UHM Journal Ahead of Print

We present two cases of cricoid chondronecrosis treated with hyperbaric oxygen (HBO2) therapy. Both patients presented with biphasic stridor and dyspnea several weeks after an intubation event. Tracheostomy was ultimately performed for airway protection, followed by antibiotic treatment and outpatient HBO2 therapy. Both patients were decannulated within 6 months of presentation and after at least 20 HBO2 therapy sessions. Despite a small sample size, our findings are consistent with data supporting HBO2 therapy’s effects on tissue edema and neovascularization as well as HBO2 potentiation of antibiotic treatment and leukocyte function. We suggest HBO2 therapy may have accelerated airway decannulation by way of infection resolution as well as the revitalization of upper airway tissues, ultimately renewing the structural integrity of the larynx. Physicians should be aware of the potential benefits of HBO2 therapy when presented with this rare but significant clinical challenge. DOI: 10.22462/01.01.2023.30

Inner ear decompression sickness (IEDCS) is an uncommon diving-related injury affecting the vestibulocochlear system, with symptoms typically including vertigo, tinnitus and hearing loss, either in isolation or in combination. Classically associated with deep, mixed-gas diving, more recent case series have shown that IEDCS is indeed possible after seemingly innocuous recreational dives, and there has been one previous report of IEDCS following routine hyperbaric chamber operations. The presence of right-to-left shunt (RLS), dehydration and increases in intrathoracic pressure have been identified as risk factors for IEDCS, and previous studies have shown a predominance of vestibular rather than cochlear symptoms, with a preference for lateralization to the right side. Most importantly, rapid identification and initiation of recompression treatment are critical to preventing long-term or permanent inner ear deficits. This case reemphasizes the potential for IEDCS following uncomplicated diving and recompression chamber operations, as it is only the second reported incident of the latter, in a U.S. Navy diver with previously unidentified RLS. DOI: 10.22462/599

Throughout more than five decades a multitude of experimental and clinical studies has shown predominantly positive, but also controversial results on the efficacy of hyperbaric oxygen (HBO2) therapy in burns. Aim of the study was to define a common denominator or constellations, respectively, linked to the effects of HBO2 in burns with special focus on dosage parameters. Based on original work since 1965, species, number of individuals, type of study, percentage of total body surface area (TBSA), region, depth of burn, causative agent, interval between burn and first HBO2 session, pressure, duration of individual session, number of HBO2 sessions per day, cumulative number of HBO2 sessions and type of chamber were assessed. Out of 47 publications included, 32 were animal trials, four were trials in human volunteers and 11 clinical studies. They contained 94 experiments whose features were processed for statistical evaluation. 64 (67.4%) showed a positive outcome, 16 (17.9%) an ambiguous one and 14 (14.7%) a negative outcome. The only factor independently influencing the results was pressure with ATA (atmospheres absolute) lower than 3 ATA being significantly associated with better outcome (p=0.0005). There is a dire need for well-designed clinical studies in burn centers equipped with hyperbaric facilities to establish dedicated ..

Objective: To analyze Hyperbaric Oxygen Therapy Registry (HBOTR) data to determine physician productivity rates and understand the frequency of simultaneous patient supervision in the United States (US). Methods: Deidentified electronic health record data from all payers were prospectively collected from the HBOTR from 2013 to 2022 and retrospectively analyzed. We estimated the mean number of yearly hyperbaric oxygen therapy (HBO2) treatments per physician per workday. We analyzed physician productivity by counting the number of physicians who administered fewer than two HBO2 treatments daily on average and the ten most productive physicians. Results: There were 262,055 HBO2 sessions provided by 333 physicians at 53 facilities in 34 states from 2013 through 2022. The annual number of patients treated by all physicians, regardless of payer, increased by 51.4% from 2013 to 2019 (n = 736 vs. 1,160) before decreasing by 10.8% in 2022 (994). The mean number of treatments/workday/provider was 3.6 (SD: 3.4); 87.1% of physicians (n = 290) performed <two treatments/workday. Only two physicians (0.6%) performed an average of >8 treatments daily. Conclusions: HBO2 utilization has varied over time, but it markedly decreased in 2022, while practice patterns have remained consistent. Physicians across the US have consistently supervised ≤4 HBO2 sessions per day ..

[ RESEARCH ARTICLE [ Quantification of referrals received at two emergency-capable hyperbaric medicine centers QUANTIFICATION OF HYPERBARIC REFERRALS ABSTRACT Emergency hyperbaric oxygen treatment capability is limited in the United States, and there is little documentation of calls received by 24/7/365 centers. Our study aimed to calculate the number of calls received for urgent hyperbaric oxygen (HBO2). We logged calls from two HBO2 chambers on the East Coast of the United States that serve a densely populated region. The total number of emergency calls was 187 at the University of Maryland (UMD) and 127 at the University of Pennsylvania (UPenn). There were calls on 180 (46%) days during the study period at UMD and 239 (63%) days at UPenn. The most common indication was carbon monoxide toxicity. The peak month of calls was March. Emergency HBO2 calls are common, and more centers need to accept emergency cases. Additional data from geographically diverse centers would add generalizability to these results and capture more diving-related emergencies. Keywords: epidemiology; hyperbaric facilities; hyperbaric oxygen; intensive care medicine; medical conditions and problems Key points: A trend toward inadequate emergency hyperbaric oxygen therapy availability has recently been discussed. Calls received at two academic emergency-capable hyperbaric medicine centers were recorded for one ..

