Skip to main content
SpringerLink
Log in

HBO Dose Titration

  • Chapter
Handbook on Hyperbaric Medicine

Abstract

The clinical application of Hyperbaric Oxygen Therapy (HBOT), although based on sound physiological principles as well as on a logical rationale, has often been characterized by empirical procedures, and the choice of the treatment schedules has been more fortuitous than rational. The indication for HBOT and the treatment protocol are originated by the general and often acritical assumption that a given lesion or malfunction is caused, facilitated or worsened by hypoxia. Furthermore, the increasingly common use of multiplace hyperbaric chambers, where many patients can be treated at the same time, although maximizing the cost benefit ration of HBOT and the performance of the chamber technical and nursing personnel justified the commonly adopted routine of using average treatment pressures and schedules without considering the differences between indications, patients, disease conditions and the evolving physiopathological stages of the healing process in the individual patients. As a consequence, it is quite frequent to witness the very strange paradox that a treatment based on extremely solid physiological grounds is often applied empirically and nonrationally.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Marroni A (1989) Fisiologia e fisiopatologia dell’ossigeno iperbarico. In: Oriani G, Faglia E (eds) Ossigeno Terapia Iperbarica, Applicazioni cliniche. Edizioni SIO Milano pp 15–43

    Google Scholar 

  2. Marroni A et al. (1984) Ossigeno Iperbarico, fisiologia ed applicazioni terapeutiche. Edizioni Studio Chieti

    Google Scholar 

  3. Lambersten CI (1978) Effects of hyperoxia on organs and their tissues. In: Extrapulmonary manifestations of respiratory disease. Lenfant C (ed), Marcel Dekker, New York 8: 239–303

    Google Scholar 

  4. Flook V et al. (1994) The differential effect of oxygen and bubbles on lung function. Undersea Hyper Med 21 (Suppl): 88

    Google Scholar 

  5. Dantzker DR (1988) Oxygen transport and utilization. Respin Care 33 (10): 874–880

    Google Scholar 

  6. Dooley JW, Mehm WJ (1989) Noninvasive assessment of the vasoconstrictive effect of hyperoxygenation. J Hyper Med 4 (4): 177–188

    Google Scholar 

  7. Weaver LK et al. (1990) Normobaric measurement of O2 tension of blood and saline tono-metered under hyperbaric O2 conditions. J Hyper Med 5: 29–38

    Google Scholar 

  8. Hunt TK, Pai NP (1975) The effect of varying oxygen tensions on wound metabolism and collagen synthesis. Surg Gynecol Obstet 135: 561–567

    Google Scholar 

  9. Hunt TK et al. (1978) Anaerobic metabolism and wound healing — an hypothesis for the initiation and cessation of collagen synthesis in wounds. Am J Surg 135: 328–332

    Article  PubMed  CAS  Google Scholar 

  10. Kivisaari J, Niinikoski J (1976) Effects of hyperbaric oxygenation and prolonged hypoxia on healing of open wounds. Acta Chir Scand 141: 14–19

    Google Scholar 

  11. Niinikoski J (1969) Effect of oxygen supply on wound healing and formation of experimental granulation tissue. Acta Physiol Scand 334: 1–72

    CAS  Google Scholar 

  12. Niinikoski J, Hunt TK, Zederfeldt B (1972) Oxygen supply in healing tissue. Am J Surg 123: 247–252

    Article  PubMed  CAS  Google Scholar 

  13. Niinikoski J, Hengan C, Hunt TK (1972) Oxygen tensions in human wounds. J Surg Res 12: 77

    Article  Google Scholar 

  14. Rabkin JM, Hunt TK (1988) Infection and oxygen. In: Davis JC, Hunt TK (eds) Problem wounds, the role of oxygen. Elsevier, New York 1–16

    Google Scholar 

  15. Remensnyder JP, Majno G (1968) Oxygen gradients in healing wounds. Am J Pathol 52: 301–308

    PubMed  CAS  Google Scholar 

  16. Sheffield PJ (1988) Tissue oxygen measurement. In: Davis JC, Hunt TK (eds) Problem wounds, the role of oxygen. Elsevier, New York 17–51

    Google Scholar 

  17. Davis JC, Hunt TK (eds) (1977) Hyperbaric oxygen therapy. UHMS, Bethesda

    Google Scholar 

  18. Lambertsen CJ (1965) Effects of oxygen at high partial pressure. In: Handbook of physiology, sect 3. Respiration Am Physiol Soc. 1047–1058

    Google Scholar 

  19. Sheffield PJ (1985) Tissue oxygen measurement with respect to soft tissue woundhealing with normobaric and hyperbaric oxygen. HBO Rev 6: 18–31

