MEDICAL PRESENTATION HYPERBARIC MEDICINEmedical presentation hyperbaric medicine. hyperbaric chamber medical device used in hbot, to ... • fibromyalgia ... presentation of cases

MEDICAL PRESENTATION

HYPERBARICMEDICINE

HYPERBARIC CHAMBERMedical device used in HBOT, to administer oxygen (O2) at high pressure, above atmospheric (1 ATM).

HYPERBARIC OXYGEN THERAPY

Hermetic Cabin: It is pressurized in a stable manner (Treatment Pressure), where the patient remains during the session.

Compressors Cabinet: It enters filtered air into the cabin to reach the treatment pressure by venting in a safe manner.

Oxygen external source:It may be by hub or tank, it supplies high-concentration of O2 to the patient.

COMPONENTS

Increasing the concentration of O2 that we breathe

Increasing the pressure of the air we breathe (environment ≥1.45 ATM) *

O2 100% HYPERBARIA

O2 dissolved in blood: HYPEROXIA reaching very poorly

irrigated tissues and producing other physiological effects

TREATMENT

HYPERBARIC OXYGENATION (HBOT)

*Undersea and Hyperbaric Medicine Society >>>1.4 ATA

DALTON'S LAW

The pressure of a mixture of

gases is equal to the sum of

partial pressures (Pp) of each of

the gases that compose it.

HENRY'S LAW

Gases dissolve in liquids

when under pressure.

PHYSIOLOGY OF OXYGENPHYSICOCHEMICAL FUNDAMENTALS

PHYSIOLOGY OF OXYGENAnalogy with a Sparkling Wather bottle

You can see no bubbles in a closed sparklingwater bottle. When you open it, bubblesappear. This is due to the physical laws statingthat gasses dilute in liquid when they are underpressure.

The same physical laws apply to our body.When O2 is breathed in a pressurized cabin, theO2 dilutes in blood plasma, which is 50% water.

PHYSIOLOGY OF OXYGEN

Normobaria (Air at sea level):

Atmospheric pressure: 760 mmHg (1 ATA)

Partial concentration of O2: 21%

Pp O2: 0.21 x 760 mmHg = 160 mmHg

Hyperbaria: 1.45 ATA

Partial concentration of O2: 21%

Pp O2: 0.21 x (1.45 x760 mmHg) = 231 mmHg

FiO2: (Fraction Inspired by O2 - NV: 0.21)

VH20: 47 mmHg (internal humidity - Water)

PACO2: 40 mmHg (Alveolar Pressure CO2)

CR = 0.8 (respiratory coefficient between CO2 and O2)

Alveolar pressure of the O2

PAO2 = (760 - 47) x 0.21 - 40 / 0.8 = 100 mmHg

100% O2 to 1.45 ATA: PAO2 = (760 * 1.45 - 47) x 1 - 40 / 0.8 = 950 mmHg

INCREASING

THE PRESSURE

IN THE

ALVEOLO

INCREASES THE

DISSEMINATION

TO THE PLASMA

VH20 PACO2 CR

PHYSIOLOGY OF OXYGEN

CONTENT OF

O2 IN THE BLOOD

The hyperbaric effect on dissolved oxygen:

1. Normobaric air (21% O2 1 ATA 97% Hb): 0.3ml / dl dissolved oxygen2. Hyperbaric oxygen (100% 1.45 ATA 100% Hb): 3.0 ml / dl dissolved oxygen

Hyperoxia:

Increases 10 times the amount of dissolved oxygen (independent of Hemoglobin) O2 is immediately and completely available for cells.