Effect of hyperbaric oxygen therapy on diabetes-related oral complications HYPERBARIC OXYGEN THERAPY IN DIABETES MELLITUS ABSTRACT Background: Diabetes Mellitus is a chronic disease characterized by uncontrolled blood sugar levels, which lead to end-organ damage. While the diagnosis and treatment of its complications have been extensively studied, the effect of Hyperbaric Oxygen Therapy (HBO2) on diabetes- related oral complications remains unexplored. Aim: This prospective clinical study aims to investigate the effect of HBO2 on diabetes-related oral complications. Methods: Twenty patients diagnosed with diabetic foot ulcers and scheduled for HBO2 were included in this study. We recorded stimulated and unstimulated saliva pH, buffering capacity, flow rate, and subjective symptoms such as dry mouth, halitosis, taste loss, difficulty swallowing, and clinical examination findings before HBO2 and after the 21st session. Results: Upon comparing the findings, we observed a significant decrease in dry mouth and halitosis, periodontal disease severity, and healing of candida-related stomatitis and angular cheilitis. Despite not reaching statistical significance for other saliva parameters, the unstimulated salivary flow rate increased to normal limits (0.3-0.4 ml/min) in 6 out of 8 patients with a flow rate of less than 0.25 ml/min. Conclusion: Our study investigated the effect of HBO2 on diabetes-related oral complications for the first time, highlighting symptomatic ..

 ABSTRACT A widely accepted belief is that Nathaniel Henshaw was the first practitioner of hyperbaric medicine. He is said to have constructed the first hyperbaric chamber where he treated several disorders and provided opportunities to prevent disease and optimize well-being. While there is little doubt Henshaw was the first to conceptualize this unique medical technology, careful analysis of his treatise has convinced this writer that his was nothing more than a proposal. Henshaw’s air chamber was never built. He would have failed to appreciate how its structural integrity could be maintained in the presence of enormous forces generated by envisioned changes in its internal pressure and, likewise, how its door could effectively seal the chamber during hypo-and hyperbaric use. Henshaw would have also failed to appreciate the limitations of his two proposed measuring devices and the toxic nature of one. Neither of these would provide any quantitative information. The impracticality of his proposed method of compressing and decompressing the chamber is readily apparent. So is the likely toxic accumulation of carbon dioxide within the unventilated chamber during lengthy laborious periods required to operate it. Henshaw recommended pressures up to three times atmospheric pressure and durations for acute conditions until their ..

Advanced high-pressure hyperbaric techniques in tunneling HIGH-PRESSURE TECHNIQUES IN TUNNELING   ABSTRACT Work in compressed air and diving are both occupational activities that have been around since the mid-19th century, and those undertaking their work under elevated pressure. Meeting the demand to go to “higher pressure for longer” in tunneling has lagged in diving, but both activities have found it necessary to adopt mixed gas breathing and saturation exposure techniques. This paper explains how work in hyperbaric conditions at high pressure is undertaken in tunneling and is illustrated by the hyperbaric activity likely to be involved in constructing a large-diameter road tunnel below a body of water such as an estuary. It also explores the practical differences between work in compressed air and diving. Keywords – decompression; hyperbaric; mixed gas; saturation; transfer under pressure; tunneling; Key points - the paper reviews work in compressed air in tunneling and describes the developing use of mixed gas and saturation exposure techniques in tunneling whilst highlighting important differences between the application of such techniques in tunneling and in diving. INTRODUCTION/BACKGROUND Work in compressed air is a construction technique developed in the mid-19th century in which compressed air is applied to a tunnel or shaft at a pressure equivalent ..

Acute effects of apnea bouts on hemoglobin concentration and hematocrit: a systematic review and meta-analysis APNEA AND HEMATOLOGICAL EFFECTS ABSTRACT Objective: This study aimed to systematically analyze the existing literature and conduct a meta-analysis on the acute effects of apnea on the hematological response by assessing changes in hemoglobin (Hb) concentration and hematocrit (Hct) values. Methods: Research in Pubmed, The Cochrane Library, and Web of Science was carried out for studies in which the main intervention was voluntary hypoventilation, and Hb and Hct values were measured. Risk of bias and quality assessments were performed. Results: Nine studies with data from 160 participants were included, involving both subjects experienced in breath-hold sports and physically active subjects unrelated to breath-holding activities. The GRADE scale showed a “high” confidence for Hb concentration, with a mean absolute effect of 0.57 g/dL over control interventions. “Moderate” confidence appeared for Hct, where the mean absolute effect was 2.45% higher over control interventions. Hb concentration increased to a greater extent in the apnea group compared to the control group (MD = 0.57 g/dL [95% CI 0.28, 0.86], Z = 3.81, p = 0.0001) as occurred with Hct (MD = 2.45% [95% CI 0.98, 3.93], Z = 3.26, p = 0.001). Conclusions: ..

