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</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.</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</p> Signup and view all the answers

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

    <p>Speeds up the healing process</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.</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</p> Signup and view all the answers

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

    <p>98.5%</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</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.</p> Signup and view all the answers

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

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

    What is the effective pressure range for conducting HBO therapy?

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

    What is a relative contraindication for hyperbaric oxygen therapy?

    <p>Ear or sinus trauma</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.</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</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</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.</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</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</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.</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</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.</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%</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</p> Signup and view all the answers

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

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

    What is a primary indication for Helium-Oxygen therapy?

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

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

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

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

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

    Which monitoring parameter is essential during Carbon Dioxide therapy?

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

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

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

    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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    Related Documents

    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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