TREATMENT

HYPERBARIC OXYGENATIONEssential effect of Hyperbaric Oxygenation

Oxygenate the tissues

The average density of capillaries varies in tissues (~ 600 / mm3)• 2500-3000 / mm3 (brain, kidneys, liver, myocardium);• 300-400 / mm3 (skeletal muscles);• <100 / mm3 (bones, adipose tissue, connective tissue)

Average separation of ~ 40μm between adjacent capillaries

Distance capillary cells in living tissues: ~ 1-3 cells

Source: Robert A. Freitas Jr., Nanomedicine, Volume I: Basic Capabilities, Landes Bioscience, Georgetown, TX, 1999

Describes radial gradients of PO2 in a tissue cylinder

of radius R. The model considers the O2 consumption,

the solubility, the diffusion coefficient of O2 and the

non-linear fall of PO2 from the arterial to the venous

end of the capillary.

It allows calculating the PO2 at any point r, where c is

the radius of the capillary and r is the distance from

the center of the capillary inside the tissue cylinder.

The penetration of O2 into tissues is a function of PO2

BLOOD END

VENOUS END

a.radial

L

L

DISSEMINATION OF O2:

KROGH MODEL

DISSEMINATION OF O2:

KROGH MODELO2 Penetration to tissues:

Pressure in hyperbaric chamber = 1.45 ATA

generates PO2arterial = 950mmHg

Minimum effective PO2, tissue = 20mmHg

Penetration radius ~ 75μm (diameter ~ 150 μm)

Under these conditions, the penetration of O2 into

all tissue cells is guaranteed

950mmHg

PHYSIOLOGICAL EFFECTS

O2 gradient between the alveolus and pulmonary capillary

O2 diffusion and availability in tissues

Blood pressure of O2 and amount of dissolved O2:

HYPEROXIA (independent of hemoglobin)

AEROBIC METABOLISM

Through HBOT, O2 is administered as an active ingredient, seeking to maximize the oxygenation of

tissues to fulfill cellular and metabolic functions.

Molecular oxygen (O2) is an essential element for the cell: its main "mechanism of action" is to

participate as fuel in the energy supply of the cell.

O2

Energy production

ATP

FREE RADICALSFree radicals (FR) are chemical species with

an unpaired electron in their outer orbit. The

FR seek to match that electron, so they are

highly reactive. Oxygen is also present in the

form of FR (ROS) used by our body for

multiple functions:

• Inflammatory and immunological

response (against viruses and / or

bacteria)

• Proliferation and cell division

• Apoptosis

ROS

OXIDATIVE STRESSANTIOXIDANT DEFENSE

BALANCE OF THE OXIDIZING SYSTEM - ANTIOXIDANT

DISBALANCE: DISEASE

(H₂O₂ -0₂ -OH NO NOO-)

antioxidant

Free radical

electron

MECHANISM OF ACTION - HOBT

HYPEROXIA

ROS production

Improves the antioxidant system

Objective: to guarantee the arrival of O2 to tissues to fulfill

biochemical, metabolic and physiological functions

InglésInglésInglés

HYPERBARIC OXYGEN

GENERATES A STRONG HYPEROXIA

BENEFICIAL PHYSIOLOGICAL EFFECTS

HYPEROXIA - PHYSIOLOGICAL EFFECTS

NON-HYPOXEMIC

VASOCONSTRICTION

ANGIOGENESIS

OSTEOGÉNESIS

CELLULAR IMMUNITY

PERIPHERAL AXONAL

REGENERATION

COLLAGEN SYNTHESIS

OXIDATIVE STRESS AND

INFLAMMATORY RESPONSE

PROLIFERATION AND STIMULATION

OF MOTHER CELLS

NEURONAL FUNCTION

AND NEUROPROTECTION

BACTERICIDAL ACTIVITY

OXYGEN DOSEThe therapeutic effect of hyperoxia is

determined by the dose of oxygen.

The dose of oxygen depends on 5 variables:

• % of O2

• Pressure of the camera

• Duration of the session

• Session frequency

• Total number of sessions

5 weekly sessions

4 weekly sessions

3 weekly sessions

2 weekly sessions

1 weekly session

INDICATION OF THE TREATMENTSessions

Generally, a minimum of 10-20 sessions are indicated, according to the pathology of each patient.