Acute aortic dissection during scuba diving RUNNING HEAD: ACUTE AORTIC DISSECTION DURING SCUBA DIVING   ABSTRACT A 60-year-old man with hypertension and dyslipidemia complained of chest pain upon ascending from a maximum depth of 27 meters while diving.  After reaching the shore, his chest pain persisted, and he called an ambulance.  When a physician checked him on the doctor’s helicopter, his electrocardiogram (ECG) was normal, and there were no bubbles in his inferior vena cava or heart on a portable ultrasound examination.  The physician still suspected that he had acute coronary syndrome instead of decompression illness; therefore, he was transported to our hospital.  After arrival at the hospital, standard cardiac echography showed a flap in the ascending aorta.  Immediate enhanced computed tomography revealed Stanford type A aortic dissection.  The patient obtained a survival outcome after emergency surgery.  To our knowledge, this is the first reported case of aortic dissection potentially associated with scuba diving.  It highlights the importance of considering aortic dissection in patients with sudden-onset chest pain during physical activity. In addition, this serves as a reminder that symptoms during scuba diving are not always related to decompression. This report also suggests the usefulness of on-site ultrasound for the differential diagnosis of ..

Cardiovascular effects of breath-hold diving at altitude RUNNING HEAD: BREATH-HOLD DIVING AT ALTITUDE   ABSTRACT Hypoxia, centralization of blood in pulmonary vessels, and increased cardiac output during physical exertion are the pathogenetic pathways of acute pulmonary edema observed during exposure to extraordinary environments. This study aimed to evaluate the effects of breath-hold diving at altitude, which exposes simultaneously to several of the stimuli mentioned above. To this aim, 11 healthy male experienced divers (age 18-52y) were evaluated (by Doppler echocardiography, lung echography to evaluate ultrasound lung B-lines (BL), hemoglobin saturation, arterial blood pressure, fractional NO (Nitrous Oxide) exhalation) in basal condition (altitude 300m asl), at altitude (2507m asl) and after breath-hold diving at altitude. A significant increase in E/e’ ratio (a Doppler-echocardiographic index of left atrial pressure) was observed at altitude, with no further change after the diving session. The number of BL significantly increased after diving at altitude as compared to basal conditions. Finally, fractional exhaled nitrous oxide was significantly reduced by altitude; no further change was observed after diving. Our results suggest that exposure to hypoxia may increase left ventricular filling pressure and, in turn, pulmonary capillary pressure. Breath-hold diving at altitude may contribute to interstitial edema (as evaluated by BL score), possibly because ..

  Hyperbaric Oxygen Therapy Regimens, Treated Conditions, and Adverse Effect Profile RUNNING TITLE:  AN UNDERSEA AND HYPERBARIC MEDICAL SOCIETY SURVEY STUDY ABSTRACT Introduction: When administering HBO2, pressures can range from 1.4 atmospheres absolute (ATA) to 3 ATA. While different treatment modalities have been proposed, there is a paucity of literature comparing the effectiveness and risk profile associated with different pressures treating the same condition. Considering the therapeutic divergence, this study aims to survey Undersea and Hyperbaric Medical Society (UHMS) members on pressure modalities and their use in different clinical conditions. Methods: The study was a voluntary cross-sectional survey administered online and open to healthcare providers who were members of the Undersea and Hyperbaric Medical Society. UHMS itself distributed the survey link. The survey period lasted from November 2022 until January 2023. Data were collected utilizing the Qualtrics platform and analyzed through Microsoft Excel.  Results: A total of 265 responses were recorded. The majority responded utilizing 2.4 ATA (35.2%) as the pressure of choice, followed by 2.0 ATA only (27.1%), and those who changed therapeutic pressure according to the treated condition (26.4%). The overwhelming choice for treatment of osteoradionecrosis (ORN) of the jaw, radiation proctitis/cystitis, diabetic foot ulcer, and chronic osteomyelitis was 2.0 ATA (68.0- 74.9%).  Among listed ..

CMS Data Demonstrates a Cost and Clinical Advantage for Hyperbaric Oxygen for Radiation Cystitis, A Controlled Study John J. Feldmeier DO 1, John P. Kirby MD 2, Helen B. Gelly MD3 Marc Robins DO 4, John Peters FACHE 5 Peter Gruhn, MA6, Sarmistha Pal, PhD6 1. Professor Emeritus and Past Chairman, Radiation Oncology, University of Toledo Medical Center. 2. Associate Professor of Surgery, Washington University School of Medicine in St Louis, MO 3. President, Regenerative and Hyperbaric Medicine, Marietta, Georgia 4. Marc Robins, DO, MPH, FUHM, FAACP 5. John S. Peters, FACHE, ED UHMS 6. Peter Gruhn, M.A., Dobson DaVanzo and Associates, LLC 6. Sarmistha Pal, Ph.D., Dobson DaVanzo and Associates, LLC Key Words: controlled study; cost-effectiveness; clinical effectiveness; hyperbaric oxygen; radiation cystitis Running Title: Hyperbaric Oxygen for Radiation Cystitis Acknowledgments: 1. The Project was supported by an unrestricted grant from Healogics, LLC 2. The authors also wish to express their thanks to the following individuals for input and editorial review: a. Joan E. DaVanzo, Ph.D., M.S.W., Chief Executive Officer Dobson DaVanzo and Associates, LLC (deceased) b. John A. Gelly, MD, Retired Physician, Marietta, GA c. Costantino Balestra Ph.D., Professor of Physiology, Vrije Universiteit Brussel (V.U.B.) VP. Research & Education DAN Europe d. Renee Duncan, BA, UHMS Consulting Copy Editor CMS Data Demonstrates a Cost and Clinical Advantage for Hyperbaric ..

Title Optimizing the hyperbaric chamber pressurization profile during standard hyperbaric oxygen therapy SHORT, RUNNING TITLE: OPTIMIZING THE HYPERBARIC CHAMBER PRESSURIZATION PROFILE Authors Lyubisa Matity¹, Francois Burman², Frans Cronje3 Hyperbaric and Tissue Viability Unit, Gozo General Hospital, Victoria VCT 2520, Malta Divers Alert Network, Durham, NC, USA King Hamad American Mission Hospital, A’ali, Kingdom of Bahrain   ABSTRACT Middle ear barotrauma (MEBT) is the most common complication in providing hyperbaric oxygen therapy (HBOT). This study explored the impact of altering the shape of the time-pressure curve to reduce the occurrence of MEBT and optimize the HBOT experience during the pressurization process. Four distinct mathematically derived protocols—Constant Pressure Difference (CPD), Constant Volume Difference (CVD), Constant Ratio (CR), and Inverted Constant Ratio (ICR)—were investigated using computer simulations on a simple ear model. Results indicated varying levels of ear strain during pressurization. The CR pressurization demonstrated balanced ear strain levels and outperformed other modalities in several measures, including the impact on the simulated ear cavity volume. The potential for enhanced patient comfort through the application of sophisticated pressurization protocols warrants further research to validate and extend the findings of this study in real-world HBOT settings.  

Position change during hyperbaric oxygen therapy for arterial gas embolism Naoto Jingami, MD 1,2, Takayuki Nitta 1,2, Yoshitaka Ishiguro, MD 1, Yudai Takatani, MD 1, Tomoyuki Yunoki, MD 1, Shigeru Ohtsuru, MD 1,2 Department of Primary Care and Emergency Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan Hyperbaric Oxygen Therapy Center, Kyoto University Hospital, Kyoto, Japan Running title: Position change during hyperbaric oxygen therapy Arterial gas embolism can be fatal and should be treated with care. Typically, the patient is placed in the supine position during treatment. However, we present a case where the patient’s position was changed to facilitate treatment. A 78-year-old man with severely reduced heart function underwent cryoablation for chronic atrial fibrillation. During the procedure, he accidentally inhaled rapidly. Subsequently, he presented with stroke symptoms. Computed tomography (CT) revealed air in the brain and left ventricle, leading to a diagnosis of arterial gas embolism. He underwent hyperbaric oxygen (HBO2) therapy as per the US NAVY Table 6 protocol. The air embolism in the brain reduced, but that in the apex of the left ventricle persisted. Subsequently, HBO2, as per the US NAVY Table 5 protocol, was performed along with a position change to the right lateral and manual vibration. The ..

Definition of delayed-onset neurologic sequelae: A review article Alik Dakessian, MD1,2, Zachary Hagen, MD1, Eugenio R Rocksmith, MD3, Kinjal N Sethuraman, MD, MPH1,2,* 1Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States of America 2Hyperbaric and Dive Medicine, University of Maryland Medical Center, Baltimore, MD, United States of America 3Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States of America   Background: Delayed-onset neurologic sequelae (DNS) is a devastating complication of carbon monoxide poisoning. Despite the abundance of research studies on DNS, the definition remains unclear, with a wide range of symptoms. The aim of this review is to identify the different symptoms and definitions that have been associated with DNS in available research.Methods: For this review, searches were conducted in both PubMed and Scopus. Research studies were screened by abstract and title by two authors and conflicts were resolved by a third. After the full-text review, data was extracted by one author. Only original full-text research studies in English with a clear definition of DNS were included.Results: A total of 127 studies were included in this review. Signs and symptoms associated with DNS were categorized into twelve groups. The most commonly used symptom categories to ..

Author names and affiliations: Bin Zhang1, Hongjie Yi1, Yue Jiang1, Chenggang Zheng Department of Hyperbaric Oxygen, Changhai Hospital, Naval Medical University, 168 Changhai Rd, Shanghai, 200433, China. The authors contributed equally to this work.   Objective: To investigate the effect of 6 ATA air/ oxygen treatment schemes and 2.8 ATA oxygen inhalation schemes on cerebral gas embolism.  Methods: 29 patients with cerebral gas embolisms admitted from January 2014 to June 2022 were retrospectively included. The patients were divided into 6 ATA air/ oxygen treatment scheme groups (14 cases) and 2.8 ATA oxygen inhalation therapy scheme groups (15 cases). The Glasgow Coma Scale (GCS) was used to evaluate the therapeutic effect before and after treatment. The effective standard of treatment was the recovery of consciousness (a GCS score＞8).  Results: There was no significant difference between the two groups regarding gender, age, cause of disease, time of onset, and GCS score before treatment (P>0.05). The two groups had no significant difference regarding GCS scores after one day and one week of treatment (P＞0.05). After one week of treatment, 78.6% (11 of 14) of patients in the 6 ATA group and 80.0% (12 of 15) in the 2.8 ATA group improved by reaching primary end point of GCS >8.  Conclusion: The 2.8 ATA oxygen inhalation scheme can effectively treat cerebral gas ..

Title: Hyperbaric Oxygen Therapy for Sudden Sensorineural Hearing Loss – A Comorbidity Lens RUNNING TITLE: HBO2 THERAPY FOR SSNHL BASED ON COMORBIDITIES    Running Title: HBO2 Therapy for SSNHL Based on Comorbidities Authors: Aleeza J. Leder Macek, B.S.1,2,4*, Ronald S. Wang B.S.1,2,3*, Justin Cottrell, M.D.2, Emily Kay-Rivest, M.D.2, Sean O. McMenomey, M.D.2, J. Thomas Roland Jr, M.D. 2, Frank L. Ross, M.D.3 1New York University Grossman School of Medicine, New York, NY  2Department of Otolaryngology, New York University Langone Health, New York, NY 3Department of Surgery, New York University Langone Health, New York, NY 4Department of Otolaryngology, University of Virginia Health, Charlottesville, VA *These authors contributed equally to this work.    ABSTRACT Objective: To determine the outcomes of patients receiving hyperbaric oxygen therapy for sudden sensorineural hearing loss and the impact of patient comorbidities on outcomes. Study Design: Retrospective chart review. Setting: Tertiary referral center. Methods: All patients over 18 diagnosed with sudden sensorineural hearing loss between 2018-2021 who were treated with hyperbaric oxygen therapy were included. Demographic information, treatment regimens & duration, and audiometric and speech perception outcomes were recorded and analyzed. Results: 19 patients were included. The median age was 45 years. 53% were female, and 21% had pre-existing rheumatologic disorders. The mean duration between hearing loss onset and physician visits was 9.6 days. All patients received an oral steroid ..

Corresponding author: Ahmet İNAL: Department of Pharmacology, Faculty of Medicine, Erciyes University, Kayseri, Turkey drahmetinal@hotmail.com +90 532 515 07 29   Corresponding author: Mohamad HALLAK: Department of Pharmacology, Institute of Health Sciences, Erciyes University, Kayseri, Turkey hallak.91@outlook.com +90 507 034 72 67 Co, author: Mehmet Akif BAKTIR: Department of Physiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey mabaktir@erciyes.edu.tr +90 533 563 73 84 Görkem EKEBAŞ: Department of Pathology, Faculty of Veterinary Medicine, Erciyes University, Kayseri, Turkey gekebas@erciyes.edu.tr +90 536 261 09 98 Ayhan ATASEVER: Department of Pathology, Faculty of Veterinary Medicine, Erciyes University, Kayseri, Turkey atasevera@erciyes.edu.tr   ABSTRACT Background: Hyperbaric Oxygen Therapy (HBOT) is a treatment modality that involves exposing patients to 100% oxygen at higher atmospheric pressures. In recent years, HBOT has emerged as a potential therapeutic option for various liver diseases, offering advantages such as improved tissue oxygenation, anti-inflammatory effects, enhanced wound healing, and potential hepatoprotective properties. Understanding the benefits of HBOT in liver diseases can pave the way for novel therapeutic strategies and improved patient outcomes. This study aimed to investigate the hepatoprotective effect of HBOT in arthritic rats treated with leflunomide (LEF) through anti-inflammatory and antioxidant pathways. Material and Methods: 24 male Sprague-Dawley rats were divided into three groups (8 animals in each group (n = 8)). 1st group was the control group, which received no treatment. 2nd group was RA + ..

EEG-based brain biomarker supports hyperbaric oxygen therapy for acute concussions Running Title: EEG device assesses HBO2 for concussion Daphne Watkins Denham, MD, FACS, FACCWS,1,2 Menley A. Denham, CHT1,2 1Healing with Hyperbarics, LLC, Northbrook, IL, USA; 2Healing with Hyperbarics of North Dakota, PLLC, Fargo, ND, USA Running head: EEGBB supports HBO2 for acute concussions Corresponding Author: Daphne Watkins Denham, MD, FACS, FACCWS Healing with Hyperbarics, LCC 1535 Lake Cook Road, Suite 404 Northbrook, IL 60062 (847) 559-8426 denham2468@gmail.com Conflicts of Interest: The authors have no conflicts of interests to disclose. Financial Support: Regenerative and Hyperbaric Medicine Inc. (Marietta, GA) funded this manuscript.   ABSTRACT Acute concussion is a significant health issue among youth athletes, affecting their quality of life and performance. However, the standard of care, rest, has been questioned, while treatments are lacking. This pilot case series used an FDA-cleared electroencephalogram-based brain biomarker (EEGBB) to demonstrate hyperbaric oxygen therapy (HBO2) improvement for treating concussion. From December 31, 2021, through May 27, 2022, school-aged patients presenting at two HBO2 clinics within ten days of injury with an acute concussion confirmed by an initial EEGBB assessment were evaluated. The EEGBB diagnoses concussions using artificial intelligence to yield a score between 0-100, with scores ≤70 considered concussed. HBO2 using 1.5-2.0 ATA, progressing stepwise per patient tolerance, was administered in ≥4-hour intervals until sustained symptom-free. EEGBB assessment was performed before and after each treatment. ..

EEG-based brain biomarker supports hyperbaric oxygen therapy for acute concussions Running Title: EEG device assesses HBO2 for concussion Daphne Watkins Denham, MD, FACS, FACCWS,1,2 Menley A. Denham, CHT1,2 1Healing with Hyperbarics, LLC, Northbrook, IL, USA; 2Healing with Hyperbarics of North Dakota, PLLC, Fargo, ND, USA Running head: EEGBB supports HBO2 for acute concussions Corresponding Author: Daphne Watkins Denham, MD, FACS, FACCWS Healing with Hyperbarics, LCC 1535 Lake Cook Road, Suite 404 Northbrook, IL 60062 (847) 559-8426 denham2468@gmail.com Conflicts of Interest: The authors have no conflicts of interests to disclose. Financial Support: Regenerative and Hyperbaric Medicine Inc. (Marietta, GA) funded this manuscript.   ABSTRACT Acute concussion is a significant health issue among youth athletes, affecting their quality of life and performance. However, the standard of care, rest, has been questioned, while treatments are lacking. This pilot case series used an FDA-cleared electroencephalogram-based brain biomarker (EEGBB) to demonstrate hyperbaric oxygen therapy (HBO2) improvement for treating concussion. From December 31, 2021, through May 27, 2022, school-aged patients presenting at two HBO2 clinics within ten days of injury with an acute concussion confirmed by an initial EEGBB assessment were evaluated. The EEGBB diagnoses concussions using artificial intelligence to yield a score between 0-100, with scores ≤70 considered concussed. HBO2 using 1.5-2.0 ATA, progressing stepwise per patient tolerance, was administered in ≥4-hour intervals until sustained symptom-free. EEGBB assessment was performed before and after each treatment. ..

TITLE PAGE"Does hyperbaric chamber attendance pose an asthma risk? Case report" Short running title: Hyperbaric chamber attendance and asthma Levent Demir1, MD, E-mail: mdleventdemirr@gmail.com 1 Department of Hyperbaric Medicine; Kayseri City Hospital, Kayseri, Turkey Keywords: hyperbaric oxygen therapy, inside attendant, lung function, occupational asthma Address: Department of Underwater and Hyperbaric Medicine, Kayseri City Hospital, Kayseri, Turkey Mobile Phone: +90 532 322 02 40 Compliance with Ethical Standards: This study did not require approval from an ethics committee. Funding: This study has been written without support of any found.Disclosure of potential conflicts of interestThe authors declare they have no conflict of interest. Informed consent It was ensured that the case gave informed consent. ABSTRACT This report details a case study of a non-smoking 33-year-old female nurse who developed occupational asthma as an Inside Attendant (IA) in a hyperbaric chamber. The report analyzes the nurse's medical history, working environment, and potential causes. After beginning work in the hyperbaric chamber, an IA experienced respiratory symptoms, including coughing, wheezing, and fatigue. Her symptoms improved during a break attending a hyperbaric nursing certification program but returned when she resumed work in the IA hyperbaric chamber. Spirometry confirmed airflow obstruction, and the IA was subsequently diagnosed with occupational asthma. As a result, the IA had to terminate their employment in the hyperbaric chamber. ..