    Google Scholar 

  20. Krogh A (1919) The number and distribution of capillaries in muscle with calculation of the oxygen pressure head necessary for supplying the tissue. J Physiol 52: 409–415

    PubMed  CAS  Google Scholar 

  21. Biglow WG (1964) The microcirculation. Can J Surg 7: 237–249

    Google Scholar 

  22. VanMeter K (1989) New Orleans wound care program. In: Symposium on problematic wound healing. University of Tennessee Medical Center at Knoxville

    Google Scholar 

  23. Knighton DR, et al. (1990) Oxygen as an antibiotic. The effect of inspired oxygen on bacterial clearance. Arch Surg 125: 97–100

    Article  PubMed  CAS  Google Scholar 

  24. Mader JT et al. (1980) A mechanism for the amelioration by hyperbaric oxygen of experimental staphylococcal osteomyelitis in rabbits. J Infect Dis 141: 915–921

    Article  Google Scholar 

  25. Muhvic KH (1988) Role of hyperbaric oxygen in the treatment of bacterial sepsis. PhD dissertation, University of Maryland School of Medicine

    Google Scholar 

  26. Kaye D (1967) Effect of hyperbaric oxygen on aerobic bacteria in vitro and in vivo. Proc Soc Exp Biol Med 124: 1091–1093

    Google Scholar 

  27. McLennan JD (1962) The histotoxic clostridial infection of man. Bact Rev 26: 177–276

    Google Scholar 

  28. Van Unnik AJM (1965) Inhibition of toxin production in Clostridium Perfringens in vitro by hyperbaric oxygen. Antonie Van Leeuwenhoek, Amsterdam 31: 191–196

    Google Scholar 

  29. Han DC et al. (1976) Effective O2 tensions and microbicidal function of leukocytes in wounds and in vitro. Surg Forum 27: 18–20

    Google Scholar 

  30. Travis J, Salvesen GS (1985) Human plasma proteinase inhibitors. Ann Rev Biochem 52: 655–709

    Article  Google Scholar 

  31. Mainous EG (1982) Osteogenesis enhancement utilizing hyperbaric oxygen therapy. HBO Rev 3: 181–185

    Google Scholar 

  32. Mehm WJ et al. (1988) Effect of oxygen on in vitro fibroblast cell proliferation and collagen biosynthesis. J Hyper Med 3: 227–234

    Google Scholar 

  33. Oriani G et al. (1990) Ossigeno Terapia Iperbarica ed Osso. In: Proceedings of the 2nd International Course in Anesthesia and Intensive Care. Gismondi A et al. (eds) Editrice Salentina, Otranto 1: 839–866

    Google Scholar 

  34. Silver IA (1969) The measurement of oxygen tensions in healing tissue. In: Herzog H (ed) Progress in respiration research III. Karger, Basel 124–145

    Google Scholar 

  35. Knighton DR et al. (1983) Oxygen tension regulates the expression of angiogenesis factor by macrophages. Science 221: 1283–1285

    Article  PubMed  CAS  Google Scholar 

  36. Knighton DR et al. (1984) Regulation of repair: hypoxic control of macrophage mediated angiogenesis. In: Hunt TK et al. (eds) Soft and hard tissue repair. Praeger, New York 41–49

    Google Scholar 

  37. Davis JC, Buckley GJ, Barr PO (1988) Comprised soft tissue wounds: correction of wound hypoxia. In: Problem wounds, the role of oxygen. Davis JC, Hunt TK (eds). Elsevier, New York 143–144

    Google Scholar 

  38. Lawrence DA, Loskutoff DJ (1986) Inactivation of plasminogenactivator inhibitor by oxidants. Biochemistry 35: 6351–6355

    Article  Google Scholar 

  39. Myers RAM, Emhoff TA (1987) Transcutaneous oxygen measurements in the nonhealing diabetic wound. In: Jacobson JH, et al. (eds) Proceedings of the Eighth International Congress on Hyperbaric Medicine. Best San Pedro, Calif 309–313

    Google Scholar 

  40. Wattel FE et al. (1989) Predictive value to TcPO2 measurement in HBO for prescribing HBO therapy in chronic vascular wounds. Undersea Biomed Res 16 (Suppl): 23

    Google Scholar 

  41. Sheffield PJ, Workman WT (1985) Noninvasive tissue oxygen measurement in patients administered normobaric and hyperbaric oxygen by mask. HBO Rev 6: 47–62

    Google Scholar 

  42. Holbach KH, Caroli A, Wassmann H (1977) Cerebral energy metabolism in patients with brain lesions at normo-and hyperbaric oxygen pressures. J Neurol 217: 17–30

    Article  PubMed  CAS  Google Scholar 

  43. De Martino G et al. (1988) Prevenzione e protezione del danno da ossigeno in ossigenoterapia iperbarica. Boll Soc It Biol Sper 64 (1): 69–76

