Hyperbaric chamber - treatment, indications and contraindications, benefits and harms of hyperbaric oxygenation. Oxygen pressure chamber: features of purpose, implementation and effectiveness of HBO contraindications

Oxygen starvation, otherwise known as hypoxia, is perhaps the main cause of the development of various pathological conditions.

A cell of any tissue equally needs sufficient nutrition and sufficient oxygen. And if the latter is absent in the required amount, the functionality of the tissue or organ noticeably decreases.

Oxygen saturation is one of the most effective non-drug treatment methods and is necessary in all cases of hypoxia. Accordingly, hyperbaric oxygenation has indications and contraindications related to circulatory disorders.

What is hyperbaric oxygen therapy

The essence of the procedure comes down to this. Oxygen in the blood is either bound to hemoglobin – 19.1 vol. %, or dissolved in plasma - 0.3 vol. %. Cells are provided with this element by red blood cells, and the gas dissolved in plasma serves as a kind of regulator. As a rule, a lack of oxygen in the body is observed against the background of anemia, disturbances in the respiratory tract, insufficient blood volume, poor circulation, and so on.

It would seem that by eliminating the above factors, a quick recovery can be achieved. Alas, the hemoglobin level takes a long time to rise, the saturation of the complex has its limits, poor blood circulation requires prolonged physical activity, and even inhaling pure oxygen only temporarily solves the breathing problem. Oxygenation allows you to get results immediately.

The solubility of a gas in blood depends on pressure. By increasing it, this indicator can be increased, that is, its content in plasma can be increased. This is sufficient to saturate the tissues with oxygen.

The effect occurs so quickly that the procedure is used in cases of severe poisoning by combustion products or chlorohydrocarbons, in infections with tissue necrosis, where there is an urgent need to saturate the body, even in case of compartment syndrome.

Effect of barotherapy

Mechanical elimination of oxygen starvation is not the only positive effect of treatment. The impact of the procedure is much deeper and persists after the end of the session.

• The absence of oxygen starvation itself means normal heart function and restoration of normal blood flow. This is especially important when peripheral capillary circulation is impaired, over which vasodilators have practically no control.
• Hyperoxia increases the level of metabolism - under conditions of increased pressure, oxygen penetrates into the cell in a larger volume. This leads to stimulation of microsomal oxidation, synthesis of macroergs, acceleration of glucose oxidation, accelerated removal of breakdown products, and so on.
• Barotherapy affects neurohumoral regulation, which leads to improved muscle tone, restoration of strength, or injury. The procedure even helps to get out of depression, as it increases the functionality of plasmatic capillaries that ensure coordination of the cerebral cortex.
• Oxygenation has an excellent effect on gastrointestinal disorders - from duodenal ulcers to, which is a symptom of stomach disease. Oxygen saturation promotes rapid healing of injuries and restoration of hemodynamics.
• Treatment of mental disorders would seem to have nothing to do with oxygen starvation. In fact, mental disorders resulting from trauma, alcohol intoxication - neurosis, various depressive states are directly related to cerebral circulatory disorders. Restoring the functioning of capillaries leads to a rapid improvement in the condition of patients.
• An equally significant feature is the method’s ability to stop destructive processes. HBOT helps to increase partial pressure, and in damaged tissues - from burns to necrosis, this helps prevent the development of irreversible processes, thereby gaining time for the body itself to implement compensatory reactions.
• HBOT stimulates the immune system. Against this background, antibiotics are more active.

The therapeutic effect is prolonged: for at least an hour after the procedure, the level of tissue pO2 is maintained, that is, the cells continue to work under hypoxic conditions. Patients claim that oxygenation has an immediate effect on the simplest level: dizziness disappears, complexion improves, appetite appears and food brings pleasure. And the benefits of grape juice or porridge turn out to be greater: after all, the functioning of the gastrointestinal tract also automatically improves.

However, an HBOT session is not a panacea for all ills. This is one of the therapy methods that is used along with medications.

How is the procedure performed?

Oxygenation is carried out in a special device - a pressure chamber. This is a sealed capsule with transparent windows. It is equipped with control sensors, which allows the doctor to set the optimal regimen for the patient.

All the patient needs to do is lie down and breathe air. The composition of the air, the number and duration of sessions are determined by the supervising doctor.

The first session is always a trial: the patient is in the pressure chamber for no longer than 30 minutes, the pressure is no more than 1 atm. If no negative consequences are observed, the pressure is gradually increased and the duration of the procedure is increased.

It is recommended to increase the compression gradually: every 0.3–0.4 atm. the increase stops and waits 3–5 minutes. The patient's condition is constantly assessed. Slowing of the pulse and breathing, pink healthy skin color, normalization of the ECG are symptoms of a positive reaction to the effect. An increase in heart rate and breathing indicates a negative effect. As a rule, the patient himself feels noise and pressure in the ears. In such cases, the pressure is lowered and increased again in order to overcome the “pain barrier”.

The course may include from 5 to 20 sessions lasting 60–90 minutes. Frequency – from 1 to 6 sessions per day.

• In case of hypoxic brain damage, adhere to a gentle regimen - 1.5–2 atm. In case of severe toxic lesions, purulent wounds, it is raised to 2–3 atm. In this case, the intervals between procedures are reduced to 6–8 hours.
• In case of severe peritonitis, start with 2–2.5 atm., repeating every 12 hours. For sepsis, sessions are repeated after 18 hours.
• Oxygenation is very effective. The procedure is carried out 2 times a day, the pressure reaches 2–3 atm.

Indications

The use of barotherapy is justified in all cases where one of the causes of the pathological process is ischemia and oxygen starvation. This list is quite extensive:

• chronic and obstructive diseases of the lungs and bronchus;
• arterial hypertension – effective in grades 1–2;
• disorders of fat and carbohydrate metabolism - diabetes mellitus, for example;
• complex treatment of angina pectoris, recovery after a heart attack, with cardiosclerosis, prevention of heart diseases;
• peptic ulcers of the duodenum and stomach;
• scleroderma, Raynaud's disease;
• mental disorders associated with insufficient blood circulation - up to some types of schizophrenia;
• skin diseases associated with disturbances in the functioning of capillaries, arterioles, venules;
• borderline states - neuroses, depression.

In addition, the method is actively used by athletes, since oxygen saturation significantly increases the effectiveness of training.

Contraindications

Hyperbaric chamber treatment involves a closed space in which pressure increases. All contraindications are related to the patient’s inability to stay in such conditions. These include:

• epilepsy;
• cysts, abscesses and cavities in the lungs, as well as pneumothorax and bilateral inflammation;
• arterial hypertension resistant to therapy;
• acute infectious diseases;
• pregnancy; ;
• claustrophobia;
• anomalies and damage to the paranasal sinuses and eustachian tubes.

Hyperbaric oxygenation has clearly disproportionate indications and contraindications: the method is effective for ailments represented by a much wider list. In addition, this is an excellent preventive remedy for healthy people who want to improve the condition of the immune system, increase their own adaptive abilities and get excellent well-being.

The beneficial effects of oxygen therapy on well-being, the speed of wound healing and recovery from illnesses have been noted by doctors for a long time, and since the middle of the last century, treatment in a pressure chamber has been widely used as an effective method of rehabilitation and prevention for a number of disorders.

A complete supply of body tissues with oxygen is a necessary condition for health and longevity. But it is precisely this process that is disrupted as a result of many diseases. Signs of such disruptions may include sleep disorders, general lethargy and distracted attention, and increased fatigue. The most sensitive in this regard are the nervous and cardiovascular systems.

Oxygen treatment in a pressure chamber

Such problems can be solved by increasing the oxygen content in the blood, but at normal atmospheric pressure, even when breathing enriched air, it will not be possible to achieve a noticeable effect. The transport capabilities of red blood cell hemoglobin, the main container of oxygen, are limited. A cell experiencing hypoxia (oxygen starvation) will eventually not receive the norm and will die over time.

Treatment with an oxygen pressure chamber (hyperbaric oxygenation) can circumvent this difficulty. An increase in the oxygen capacity of the blood is achieved by saturating plasma, not hemoglobin. This becomes possible due to the increased pressure inside the chamber, at which the solubility of gases increases.

Indications for treatment in a pressure chamber

Due to its healing and strengthening properties, hyperbaric oxygen therapy (HBO) is performed:

• for preventive purposes, for general health and immunity enhancement
• as a method of rehabilitation for injuries, wounds, surgery
• as a therapeutic non-drug procedure for a wide range of diseases of systems and organs

What does a hyperbaric chamber treat?

The HBOT method is widely used in modern medicine:

1. In the treatment of vascular diseases and in cardiology. Vascular gas embolism, trophic ulcers, coronary heart disease, arrhythmia, diseases accompanied by impaired peripheral circulation.
2. For gastrointestinal disorders. Peptic ulcers of the digestive system.
3. In case of poisoning by combustion products.
4. To accelerate wound healing in obstetrics, gynecology, and plastic surgery.

HBOT is widely used as a method of preoperative preparation, and is also prescribed after operations to facilitate recovery from anesthesia and reduce the risk of complications.

Hyperbaric chamber treatment: contraindications

There are a number of diseases in which HBOT can lead to complications:

• severe hypertension
• Acute respiratory infections, inflammation of the nasopharynx and middle ear
• individual hypersensitivity to oxygen
• claustrophobia

The prescription of HBOT should be carried out by a specialist based on the individual characteristics of the client, his diagnosis and medical history.

The word “hyperbaric chamber” sounds somewhat scary. What kind of device this is and what it is intended for, few people know. In fact, there is nothing scary about this word. This is for hyperbaric oxygenation - a small hermetically sealed space in which pressure is created below or above atmospheric pressure. In appearance, the pressure chamber resembles a bathyscaphe with portholes, only it is not in the depths of the sea, but in a bright, sterile room. Barotherapy was first used in 1955.

Operating principle of HBO

The hyperbaric chamber is a unique opportunity to use the latest scientific developments for treatment. The very principle of its operation is determined by the laws of physics, which are regulated by the dissolution of gases in the interstitial fluid. Everyone knows that a person can survive without food and water for no more than a month, but in a matter of minutes it leads to death.

In absolutely all pathological processes, when the delivery of oxygen to tissues is impaired, hypoxia develops. Vital organs such as the brain, heart, kidneys and liver cannot function properly. The causes of hypoxia can be different: low hemoglobin, poor vascular permeability, heart failure, diseases of the respiratory system.

To resolve these conditions, specialists developed oxygen therapy. For this, special equipment is used - a pressure chamber. Treatment under pressure can increase the body's resistance to adverse factors. It has been proven that even clean atmospheric air cannot eliminate hypoxia at the cellular level.

Under pressure, oxygen dissolves faster in the interstitial fluid and blood plasma, thereby delivering the required amount of nitrogen to the organs. As a result, the affected area restores its functions. The conditions created in the medical chamber are equivalent to diving five meters under water. During the session, the patient’s ears may become blocked, but this is where all the unpleasant sensations end.

Benefits of barotherapy

The method has a wide range of positive effects. Barotherapy has an anti-inflammatory and decongestant effect, accelerates the formation and normalizes collagen production. So, to the question: “Hyperbaric chamber - what is it?” can be answered as follows: this is a modern technical device that is used for therapeutic and prophylactic purposes, restores blood flow, promotes the proliferation of capillaries and prevents the development of osteoporosis, which has been clinically proven.

Hyperbaric oxygen therapy allows you to minimize drug therapy, shorten the recovery period, help patients cope with severe chronic pathologies and significantly strengthen the immune system. It is also actively used to treat erectile dysfunction in men. HBOT shows successful results in narcology (relieves withdrawal symptoms), surgery, cosmetology, pediatrics and veterinary medicine.

Where is the method used?

Hyperbaric oxygen therapy is included in the complex of health-improving measures in many sanatoriums and health centers. The procedures significantly reduce the risk of dangerous diseases, have a restorative and tonic effect, relieve irritability, pathological fatigue and increase muscle tone. After a full course of therapy, patients note an improvement in their psycho-emotional state and increased performance.

Physiotherapy is used in sports medicine to speed up the recovery period after injuries and physical activity. The number and time of the session is calculated individually. On average, the duration of therapy ranges from 5 to 12 sessions. The residence time in the oxygen room is about an hour. The hyperbaric chamber is usually well tolerated.

Indications for hyperbaric oxygen therapy

In addition to problems with the heart, blood vessels and blood circulation, the method is used to treat almost all chronic ailments. used to combat diabetes mellitus, periodontal disease, scleroderma, furunculosis, endarteritis obliterans, liver cirrhosis, psoriasis and gastric ulcer.

The method is indispensable for hepatitis (of any form), pancreatitis, hearing loss, mental illness, enterocolitis, multiple sclerosis, impaired cerebral circulation and obesity. In addition, it is used to treat intoxication with any toxic products, gas gangrene, frostbite, and also relieves various wounds and traumatic ischemia.

Contraindications

Unfortunately, HBOT, like any other therapeutic procedure, is not a panacea. Experts do not recommend its use for people with high blood pressure, epilepsy, polyps, acute colds, cysts, abscesses and fear of confined spaces (claustrophobia), as well as blood diseases and fever. In all other cases, an oxygen pressure chamber shows excellent results. What kind of vessel this is and what it is needed for was described above. Health and prosperity!