Hyperbaric Oxygen Treatment for Long-COVID syndrome: A Systematic Review of Current Evidence on Cognitive Decline Fernanda Valeriano Zamora, M.D.1*, Ana Clara Felix de Farias Santos2, Andres Villca Zamora, M.D.3, Lorhayne Kerley Capuchinho Scalioni Galvao, M.D.3, Nicole dos Santos Pimenta4, João Pedro Costa Esteves Almuinha Salles4, Vitoria Batista Carneiro5, Prof. Dr. Carlos Ernesto Ferreira Starling3 1Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil; 2City University of São Paulo (UNICID), São Paulo, SP, Brazil; 3 Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil; 4 Federal University of the State of Rio de Janeiro (UNIRIO); 5 Petrópolis Medical School (FMP). Short title: HBO2 for LCS  Key-words: HBO2; post-COVID; long COVID. ABSTRACT Introduction: There is no established specific treatment for long-COVID syndrome (LCS), yet hyperbaric oxygen (HBO2) treatment has been studied as a potential option. Therefore, we conducted a systematic review to evaluate the benefits of HBO2 treatment in LCS patients. Methods: We systematically searched PubMed, Embase, and Cochrane databases until April 2024. Risk of bias and GRADE quality assessment were evaluated. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with ID CRD42024530421. Results: Seven studies from seven countries, divided into RCTs and observational studies, included 199 participants. HBO2 treatment protocols included breathing 100% oxygen at 2.0 ATA until 2.5 ATA; ..

Behavior and changes in rectal temperature in dogs and cats undergoing hyperbaric oxygen therapy: clinical data reviewBEHAVIOR AND TEMPERATURE ASSOCIATED TO HBO2 THERAPY MVM Bernardo N. ANTUNES,1 DVM Daniel C. M. MÜLLER,1 DVM Vanessa MILECH,1,2 MVM Pamela CAYE,1 MVM Emanuelle B. DEGREGORI,1 MVM Daniel VARGAS,1 MVM Rainer S. REINSTEIN,1 and PhD Maurício V. BRUN1,* 1)Graduate Program in Veterinary Medicine, Center of Rural Science, Federal University of Santa Maria (UFSM), Av. Roraima, 1000, building 42, room 3135, 97105-900 Santa Maria, RS, Brazil2) Graduate Program in Animal Health, Biotechnology Institute, University of Caxias do Sul (UCS), St. Francisco Getúlio Vargas, 1130, building 57, room 108, 95070-560 Caxias do Sul, RS, Brazil *Correspondence to: Maurício V. Brun. Researcher of CNPq/Brazil (200346/2017-2; 305876/2018-0; 3304353/2021-3). Phone/Fax: +55-54-99962-7707. E-mail: mauriciovelosobrun@hotmail.com KEY WORDS: adverse effect, canine and feline, chamber, monoplace, oxygen ABSTRACT Assessment of rectal temperature and behavior are important parameters in all patients in whom hyperbaric oxygen (HBO2) therapy is used. The study aims to verify if there is less reduction in body temperature after HBO2 therapy in restless patients and their behavior during the therapeutic session. Clinical data from 217 HBO2 therapy sessions with 2 to 2,5 atmospheres absolute (ATA) were reviewed, under therapy protocols of 30 (P1) or 45 (P2) minutes, covering 29 canines and 13 felines. Behavioral data, initial rectal ..

Title: Technical Suitability of Implantable Cardiac Devices for Recreational Diving. Running Title: Implantable Cardiac Devices and Diving Authors: Matteo Paganini MD 1, Luigi Tarsia MSc(Eng) 2,3, Gerardo Bosco MD PhD 1, Enrico M Camporesi MD 4, Mauro Biffi MD 3, Cristian Martignani MD PhD 3, Matteo Ziacchi MD 3, Giuseppe Boriani MD PhD 5, Marco Vitolo MD 5,6, Igor Diemberger MD PhD 2,3.  1) Department of Biomedical Sciences, University of Padova, Padova, Italy 2) Department of Medical and Surgical Sciences, DIMEC, University of Bologna, Bologna, Italy. 3) Cardiology Division, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S. Orsola-Malpighi, Bologna, Italy 4) TEAMHealth Research Institute, Tampa General Hospital, Tampa, Florida, USA 5) Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy. 6) Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy. Corresponding author: Matteo Paganini, MD. Department of Biomedical Sciences, University of Padova, Italy. Phone: +39 049-8275297. Correspondence: Via Marzolo, 3, 35131 Padova, Italy. Email: matteo.paganini@unipd.it ORCID No. 0000-0002-7556-6928     Background: Diving is a diffused recreational activity, and the number of divers carrying cardiac implanted devices is similarly growing. Due to the lack of guidelines or technical indications, the suitability of such devices for diving or the fitness to dive for these patients still needs to be determined.Objective: This work summarizes implantable cardiac devices’ suitability for ..