    Google Scholar 

  44. Ortolani O et al. (1987) Oxygen free radicals damage on coagulative and respiratory apparatuses in the critical patients. Bull Soc It Biol Sper 63: 1173–1179

    CAS  Google Scholar 

  45. Yusa T et al. (1984) Liposome mediated augmentation of brain SOD and catalase inhibits CNS oxygen toxicity. J Appl Physiol 57: 16–74

    Google Scholar 

  46. Lipecka K et al. (1982) Lethal doses of ionizing radiations vs. endogenous level of SOD. Stud Biophys 89: 57–64

    CAS  Google Scholar 

  47. Uchiyama H, Michaza M (1978) Determination of malonaldehyde precursor in tissues by thiobarbituric test. Anal Biochem 86: 271–278

    Article  PubMed  CAS  Google Scholar 

  48. Vladimirov JA et al. (1973) Chemoluminescence of blood plasma upon addition of bivalent iron. Biofizika 18: 148–152

    PubMed  CAS  Google Scholar 

  49. Mayes PA (1983) Biologic oxidation. In: Martin DW et al. (eds): Harper’s review of biochemistry. Lange Medical Publications, Los Altos, Calif 129–130

    Google Scholar 

  50. Raskin P et al. (1971) Effect of hyperbaric oxygen on lipid peroxidation in the lung. Aerospan Med 42: 28–30

    CAS  Google Scholar 

  51. Wells CH et al. (1977) Tissue gas measurement during hyperbaric oxygen exposure. In: Smith G (ed) Proceedings of the Sixth International Congress on Hyperbaric Medicine. Aberdeen University Press pp 118–124

    Google Scholar 

  52. Vincent HG, Landry JR (1990) Wound care and maintenance of skin integrity protocols. J Hyper Med 5: 39–50

    Google Scholar 

  53. Moon RE, Camporesi EM, Shelton DL (1987) Prediction of arterial PO2 during hyperbaric treatment. In: Bove A, et al. (eds) Proceedings of the IX International Symposium on underwater and Hyperbaric Physiology. UHMS, Bethesda, pp 1127–1131

    Google Scholar 

  54. Freeman HB (1989) Regional vascular reconstruction. In: Symposium on Problematic Wound Healing. University of Tennessee Medical Center at Knoxville

    Google Scholar 

  55. Marroni A, Cramer FS (1990) HBO in problem wounds: healing expectancy according to peripheral arterial pressure. In: Hyperbaric Medicine Proceedings — znd Swiss Symposium on Hyperbaric Medicine, Schmutz J, Bakker DJ (eds), Foundation for Hyperbaric Medicine, Basel, pp 203–207

    Google Scholar 

  56. Ohta H et al. (1990) Transient effect of hyperbaric oxygen on cerebral blood flow and intracranial pressure. J Hyper Med 5: 3–14

    CAS  Google Scholar 

  57. Sukoff MH, Ragatz RE (1982) Hyperbaric oxygenation for the treatment of acute cerebal edema. Neurosurgery 10: 29–38

    Article  PubMed  CAS  Google Scholar 

  58. Holbach KH, Wassman H, Hoheluchter KL (1976) Reversibility of the chronic post stroke state. Stroke 7: 196–300

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. President DAN Europe, Via Puglie 82, 64026, Roseto degli Abruzzi, Italy

    A. Marroni

  2. Anaesthesia, Intensive and Hyperbaric Care Department, Galeazzi Orthopaedic Institute, Via Riccardo Galeazzi 4, 20161, Milan, Italy

    G. Oriani

  3. Anaesthesia and Reanimation Service, Pol. San Marco, C. so Europa 7, Verbello, 24040, Zingonia (BG), Italy

    C. Longoni

Authors
  1. A. Marroni
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Oriani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Longoni
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Anaesthesia, Intensive and Hyperbaric Care Department, Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milano, Italy

    G. Oriani

  2. Divers Alert Network Europe, Via Puglie 82, 64026, Roseto degli Abruzzi, Italy

    A. Marroni

  3. Service de Réanimation Mèdicale et de Médicine Hyperbare, Hôpital Albert Calmette, Blvd. du Prof. Leclercq, 59037, Lille Cedex, France

    F. Wattel

Rights and permissions

Reprints and permissions

Copyright information

© 1996 Springer-Verlag Italia, Milano

About this chapter

Cite this chapter

Marroni, A., Oriani, G., Longoni, C. (1996). HBO Dose Titration. In: Oriani, G., Marroni, A., Wattel, F. (eds) Handbook on Hyperbaric Medicine. Springer, Milano. https://doi.org/10.1007/978-88-470-2198-3_4

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2198-3_4

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2200-3

  • Online ISBN: 978-88-470-2198-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation