Hyperbaric Oxygen Therapy Overview
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Questions and Answers

What is the primary treatment for carboxyhemoglobin levels greater than 25%?

  • Hyperbaric Oxygen (correct)
  • 100% oxygen
  • Room Air
  • No treatment necessary

Which of the following symptoms is NOT typically associated with 50-60% carbon monoxide concentrations?

  • Tachycardia
  • Severe hypoxia (correct)
  • Hypertension
  • Altered judgement

How does hyperbaric oxygen therapy affect blood flow during treatment?

  • It has no effect on blood flow
  • It decreases oxygen availability to tissues
  • It increases blood flow to all tissues equally
  • It causes peripheral vasoconstriction (correct)

What effect does intermittent exposure to hyperbaric oxygen have on tissue repair?

<p>Stimulates neovascularization (A)</p> Signup and view all the answers

Which of the following statements about Gay-Lussac's law is true?

<p>Higher pressure leads to an increase in gas density. (D)</p> Signup and view all the answers

What is the time required for carbon monoxide clearance using 100% oxygen in comparison to room air?

<p>3 hours vs. 10 hours (C)</p> Signup and view all the answers

How does hyperbaric oxygen therapy impact the healing of skin grafts?

<p>Speeds up the healing process (D)</p> Signup and view all the answers

What is the consequence of cerebral hypoxia in a closed space?

<p>It can lead to confusion and disorientation within minutes. (C)</p> Signup and view all the answers

Which of the following is NOT an indication for Hyperbaric Oxygen Therapy (HBO)?

<p>Chronic obstructive pulmonary disease (B)</p> Signup and view all the answers

What percentage of oxygen in the blood is bound to hemoglobin?

<p>98.5% (D)</p> Signup and view all the answers

Hyperbaric Oxygen Therapy typically requires chamber pressure to be at least what amount to be considered hyperbaric?

<p>1.5 ATM (C)</p> Signup and view all the answers

How does HBO therapy directly affect the solubility of oxygen in plasma?

<p>It increases solubility, which is directly proportional to the PO2. (A)</p> Signup and view all the answers

What is one of the acute conditions that HBO therapy can treat?

<p>Air embolism (D)</p> Signup and view all the answers

Which of the following chronic conditions can be treated with HBO as an adjunct to conventional treatment?

<p>Actinomycosis (C)</p> Signup and view all the answers

Which gas law is most relevant to understanding how HBO affects the respiratory system?

<p>Boyle's Law (C)</p> Signup and view all the answers

What is the primary therapeutic benefit of HBO for carbon monoxide poisoning?

<p>Displacing carbon monoxide from hemoglobin (A)</p> Signup and view all the answers

In treating diabetic wounds, what mechanism does HBO most significantly employ?

<p>Enhancing oxygen supply to promote healing (B)</p> Signup and view all the answers

What is the effective pressure range for conducting HBO therapy?

<p>1.5-3 ATM (A)</p> Signup and view all the answers

Which type of chamber is specifically designed to accommodate only one patient during hyperbaric oxygen therapy?

<p>Monoplace chamber (B)</p> Signup and view all the answers

What is the primary use of hyperbaric oxygen therapy in relation to microorganisms?

<p>Inhibits the growth of anaerobic microorganisms (B)</p> Signup and view all the answers

What is a relative contraindication for hyperbaric oxygen therapy?

<p>Ear or sinus trauma (A)</p> Signup and view all the answers

During multiplace hyperbaric oxygen therapy, how do patients receive supplemental oxygen?

<p>Through a mask, head tent, or endotracheal tube. (C)</p> Signup and view all the answers

What potential complication is specifically associated with hyperbaric oxygen therapy in patients with asthma or COPD?

<p>Pneumothorax (B)</p> Signup and view all the answers

What is the primary therapeutic purpose of nitric oxide therapy?

<p>To treat persistent pulmonary hypertension in newborns (C)</p> Signup and view all the answers

What is a critical safety measure implemented during monoplace hyperbaric oxygen therapy?

<p>Special ventilators and monitors are mandatory. (B)</p> Signup and view all the answers

What is the general initial therapeutic dose range for nitric oxide in newborns?

<p>5 to 80 parts per million (D)</p> Signup and view all the answers

Which of the following is a major safety concern during hyperbaric oxygen therapy?

<p>The risk of fire (C)</p> Signup and view all the answers

How should patients manage oxygen toxicity during treatment in a multiplace chamber?

<p>Breathe air every 20 minutes to rest. (D)</p> Signup and view all the answers

What is the maximum recommended exposure time for 100% oxygen at 3 atmospheres to minimize the risk of seizure?

