577: Exam 1: Hyperbaric Oxygen Therapy

Front 1

what is the main factor causing chronic wounds

Back 1

lack of blood flow (lack of O2)

Front 2

what is the pathophys behind patients with vascular compromise

Back 2

poor tissue perfusion --> oxygen deifict (or hypoxia) of tissue

Front 3

what is the process of vascular compromise

Back 3

1) occlusion of the arterial blood flow
2) tissue ischemia
3) hypoxia, metabolic and CO2 retention
4) microcirculation changes
5) loss of vascular membrane integrity
6) extraversation of intravascular fluids --> edema

Front 4

why is oxygen so imporant

Back 4

1) all three wound healing phases are O2 dependent
2) tissue oxygen tensions above 30 mmHg are needed for collagen synthesis
3) promotion of angiogenesis is O2 dependent
4) antimicrobial activity is O2 dependent

Front 5

what level of tissue O2 tensions are needed for collagen synthesis

Back 5

above 30 mmHg

Front 6

what is the difference between bacteriostatic and bacteriocidal

Back 6

bacteriocidal kills (bleach and iodine)

Bacteriostatic just maintains (hydrogen peroxide and vinegar)

Front 7

what are the consequences of O2 augmentation

Back 7

1) maximize vascularity
2) decrease edema
3) decrease tissue demants - control infection
4) maximize delivery

Front 8

what is hyperbaric oxygen therapy

Back 8

inhaled 100% O2 in a systemic pressurized environment

Front 9

what are the two MOST IMPORTANT components to make something hyperbaric O2 therapy

Back 9

must be PRESSURIZED and have to BREATH 100% O2

Front 10

what is the mechanism of Hyperbaric O2

Back 10

- normal sea level is 1 ATM .... at this pressure only 0.3% of O2 is dissolved in plasma

- at 3 ATM breathing 100% O2, 6.9% O2 is dissolved in plasma

Front 11

how does the increased pressure affect diffusion radious

Back 11

diffusion radius increases 5X .... so it can push the oxygen 5X further

Front 12

what are the two types of O2 therapy

Back 12

monoplace chamber (single patient with no hands on care)

multiplace (can filt multiple people and hands on care)

Front 13

what are the emergent indications for HBOT

Back 13

- acute carbon monoxide poisoning
- acute cyanide poisoning
- smoke inhalation
- decompression illness
- air or gas embolism
- gas gangrene
- necrotizing fascitis
- crush injury
- exceptional blood loss

Front 14

what are the routine indications for HBOT

Back 14

- problematic/compromised wounds
- osteomyelitis
- soft tissue radionecrosis
- osteoradionecrosis
- compromised flaps/grafts
- burns
- intracranial abscess

Front 15

what are the experimental indiactions for HBOT

Back 15

- lyme disease
- sickle cell disease
- priapism
- anoxic brain injury
- cerebral palsy
- myocardial or brain infaction
- brown recluse spide bite

Front 16

what are the side effects to HBOT

Back 16

- barotrauma
- oxygen toxicity
- hypoglycemia
- claustrophobia
- congestive heart failure

Front 17

how do you avoid barotrauma

Back 17

teach valsalva maneuver to avoid it

Front 18

what are the absolute contraindications to HBOT

Back 18

untreated pneumothorax!

Front 19

what are the relative contraindications to HBOT

Back 19

- fever
- claustrophobia
- COPD
- CHF
- High FiO2
- Chemotherapy agents

Front 20

what are the effects of HBOT

Back 20

- tissue hyperoxygenation
- angiogenesis
- decreased tissue edema
- antimicrobial
- upregulation of growth factor receptors
- antioxidant

Front 21

what are the benefits to tissue hyperoxygenation

Back 21

1) may be able to salvage marginal tissue
2) meet increased oxygen tissue demand