Duration of the session

The average time used is 60 minutes. In acute patients, sessions of 90 minutes up to 2 times a day

are performed.

Session cycle

Number of sessions to be done indicating: total number, daily amount, weekly periodicity (1 to 6)

and duration of the session.

Intercycle period

Rest indicated between cycles.

HBOT: INDICATIONS

MEDICAL CLINIC

• Fibromyalgia

• Chronic fatigue

• Migraines and headaches

• Tinnitus

• Geriatrics

• Apneas of sleep

• Crohn's disease

Adjuvant treatment that reduces inflammation and edema, relieves pain, improves tissue perfusion, energy efficiency and quality of life.

Inglés

• Trauma

• Pre and post-surgical

• Progressive bacterial gangrene

• Acute traumatic ischemia

• Ligament injuries

• Osteomyelitis

Adjuvant treatment accelerates recovery and healing, reduces inflammation and edema, relieves pain, reduces the risk of infection and amputation and improves quality of life.

HBOT: INDICATIONS

TRAUMATOLOGY

Adjuvant treatment prepares athletes during training, improves energy efficiency, shortens recovery, prevents fatigue and improves injury rehabilitation.

• Training

• Muscle and tendon injuries

• Post-exercise recovery

• Chronic Fatigue Syndrome

HBOT: INDICATIONS

SPORT MEDICINE

• ACV

• Parkinson's disease

• Multiple sclerosis

• Alzheimer disease

Adjuvant treatment reduces edema, redistributes blood flow and improves cerebral oxygenation, reduces spasticity and tremors, improves cognitive function, neuroprotection and quality of life.

PEDIATRIC PATIENT:

• Autism

• PDD (Pervasive Developmental Disorder)

• Cerebral palsy

• Detoxification

HBOT: INDICATIONS

NEUROLOGY

• Wounds

• Ulcers - Diabetic foot

• Venous ulcers

• Post-surgical injuries

• Burns

• Grafts and implants

The treatment of hyperbaric oxygenation accelerates healing, favors angiogenesis, reduces

inflammation and edema, stimulates collagen synthesis, triggers the immune response and

improves perfusion.

HBOT: INDICATIONS

WOUNDS

Fibromyalgia

Rheumatoid arthritis

Osteoarthritis

Bone edema

Bone necrosis

Osteomyelitis

Adjuvant treatment to accelerate recovery, relieve pain, reduce inflammation and edema, reduce the risk of infection and improve quality of life.

HBOT: INDICATIONS

REUMATOLOGY

• Tumors

• Radio-necrosis and radiotherapy

Adjuvant treatment to improve sensitivity to radio and chemotherapy, control tumor growth, relieve

pain, prevent and recover radio-necrosis and improve quality of life

HBOT: INDICATIONS

ONCOLOGY

EVIDENCE ANDPRESENTATION OF CASES

VARIOUS ESSAYS, SERIES AND CASE REPORTS

RAISE THE EFFECTIVENESS OF HBOT AS A

SUCCESSFUL TREATMENT FOR DIFFERENT

DISEASES.

Hyperbaric Oxygen Induces Late Neuroplasticity

in Post Stroke Patients - Randomized,

Prospective Trial

Shai Efrati1,2,3*, Gregori Fishlev1, Yair Bechor1,

Olga Volkov3,4, Jacob Bergan1, Kostantin

Kliakhandler5,

Izhak Kamiager3,6, Nachum Gal1, Mony

Friedman1, Eshel Ben-Jacob2,5,7, Haim Golan3,4

Hyperbaric Oxygen Induces Late Neuroplasticity in PostStroke Patients -Randomized, Prospective Trial

A normal and healthy adult brain

should be seen primarily yellow in

the SPECT scanner. Green

indicates lower blood flow and

oxygen. Blue and violet represent

a significant reduction of blood

flow in the brain.