<p>90 minutes (C)</p> Signup and view all the answers

How does Dalton's Law relate to the amount of oxygen carried in the arterial blood?

<p>It shows that increasing the partial pressure of oxygen raises its solubility in the blood. (A)</p> Signup and view all the answers

What is the solubility of oxygen in blood at 333 mmHg of PaO2 based on Henry's Law?

<p>1 vol% (A)</p> Signup and view all the answers

What complication can arise from exposure to 100% oxygen at 2 atmospheres for an extended duration?

<p>Atelectasis (A)</p> Signup and view all the answers

What percentage of oxygen is normally needed by the body for metabolic functions?

<p>5.0 vol% (D)</p> Signup and view all the answers

What is a primary indication for Helium-Oxygen therapy?

<p>Exacerbation of asthma (C)</p> Signup and view all the answers

What is a potential danger associated with the rapid discontinuation of certain respiratory therapies?

<p>Rebound vasoconstriction (B)</p> Signup and view all the answers

Which feature of helium affects its use in respiratory therapy?

<p>Low density improves gas movement around obstructions (D)</p> Signup and view all the answers

Which of the following is NOT a clinical application of Helium-Oxygen therapy?

<p>Treatment of pulmonary embolism (A)</p> Signup and view all the answers

What is the actual flow rate when administering an 80-20% heliox mixture set at 10L/min?

<p>18L/min (A)</p> Signup and view all the answers

What is the purpose of Carbon Dioxide (Carbogen) therapy?

<p>Treating hiccups and carbon monoxide poisoning (A)</p> Signup and view all the answers

Which monitoring parameter is essential during Carbon Dioxide therapy?

<p>Patient pulse (A)</p> Signup and view all the answers

Which concentration of Helium-Oxygen has the highest proportion of helium?

<p>80% Helium and 20% oxygen (B)</p> Signup and view all the answers

Which of these gas mixtures is used for the treatment of carbon monoxide poisoning?

<p>7% carbon dioxide and 93% oxygen (C)</p> Signup and view all the answers

What should be done if significant changes are observed during Carbon Dioxide therapy?

<p>Stop the therapy immediately (D)</p> Signup and view all the answers

Flashcards

CO Poisoning Symptoms

Symptoms of CO poisoning include tachycardia, tachypnea, hypertension, altered judgment, confusion, and disorientation at 50-60% CO concentrations. Higher concentrations cause severe hypoxia, brain damage, and death.

CO Poisoning Treatment (<25% COHb)

For carboxyhemoglobin (COHb) levels below 25%, 100% oxygen therapy is used to decrease CO blood levels by about 50% within approximately 50 minutes.

CO Poisoning Treatment (>25% COHb)

For COHb levels above 25%, hyperbaric oxygen therapy (HBO) is used to quickly reduce COHb levels.

Hyperbaric Oxygen (HBO) and Vasoconstriction

High oxygen concentrations during HBO cause generalized vasoconstriction, resulting in reduced blood flow to the tissues and increased peripheral resistance.

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HBO and Neovascularization

Intermittent HBO stimulates the growth of new blood vessels (neovascularization) and improves collagen synthesis by fibroblasts, aiding wound healing and tissue regeneration.

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HBO and Limb Amputees

Hyperbaric oxygenation has shown promise in accelerating the rehabilitation of lower limb amputees by aiding the healing process.

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HBO Chamber Monitoring

HBO chamber monitoring focuses on eliminating rising chamber temperature through ventilation, preventing potential issues.

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HBO and Work of Breathing (WOB)

Increased oxygen partial pressure raises gas density, which increases the work of breathing. Monitoring the patient's work of breathing is crucial.

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Hyperbaric Oxygen Therapy (HBO)

Using high-pressure oxygen in a sealed chamber to treat medical conditions.

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HBO Pressure

Pressure in a hyperbaric chamber is higher than normal atmospheric pressure.

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Acute conditions treated with HBO

Conditions requiring immediate treatment, like carbon monoxide or decompression sickness.

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Decompression sickness

A condition that can happen when pressure changes rapidly.

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Air or gas embolism

A medical emergency that involves air or gas in the bloodstream.

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Carbon monoxide poisoning

A serious condition caused by inhaling carbon monoxide.

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Chronic conditions treated with HBO

Long-term conditions like non-healing wounds or infections.

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Diabetic wounds

Non-healing wounds that can result from diabetes.

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Oxygen in blood

Oxygen is either dissolved in plasma or bound to hemoglobin.

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Respiratory system effects of HBO

HBO affects the respiratory system by increasing the concentration of oxygen.

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Monoplace chamber

A hyperbaric oxygen chamber that accommodates a single patient.

