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Hyperbaric oxygenation

Univ Prof Dr Felix Stockenhuber

Hyperbaric Oxygenation focused on the single pressure chamber

The hyberbaric Oxygenation is a form of therapy in which the patient is breathing air, that has been enriched with oxygen, under encreased ambient pressure over a certain amount of time. The encreased ambient pressure is usally produced through a pressure chamber.

Principle:

In the context of hyperbaric oxygen therapy, the patient is treated with 100% pure oxygen, which accumulates in the body fluids according to the applied pressure. In humans is oxygen mainly transported by the chemical bond to the hemoglobin contained in the red blood cells. The number of red blood cells, or the amount of hemoglobin is therefore crucial for the oxygen transport capacity of the blood. Oxygen is - to a small extent - but also in physically dissolved form in the blood, as well as in all body fluids. The amount of physically dissolved oxygen depends on the oxygen partial pressure in the respiratory air. Since the red blood cells or hemoglobin are already 95% to 100% saturated in normal breathing air (21% oxygen), an increase in the blood oxygen content via the oxygen bound to hemoglobin is virtually impossible. Increasing the oxygen content (partial pressure) in the breathing air from 21 to 100% (about five times) causes a proportional increase in the amount of oxygen dissolved in the blood. A further increase in the oxygen partial pressure is possible by increasing the ambient pressure, because the amount of in a liquid of dissolved gas increases proportionally with the pressure applied to the liquid pressure.. If a person breathes pure oxygen in a pressure chamber at a pressure of, for example, 2.5 bar, about 20 times the amount of oxygen in the blood comes into solution. In relation to the total oxygen content in the blood, this increase effect is not very large, but nevertheless significant: this increases the diffusion distance for oxygen in the capillary area (the distance between blood vessel and cell) from 64 microns to 247 microns, which is about 4 times larger , which is important in circulatory disorders and other oxygen deficiency states.

Aplication area:

According to the recommendations of the medical scientific associations for hyperbaric oxygen therapy in Europe and worldwide arise due to evidence-based scientific investigations the following indications:

  • Clostridial myonecrosis / gas gangrene infection or other anaerobic infections
  • Bone necrosis
  • Carbon monoxide / cyanide / smoke poisoning
  • Air or gas embolism caused by diving accident or iatrogenic air embolism
  • Necrotizing soft tissue infections
  • Recurrent Neuroblastoma, stage IV
  • Radiation necrosis of bones and soft tissues
  • Bridging of acute blood loss in case of refusal of blood transfusion for religious reasons
  • Diabetic foot syndrome
  • Acute traumatic ischemia (crush injuries, compartment syndrome)
  • Acute hearing loss, bang trauma, acute noise damage, acute tinnitus with proven hair cell damage
  • Selected problem wounds (wound healing disorders in diabetes mellitus, arterial non-healing ulcers)
  • Impaired graft (grafts and sliding lobes)
  • Brain abscesses
  • Bone marrow edema and aseptic bone necrosis
  • Side effects of radiotherapy with wounds or organ damage to skin, bladder or rectum
  • Chronic treatment-refractory osteomyelitis
  • Otitis externa maligna

In general there are single-person pressure chambers and multi-person pressure chambers. The density of multi-person pressure chambers is far from sufficient. The incomparably higher costs, the much larger space requirements seem to be the main hindrance.
The advantages of the one-person pressure chamber depicted, on the other hand, are evident and obvious. Unequal lower acquisition costs, unequally smaller space requirements, simple and safe operation.
Thus, a significantly larger number of these single-person chambers can cover not only in metropolitan areas the comprehensive range of indications for the mentioned therapy on site without long travel distances and arrival times and without long waiting times for the patients.

Univ. Prof. Dr. Felix Stockenhuber

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