HYPERBARIC OXYGEN THERAPY IN SURGICAL SITE INFECTIONS: A CLINICAL EXPERIENCE HYPERBARIC OXYGEN THERAPY IN SURGICAL SITE INFECTIONS Title Page Eylem Burcu Kahraman Özlü M.D Haydarpasa Numune Education and Research Hospital, Neurosurgery Email: burcu.kahraman@gmail.com Selimiye, Tıbbiye Cd No:23, 34668 Uskudar/Istanbul/TURKEY Tel: +0905327667013 (Corresponding author) Şerif Aytekin M.D. Haydarpasa Numune Education and Research Hospital, Neurosurgery Uskudar/Istanbul/TURKEY Email: serif.aytekin5@gmail.com Tel: +0905432457593 Ezgi Akar, Assoc Prof Haydarpasa Numune Education and Research Hospital, Neurosurgery Uskudar/Istanbul/TURKEY Email: ezgiaycicek@gmail.com Tel: +905063444256 Arif Tarkan Çalışaneller, Prof       Haydarpasa Numune Education and Research Hospital, Neurosurgery       Uskudar/Istanbul/TURKEY Email: tarkan_ca@yahoo.com Tel: +0905337668845 Declarations Funding * No funding was received for this research. Conflict of Interest * The authors of this article do not have a conflict of interest. Data and Material * This article does not contain any studies with human participants or animals performed by any of the authors.   OBJECTIVE: Surgical site infections are difficult complications to manage in neurosurgery practice. We aimed to evaluate the use of hyperbaric oxygen (HBO2) therapy in neurosurgery practice through cases followed in our clinic.METHOD: HBO2 therapy was performed in 13 cases between 2019-2022 at our neurosurgery clinic. We retrospectively evaluated the cases in terms of the age at the time of treatment, the primary pathology, the number of sessions in which HBO2 therapy was performed, the sedimentation and CRP values and radiological images.RESULTS: The mean age of the cases was 55.1. Seven of the cases ..

Transcutaneous Oximetry Optimizes Clinical Management and Cost-Effectiveness of Diabetic Foot Ulcers Treated with Hyperbaric Oxygen: A Review of Point of Care Vascular Screening Options  Richard E. Clarke, CHT-ADMIN  National Baromedical Services, Columbia, South Carolina, USA CORRESPONDING AUTHOR: dickclarke@baromedical.com ABSTRACT  Hyperbaric oxygen therapy has been employed to treat diabetic foot ulcers for more than four decades. While supported by some high-quality evidence, sufficient conflicting data makes its use open to criticism. Even systematic and other reviews favorably disposed to this treatment adjunct invariably plead  for better patient selection. Common among several causes of non-healing ulcers is persistent hypoxia. Transcutaneous oximetry uniquely measures tissue oxygen tension. Combination air and oxygen testing provide an evidence-based approach to hyperbaric patient selection by demonstrating locally reversible hypoxia. Transcutaneous oximetry differentiates hyperbaric responders from non-responders early in their treatment course by detecting neo-angiogenesis, thereby providing the basis for continued hyperbaric dosing only in those benefiting. Finally, such testing guides therapeutic endpoint determination, namely normalized peri-ulcer oxygen tensions. This contrasts with continuing medically unnecessary and costly hyperbaric treatments until wound closure. Measurements of blood pressure and blood flow represent imperfect oxygen delivery surrogates and imperfect ones. Recently introduced near-infrared spectroscopy and long-wave infrared thermography provide insights into tissue oxygen saturation and changes in micro-vascular density, respectively. ..

AUTHORS: Cong Wang1, Lei Zhang1, Qiuhong Yu1, Yaling Liu1, Ziqi Ren1, Lianbi Xue2* 1Department of Hyperbaric Oxygen, Beijing Tiantan Hospital, Capital Medical University, A zone, No.199 Nansihuan West Road, Fengtai District, Beijing 100070, China 2Department of Hyperbaric Oxygen, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), No. 89 Taoyuan Road, Nanshan District, Shenzhen 518052, China *Corresponding Author, E-mail: xue40@vip.sina.com, Tel.: +86-0755-26553111-26681.   FULL TITLE: Characteristic of volume-controlled ventilation with small tide volume in hyperbaric oxygen chamber SHORT TITLE: VCV IN HBO2 CHAMBER ABSTRACT Purpose: To evaluate the characteristics of tidal volume (VT) delivered by a Shangrila590 ventilator with preset tide volume (VTset) 50-300 mL in volume-controlled ventilation (VCV) during hyperbaric oxygen (HBO2) therapy. Methods: Experiments were carried out in a multiplace HBO2 chamber at 1.0, 2.0, and 2.8 atmospheres absolute (atm abs) and divided into three groups accordingly. The ventilator was connected to the test lung in the chamber. The VTset of the ventilator was adjusted before the experiments. At 5 VTset levels (50, 100, 150, 200, 300 mL), the VT and inspiratory peak pressure (Ppeak) detected by the ventilator and the test lung were recorded for 30 cycles (n=30). The measurements of the test lung were considered to be the true value, and the ventilator and test lung data were compared to evaluate the accuracy of the ventilator. Test lung compliance (Ctl) was detected by the ventilator, and breathing circuit compliance (Cbc) ..