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Multiplace chamber

A hyperbaric chamber treating multiple patients at once.

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Oxygen Toxicity

Adverse effects from high oxygen levels during HBO.

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Untreated Pneumothorax

A collapsed lung that is not treated and is a contraindication (absolute) for HBO.

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Anaerobic Microorganisms

Microbes that do not require oxygen to grow.

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Nitric Oxide Therapy (for newborns)

Using nitric oxide to treat persistent pulmonary hypertension in newborns.

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INOmax/INOvent

Devices used to administer nitric oxide.

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Relative Contraindications

Medical conditions that increase the risk of complications during hyperbaric oxygen treatments, but aren't absolute reasons to avoid the treatment.

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Ear/Sinus Trauma

A possible complication of hyperbaric oxygen therapy related to increased pressure.

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Boyle's Law

States that the volume of a gas is inversely proportional to its pressure, meaning as pressure increases, volume decreases. This is key for understanding how air bubbles change size in the body under pressure.

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Alveolar & Arterial PO2

These refer to the partial pressure of oxygen in the alveoli (tiny air sacs in the lungs) and in the arterial blood. Increased PO2 means more oxygen dissolved in the blood.

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Dalton's Law

States that the total pressure of a gas mixture is the sum of the partial pressures of its components. This helps calculate how much oxygen is available in the air we breathe.

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Henry's Law

Explains how much gas dissolves in a liquid based on its partial pressure. Higher pressure, more gas dissolves. Crucial understanding for oxygen intake under pressure.

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100% Oxygen at Increased Pressure

Breathing 100% oxygen at increased pressure enhances oxygen dissolved in the plasma, exceeding the body's normal needs. However, it can lead to oxygen toxicity, resulting in symptoms like seizures.

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Heliox Therapy

A therapy using a mixture of helium and oxygen to treat obstructive airway diseases, improving gas movement around blockages.

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Helium-Oxygen Ratio

Heliox mixtures are different concentrations of helium and oxygen for different breathing needs. (e.g., 80% helium, 20% oxygen).

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Correction Factor (Heliox)

Multiplier to adjust flowmeter readings for accurate gas delivery when using Heliox, as its low density affects measurements.

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Asthma Exacerbation

A sudden worsening of asthma symptoms, requiring immediate medical attention.

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Nebuliser

A medical device that turns liquid medication into a fine mist, for inhalation/breathing.

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Carbon Dioxide Therapy

Treatment using carbon dioxide and oxygen mixtures for specific conditions like hiccups and carbon monoxide poisoning.

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Monitoring (Gas Therapy)

Regularly check vital signs (blood pressure, pulse, respirations, mental status) during gas therapy.

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Postextubation Stridor

A high-pitched whistling sound during breathing that occurs after a patient is taken off a breathing tube.

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Refractory Croup

Severe croup that doesn't respond to typical treatments.

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Study Notes

Hyperbaric Oxygen Therapy (HBO)

  • Oxygen in the blood exists as dissolved in plasma (1.5%) and bound to hemoglobin (98.5%).
  • Dissolved oxygen is directly proportional to the partial pressure of oxygen (PO2) in the blood.
  • Atmospheric pressure increases with depth.
  • At sea level, atmospheric pressure is 1 ATA.
  • 10 meters (33ft) = 2 ATA, 20 meters (66ft)= 3 ATA, 5,500 meters (18,000ft) = 0.5 ATA.
  • HBO involves a chamber with 100% oxygen at a pressure greater than sea level (1 atmosphere absolute).
  • Therapy ranges from 2-3 ATA.
  • Chamber pressure must be at least 1.5 ATM to be considered hyperbaric.

Indications for HBO Therapy

Acute Conditions

  • Decompression sickness
  • Air or gas embolism
  • Carbon monoxide and cyanide poisoning
  • Acute traumatic ischemia (compartment syndrome, crush injury)
  • Acute peripheral arterial insufficiency
  • Intracranial abscesses
  • Crush injuries and suturing of severed limbs
  • Clostridial gangrene
  • Necrotizing soft tissue infection
  • Ischemic skin graft or flap

Chronic Conditions

  • Diabetic wounds of the lower extremities and other nonhealing wounds
  • Refractory osteomyelitis
  • Actinomycosis (chronic systemic abscesses)
  • Radiation necrosis (HBO as an adjunct to conventional treatment)

Effects of HBO

  • Effects of HBO on the respiratory system include possible changes in lung volumes and gas laws influences.
  • Exposure to high oxygen levels can result in seizures.
  • Exposure to higher levels of 100% oxygen at 3 atmospheres for 90 minutes or less is recommended.

How HBO Can Impact Respiratory System

  • HBO's effects involve the principles of gas laws, which relate to the density of gases and affect lung volumes.

Lung Volumes

  • HBO can reduce the size of air bubbles in the body.

CO Poisoning Complications

  • Symptoms of CO poisoning include tachycardia, tachypnea, hypertension, altered judgment, confusion, and disorientation
  • Severe levels can lead to severe hypoxia, permanent brain damage, and death.

Treatment for CO Poisoning

  • Treatment depends on carboxyhemoglobin levels.
  • Carboxyhemoglobin levels less than 25% are treated with 100% oxygen, reducing CO levels by approximately 50% within 50 minutes.
  • Carboxyhemoglobin levels above 25% necessitate hyperbaric oxygen therapy
  • Room Air 10 hours, 100% O2 3 hours, HBO at 3 ATM 1 hour.

HBO and Gas Temperature

  • The hyperbaric chamber should be regularly monitored and ventilated to maintain an appropriate temperature to avoid gas law complications.

WOB (Work of Breathing)

  • Increasing partial pressure leads to increased gas density, which increases breathing effort (work of breathing)
  • Patient monitoring is key.

Vascular Effects of HBO

  • High oxygen concentration causes generalized vasoconstriction of the cardiac output.
  • Peripheral vasoconstriction reduces blood flow to tissues.
  • The elevated partial pressure of oxygen (PaO2) compensates for the reduced blood flow.
  • Vasoconstriction typically doesn't occur in hypoxic tissues.

Neovascularization

  • Intermittent HBO allows regenerating cells to receive adequate oxygen.
  • Macrophages continue to stimulate new vessel growth.
  • Oxygen also promotes collagen synthesis by fibroblasts.
  • This supports skin graft/flap healing, wound repair, and repair of burned and irradiated tissue;

Prosthetic Rehabilitation

  • Hyperbaric oxygen therapy speeds up the prosthetic rehabilitation process of lower limb amputees.
  • Continued study in this field is necessary to confirm increasing validity.

Immune Effects of HBO

  • HBO inhibits the growth of anaerobic, facultative, and aerobic microorganisms, improving leukocyte functions.

Equipment

HBO Chambers

  • Can be multiplace (2-13 patients) or monoplace (single patient).
  • Primarily utilize one gas.
  • Multiplace chambers have patient and provider chambers, and the patient may rest via breathing normal air every 20 minutes to avoid oxygen toxicity.
  • Monoplace chambers require portability; the patient does not need a mask.
  • Special ventilators and monitors are crucial due to the high oxygen percentage and pressure.
  • Outer shell is typically made of steel and clear double-layered acrylic

Contraindications

Absolute Contraindications

  • Untreated pneumothorax
  • Untreated pneumomediastinum

Relative Contraindications

  • Congenital spherocytosis
  • High fevers
  • Hypercapnia
  • Obstructive airway disease
  • Optic neuritis
  • Pneumothorax
  • Seizure disorders
  • Sinusitis
  • Upper respiratory infections
  • Viral infections

Complications

  • Ear or sinus trauma
  • Tympanic membrane rupture
  • Pneumothorax (especially with asthma or COPD)
  • Oxygen toxicity
  • Fire
  • Sudden decompression

Mixed Gas Therapy

  • Usually used in the treatment of divers with decompression sickness or in other situations requiring treatment with multiple gases.

Nitric Oxide Therapy

  • Used as a pulmonary vasodilator to treat persistent pulmonary hypertension in newborns.
  • Initial therapeutic dose is 5 to 80 parts per million.
  • Commonly administered with INOmax or INOvent devices.
  • Potential dangers include rebound vasoconstriction.

Helium-Oxygen Therapy

  • Low-density gas mixture improves gas movement around obstructions in the airways.
  • Used for asthma exacerbations, postextubation stridor, refractory croup, severe airway obstruction in chronic bronchitis and emphysema.
  • Common concentrations include 80% helium/20% oxygen, 70% helium/30% oxygen, and 60% helium/40% oxygen.
  • Actual flow rates for different types of gas mixtures are adjusted using corrective factors.

Carbon Dioxide Therapy

  • Used less commonly than other therapies
  • Used in treating hiccups and in carbon monoxide poisoning, also during cardiopulmonary bypass
  • Usually supplied with non-rebreathing masks
  • Patient monitoring is critical.

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Hyperbaric Oxygen Therapy PDF

Description

Explore the fundamentals of Hyperbaric Oxygen Therapy (HBO) and its critical applications in treating various acute conditions. Learn about the principles of oxygen absorption in the blood, the role of atmospheric pressure, and specific indications for therapy, such as decompression sickness and gas embolism.

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