The hyperbaric oxygenation method allows you to treat any hypoxia with oxygen under high pressure. And the hypobaric adaptation method stimulates the body's defenses. Sick and healthy.

The abundance and accessibility of medications, the confidence of patients that only good pills can help them, do not allow the doctor to pay due attention to non-drug methods that mobilize human reserves inherent in nature itself.

Hyperbaric oxygen therapy method allows you to treat any hypoxia with oxygen under high pressure. A method of hypobaric adaptation stimulates the body's defenses. Sick and healthy.

In the blood, oxygen is chemically bound to hemoglobin (19.1 vol.%) and is also dissolved in plasma (0.3 vol.%). Under normal conditions, it is delivered to the tissues by hemoglobin in red blood cells, and the dissolved fraction only regulates the process. The vast majority of diseases are accompanied by oxygen starvation of the cell - hypoxia, which leads to its death. With cell hypoxia and normal atmospheric pressure, even breathing pure oxygen will not help, since hemoglobin saturation has a limit, and the level of oxygen in the plasma does not change. The only solution is to increase the dissolved oxygen fraction. This is only possible in a pressure chamber, because with increasing pressure the solubility of gases increases. The method of hyperbaric oxygenation (HBO), included in the complex therapy of patients, turns out to be very effective, and in some cases, the main one.

Absolute indications for HBOT

• Poisoning by combustion products, cyanides, methemoglobin formers, chlorinated hydrocarbons. Air embolism and decompression sickness. Gas gangrene.
• Anaerobic and aerobic infections with soft tissue necrosis.
• Crash syndrome and other acute traumatic ischemia. Acute obstructive disorders of the retinal artery. Conditions after mechanical asphyxia.

Conditions in which HBOT is an effective pathogenetically determined non-drug treatment:

• Heart: acute coronary syndrome and myocardial infarction, arrhythmic variant of coronary artery disease, angina pectoris, arrhythmias, extrasystoles, heart failure, decompensation of post-infarction conditions, intoxication with cardiac glycosides, pulmonary heart failure.
• Vessels: obliterating vascular diseases in the pre- and postoperative periods, early recovery period after surgical elimination of thromboembolism, trophic ulcers as a result of circulatory disorders, vasculitis.
• Lungs: purulent-destructive (in the pre- and postoperative periods), chronic nonspecific diseases (with pronounced signs of cor pulmonale).
• Gastrointestinal tract: peptic ulcer of the stomach and duodenum, post-hemorrhagic syndrome after ulcer bleeding, dynamic obstruction, inflammatory diseases of the small and large intestine.
• Liver and pancreas: acute and chronic hepatitis, cirrhosis, liver failure, all forms of acute pancreatitis, including in the postoperative period.
• Nervous system: ischemic stroke, TBI (acute and late recovery periods), spinal cord injury, conditions after neuroinfection, encephalopathy, peripheral nerve paresis, dorsopathies, demyelinating diseases.
• Endocrine system: diabetes mellitus and its complications, diffuse toxic goiter.
• Obstetrics: intrauterine hypoxia and fetal hypotrophy, threat of miscarriage, pregnancy with concomitant pathology, immunoconflict, pathology of the endocrine system, infertility.
• Pathology of newborns: birth asphyxia, cerebrovascular accident, hemolytic disease, necrotizing ulcerative enterocolitis.
• Gynecology: chronic inflammatory diseases of the pelvic organs.
• Traumatology: slowly consolidating fractures, osteomyelitis, osteoporosis.
• Wounds: prevention of infection, flaccid granulating, bedsores, burns, frostbite, positional compression syndrome, postoperative.
• Skin and subcutaneous tissue infections, dermatitis, psoriasis.
• Eyes: retinal circulatory disorders, diabetic retinopathy, optic nerve dystrophy due to methyl alcohol poisoning.
• ENT organs: sudden deafness, sensory hearing loss.
• Maxillofacial pathology: periodontal disease, necrotizing gingivitis and stomatitis.
• Reconstructive and plastic surgery: replantation of severed segments, transplantation of flaps on a nutritional pedicle, improvement of healing after plastic and cosmetic surgeries.
• Oncology and radiation medicine: patients receiving chemotherapy and radiation therapy; radiation osteonecrosis, myelitis, enteritis.
• Psychiatry and Narcology: mental disorders with the leading role of hypoxia in pathogenesis (cerebral atherosclerosis, ischemic heart disease and myocardial infarction, traumatic, toxic and degenerative-atrophic brain lesions), mental disorders due to chronic or acute intoxication (chronic alcoholism, alcoholic psychoses, barbiturate poisoning), endogenous psychoses , certain forms of schizophrenia, neurasthenia, asthenic disorders, a wide group of affective disorders, a number of depressive disorders, psychoorganic syndrome with decreased memory and intelligence, withdrawal syndrome, drug addiction.
• Pediatrics: cerebral palsy, myopathies, delayed motor development. Certain diseases of the gastrointestinal tract, liver, kidneys, nervous system, endocrine system (as in adults).
• Severe hemorrhagic anemia.
• Post-resuscitation illness.

