Anaerobic necrotizing fasciitis

Although the term necrotizing fasciitis was coined by Meleney in 1924 to designate gangrene related to haemolytic Streptococci29, since Wilson (1952)30 it is now used for a sub-cutaneous infection spreading along the deep fascia, causing secondary skin lesions and sparing muscles until late stages of infection. Many terms have been coined necrotizing fasciitis31-34 clostridial cellulitis35,36 non-clostridial crepitant cellulitis37 synergistic necrotizing cellulitis , and for penis and scrotum...

Criteria for using HBO in acute traumatic ischemia

The jury of the 7th ECHM Consensus Conference organised by the European Committee for Hyperbaric Medicine (ECHM) issued recommendations on the use of HBO treating crush injury and other acute traumatic ischemia. They used a 3 grade scale according to the strength each recommendation has been evaluated Type 1 Strongly Recommended. The jury considers the implementation of the recommendation of critical importance for final outcome of the patient. Type 2 Recommended. The jury considers the...

References

Etude de l'embolie gazeuse exp rimentale et de son traitement . Rev. Path. Gen. 1959, 59 891-896. 2. Adorn to D., Gildenberg P., Ferrario C., Smart J., Frost M. Pathophysiology of intravenous air embolism in dogs . Anesthesiology. 1978, 49, 2 120-127. 3. Spencer M., Oyama Y. Pulmonary capacity for dissipation of venous gaz emboli . Aerospace med. 1971, 42 822-827. 4. Tanus-Santos J., Gordo W., Udelsmann A., Cittadino M., Moreno H. Nonselective...

Literature review

The rationale for using HBO in acute traumatic ischemia is to increases tissue oxygen tensions in hypoxic tissues to levels which make it possible for the host responses to become functional. With HB0 at 240 kPa the haemoglobin-borne oxygen content is increased only from 19,8 ml of oxygen per dl blood to 20,4 ml O2, whereas plasma and tissue oxygen tensions increase tenfold. The resulting effect is that oxygen diffusion distance from capillaries is increased by a threefold factor (Krogh19)....

Effects of HBO on the host defence mechanisms

Hamblen47 carried out the first experimental study of the effects of HBO on osteomyelitis in rats. In 1980, in a rabbit model for osteomyelitis, Mader showed how HBO (100 O2 at 2 ata) improved the bactericidal activity of the PMN's against Staphylococci and how intramedullary PO2 increased from 20 mmHg in normoxia to 104 mmHg at 2 ata48. In an in vitro study carried out at the same time, after increasing pressure of oxygen from 45 to 150 mmHg for two hours, the bactericidal activity of PMN's...

Risk factors

An important risk factor associated with osteoradionecrosis is the total radiation dose. Several authors found a total radiation dose greater than 6570 Gy as increasing the risk of osteoradionecrosis , - . Bedwinek found no osteoradionecrosis when the dose was less than 60 Gy, and 9 for doses greater than 70 Gy. Morrish37 found 0 incidence less than 65 Gy, 27.6 (dentulous patients) and 6.6 (edentulous patients) for 65 to 75 Gy, and 84.6 (dentulous patients) and 50 (edentulous patients) for...

Features of diffusion

At the microvascular level the delivery of oxygen to the tissues is achieved by diffusion. The driving force determining the amount of diffusion is the difference in partial pressures of the blood between the capillary and the mitochondria in adjacent cells. The quantity of diffusing agent per unit time (J) is proportional to the surface of diffusion (F), the absolute temperature (T) and the ideal gas constant (R) and inversely proportional to the viscosity of the solvents and the radius (r) of...

Hyperbaric oxygen therapy

Several authors have studied the use of hyperbaric oxygen in patients with radiation cystitis174'178'206-221 (Table 2.2.8-3). Bevers206 reported a prospective study of 40 patients most of them required transfusion. Patients had received unsuccessful treatments clot evacuation, electrocoagulation, alum, tranexamic acid. They received 20 sessions of 100 oxygen at 3 bar pressure for 90 minutes, 5 or 6 times a week. In 4 patients, 40 sessions were given because of persistence of symptoms. Hematuria...

Clinical studies

Although animal studies considering the reported evidences on compromised grafts and flaps confer a high degree of validity, relevant human studies for HBO as adjunct therapy are essential to enroll it in the therapeutic armamentarium. In 1966 Perrins reported the use of HBO to enhance flap survival reducing the failure rate in a series cases and next year he presented a controlled study106 of HBO effect on skin split grafts. The protocol included 48 patients randomly assigned to a control and...

History Of Hyperbaric Medicine

Service d'Urgence Respiratoire, de R animation M dicale et de M decine Hyperbare, H pital Calmette, Centre Hospitalier et Universitaire, Lille, France Hyperbaric Medicine goes back a long way, since its history derives from the history of diving which dates back to ancient times. The history of Hyperbaric Medicine has been closely linked with the development of technology for underwater activities and the advance in knowledge about the physical laws and physiological mechanisms of breathing...

Contents

Physical and Pathophysiological Bases of Hyperbaric B. Ratzenhofer-Komenda, J. Niinikoski, M. Hamilton-Farell 1.1. Physics of Hyperbaric Pressure 15 W. Welslau 1.2. Biochemistry of Oxygen 25 1.3. Physiologic Effects of Increased Barometric Pressure 31 W. Welslau 1.4. Physiologic Effects of Hyperbaric Oxygen on Oxygen Transport and Tissue Oxygen Pressure 49 B. Ratzenhofer-Komenda, R. Favory, W. Welslau, F.M. Smolle-J ttner, D. Mathieu 1.5. Physiologic Effects of Hyperbaric Oxygen on Hemodynamics...

Mechanisms of hyperoxic vasoconstriction

Hyperoxic vasoconstriction does not seem to be of reflexive in origin. Differences in regional distribution, the vascular site of action88 and the decrease in sympathetic activity during hyperoxia11-13,89 argue against this theory. All authors agree that hyperoxic vasoconstriction is linked to regulatory mechanisms acting at the level of the microcirculation units. Whalen amp Nair81,82, were the first to show that cellular PO2 in muscles underwent no change in hyperoxia and that this was due to...