Patient: male

Age: 60 years

Number of sessions: 40Diagnosis: Ischemic ulcer - rheumatoid arthritis

EVIDENCE ANDPRESENTATION OF CASES

Patient: male

Age: 27 years

Number of sessions: 34

Diagnosis: Arteriovenous fistula

Patient: male

Age: 27 years

Number of sessions: 34

Diagnosis: Arteriovenous fistula

Patient: male

Age: 60 years

Number of sessions: 35

Diagnosis: Post-heart surgery

Patient: male

Age: 60 years

Number of sessions: 20

Diagnosis: lower limb, Necrosis, circulatory failure

Patient: male

Age: 5 years

Number of sessions: 70

Diagnosis: Arteriovenous malformation

Patient: male

Age: 70 years

Number of sessions: 70

Diagnosis: Diabetic ulcer

Patient: female

Age: 90 years

Number of sessions: 35

Diagnosis: Gluteal scapula

Patient: female

Age: 60 years.

Number of sessions: 40

Diagnosis: Pyoderma gangrenosum

Patient: female

Age: 11 years

Number of sessions: 40

Diagnosis: Trauma

Patient: female

Age: 70 years

Number of sessions: 20

Diagnosis: Lip melanoma

Patient: male

Age: 90 years

Number of sessions: 20

Diagnosis: Venous insufficiency

Patient: male

Age: 90 years

Number of sessions: 20

Diagnosis: Venous insufficiency

Patient: baby

Age: 3 days

Number of sessions: 3Diagnosis: Penicillin reaction

Patient: baby

Age: 3 Weeks

Number of sessions: 10

Diagnosis: Fasciitis Necrotizing

Patient: female

Age: 40 years

Number of sessions: 40

Diagnosis: Necrotizing Fasciitis

Patient: male

Number of sessions: 30

(Lesion in evolution for 4 years)

Diagnosis: Buruli ulcer

Courtesy Dr. AmousaBioBarica Headquarters

Gabon - Africa

Number of sessions: 18

Upper and left floor gangrene

Diagnosis: Diabetic Foot

Diagnosis: Sickle cell ulcer Number of sessions: 20

Courtesy Dr. AmousaBioBarica Headquarters

Gabon - Africa

Diagnosis: Dry gangrene of the fingers

Significant risk of amputation Improvement of the vascular

bed and conservation of the

fingers

Courtesy Dr. AmousaBioBarica Headquarters

Gabon - Africa

Diagnosis: Diabetic leg and foot gangrene

After surgical debridement Leg waiting for skin graft

Courtesy Dr. AmousaBioBarica Headquarters

Gabon - Africa

AbsolutePneumothorax not treatedBulla Pulmonar

RelativeTympanic perforationCancer treatment (Bleomycin, Cisplatin, Doxorubicin, Disulfiram)Pacemaker

Special caresMild hypoglycemic and Hypertensive.Congestion or catarrhClaustrophobiaPathology of VAS and COPD

CONTRAINDICATIONS

HYPERBARIC TREATMENT WITHREVITALAIR 430 CHAMBERS

Verification protocol in healthy patients:

It concludes:

Treatment at 1.45 ATA does not modify the biochemical parameters of acute phase

inflammation and oxidative stress in healthy volunteers.

Significant increase in antioxidant enzyme suggests the effect of hyperoxia in healthy

The biochemical parameters at 10 and 20 sessions are kept within the values of reference.

The treatment is safe and well tolerated, without adverse effects

CONCLUSION

The strong HYPEROXIA increases the volume of dissolvedoxygen in the blood plasma. This increase in O2 diffusionreaches less irrigated tissues.

Hyperoxia produces a broad chain of PHYSIOLOGICAL BENEFITS in the body.

HYPERBARIC TREATMENT: The patient breathes high doses of O2 in a hyperbaric environment.

SYSTEMIC PERFORMANCE IN PATHOLOGIES.