In sports medicine - increasing the level of fitness and accelerating recovery after exercise.

In healthy people, HBOT significantly increases adaptive capabilities. Sessions in a pressure chamber relieve fatigue, restore strength after hard work, increase muscle tone, have anti-stress, restorative and tonic effects, improve sexual function in men, and reduce the adverse effects of a polluted atmosphere. Those who have completed the HBOT course note an increase in performance and stabilization of their psycho-emotional state.

Main contraindications for HBOT:

• history of convulsive syndrome (epilepsy);
• persistent poorly corrected arterial hypertension (BP above 160/90);
• the presence of closed cavities (cavities, abscesses, air cysts in the lungs);
• undrained pneumothorax;
• polysegmental bilateral pneumonia;
• acute respiratory diseases;
• increased sensitivity to oxygen;
• claustrophobia (fear of closed spaces).

"Mountain" road of stimulation

Hypobaric adaptation (HBA) is a non-drug method for stimulating the body's own defenses and physiological reserves. Its essence: breathing a gas mixture with a reduced partial pressure of oxygen in conditions of “mountain air” (low atmospheric pressure), training baroreceptors. It is carried out in multi-place or single pressure chambers. The zone of therapeutic influence of artificially created intermittent hypobaric hypoxia is an altitude of 2,800–6,000 m above sea level. The oxygen concentration in the inhaled gas mixture is 14–10%. Reduced partial pressure of oxygen and atmospheric lead to an increase in the volume of inhaled air and the coefficient of oxygen utilization from it, an increase in the oxygen capacity of the blood and the ability of tissues to utilize oxygen, the number of functioning capillaries, an improvement in the condition of the capillary bed, the contractile function of the myocardium, and a decrease in the severity of risk factors for coronary artery disease.

Indications for hypobaric adaptation:

• bronchial asthma, chronic obstructive pulmonary diseases;
• when correcting borderline conditions; neuroses, depressive and hypochondriacal states, NCD, migraines during the interictal period;
• complex treatment of stable angina, rehabilitation of post-infarction cardiosclerosis, prevention of coronary heart disease (inpatient and outpatient);
• arterial hypertension of 1–2 degrees (has a persistent hypotensive effect);
• lipid metabolism disorders;
• those who suffer from colds for a long time and often;
• healthy people with risk factors for coronary artery disease and hypertension - to improve hemodynamics and general condition;
• increasing the effectiveness of the training process of athletes.
• After a course of GBA, patients experience significantly less relapses and exacerbations of the underlying disease, and the amount of drug therapy is reduced. There is an increase in mental and physical performance, resistance to adverse factors, and a decrease in fatigue.

Main contraindications to GBA:

• disruption of the patency of the Eustachian tubes and canals connecting the paranasal sinuses with the external environment (polyps, inflammatory processes in the nasopharynx, middle ear, paranasal sinuses, developmental anomalies);
• diseases of the veins of the lower extremities;
• hernias of any localization;
• history of TBI within 1 year;
• uterine bleeding;
• all acute infectious and somatic diseases or their exacerbation;
• pregnancy;
• age over 60 years;
• claustrophobia.

In Belarus, HBOT treatment sessions are carried out in more than 40 departments and rooms. In the 5th City Clinical Hospital of Minsk and the clinic of Vitebsk State Medical University they work GBA multi-place pressure chambers. All pressure chambers in operation are manufactured in Russia and are sufficiently reliable and safe. More than 17 thousand patients are provided assistance annually. The need for this type of treatment and prevention is still far from optimal. Limiting factors are the relatively high cost of pressure chambers and insufficient awareness of the medical community. The HBOT method for a number of diseases and conditions is an integral part of intensive care. Thus, in 2008, in Department 5 of the Minsk City Clinical Hospital alone, emergency assistance was provided to more than 130 victims of carbon monoxide poisoning.

Indications and contraindications for treatment with HBO and GBA methods are determined by the doctor after an individual examination of the patient and studying his medical history.