM. Contrast-enhanced computed tomography for postoperative follow-up of appendiceal cancer showed a mass lesion with poor contrast enhancement extending from the upper pole of the left kidney to the dorsal side. Therefore, a diagnosis of RA was established. The lesion was percutaneously punctured and a drainage tube was placed. Antibiotics following sensitivity testing was administered. The catheter was removed six days after its placement. However, pus discharge continued from the catheter removal site, with persistent redness around the wound. Therefore, lumbotomy incision for abscess drainage was performed on the 49th day. However, the pus discharge persisted, and we decided to perform HBO2 therapy, expecting decreases in bacterial proliferation, reduction in local edema, and improvement of host defense. HBO2 therapy for 90 minutes at two atmosphere absolute was performed 10 times. The amount of pus discharge decreased and redness improved from the fifth day after HBO2 therapy. One month after starting HBO2 therapy, the wound was closed and pus discharge resolved completely. Four years have passed since the HBO2 therapy, and there have been no symptomatic or imaging relapses of RA.
{"title":"Successful management of renal abscess secondary to diabetes mellitus with surgical treatment and hyperbaric oxygen therapy","authors":"K. Yanagida, Daisuke Watanabe, Takahiro Yoshida, T. Nakagawa, A. Mizushima, K. Miura","doi":"10.22462/01.01.2023.28","DOIUrl":"https://doi.org/10.22462/01.01.2023.28","url":null,"abstract":"Renal abscess (RA) is a collection of infective fluid in or around the renal parenchyma. It typically occurs in immunocompromised patients including those with diabetes mellitus (DM), poor nutritional status, or steroid administration. We herein report a case of RA associated with DM in which hyperbaric oxygen (HBO2) therapy greatly contributed to the resolution of this disease. The patient was an 85-year-old man with poorly controlled type 2 DM. Contrast-enhanced computed tomography for postoperative follow-up of appendiceal cancer showed a mass lesion with poor contrast enhancement extending from the upper pole of the left kidney to the dorsal side. Therefore, a diagnosis of RA was established. The lesion was percutaneously punctured and a drainage tube was placed. Antibiotics following sensitivity testing was administered. The catheter was removed six days after its placement. However, pus discharge continued from the catheter removal site, with persistent redness around the wound. Therefore, lumbotomy incision for abscess drainage was performed on the 49th day. However, the pus discharge persisted, and we decided to perform HBO2 therapy, expecting decreases in bacterial proliferation, reduction in local edema, and improvement of host defense. HBO2 therapy for 90 minutes at two atmosphere absolute was performed 10 times. The amount of pus discharge decreased and redness improved from the fifth day after HBO2 therapy. One month after starting HBO2 therapy, the wound was closed and pus discharge resolved completely. Four years have passed since the HBO2 therapy, and there have been no symptomatic or imaging relapses of RA.","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"19 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73657599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}