Undersea Hyperbar M
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Undersea Hyperbar M · Jul 2012
Exercise carbon dioxide (CO2) retention with inhaled CO2 and breathing resistance.
Combined effects on respiratory minute ventilation (VE)--and thus, on end-tidal carbon dioxide partial pressure (P(ET)CO2)--of breathing resistance and elevated inspired carbon dioxide (CO2) had not been determined during heavy exercise. In this Institutional Review Board-approved, dry, sea-level study, 12 subjects in each of three phases exercised to exhaustion at 85% peak oxygen uptake while V(E) and P(ET)CO2 were measured. Participants inhaled 0%, 1%, 2% or 3% CO2 in air, or 0% or 2% CO2 in oxygen, with or without breathing resistance, mimicking the U. ⋯ Subjects identified hypercapnia poorly. Results support dual optimization of arterial carbon dioxide partial pressure and respiratory effort. Because elevated CO2 may not increase V(E) if breathing resistance and VE are high, rebreather UBA safety requires very low inspired CO2.
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Undersea Hyperbar M · Jul 2012
ReviewThe effect of hyperbaric oxygen in crush injuries and skeletal muscle-compartment syndromes.
Crush injuries represent a spectrum of injury to body parts as result of trauma. Presentations vary from minor contusions to limb-threatening damage. Typically, the injury involves multiple tissues, from skin and subcutaneous, to muscle and tendons, to bone and joints. ⋯ The SMCS, especially in its incipient stages before a fasciotomy is required, is a therapeutic challenge since no means to arrest its progression exist other than hyperbaric oxygen (HBO2). Unfortunately, HBO2 is woefully neglected as an adjunct for managing crush injury and SMCS. Strong arguments exist for its use based on evidenced-based information and how HBO2 mitigates the pathology of these conditions.
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Undersea Hyperbar M · Mar 2012
Symptoms of carbon monoxide poisoning do not correlate with the initial carboxyhemoglobin level.
Symptoms in carbon monoxide (CO) poisoned patients have traditionally been described as being related to corresponding carboxyhemoglobin (COHb) levels without substantive support for the relationship. This study sought to determine whether prospectively collected symptoms correlate with specific COHB level ranges in a large population of CO-poisoned patients. ⋯ While symptoms are common in acute CO poisoning, none can be directly correlated to COHb levels, even in a population of more than 1,000 patients. The concept of a table relating specific symptoms to specific COHb levels is invalid. One such table that has often been published comes from a 1923 U.S. government publication and appears to be based at least in part upon the symptoms experienced by three men in a total of 10 low-level laboratory CO exposures.
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Undersea Hyperbar M · Mar 2012
Partnering with a medical specialty society to perform online public health surveillance.
While accidental carbon monoxide (CO) poisoning is common, it is felt to be largely preventable through targeted public education. Development of effective education programs requires accurate epidemiologic information about the condition. Many acute, severe cases of CO poisoning are treated with hyperbaric oxygen (HBO2) at hospital-based facilities staffed by members of the Undersea and Hyperbaric Medical Society (UHMS). ⋯ This report describes development and implementation of the internet-based surveillance system, as well as its first year of operation. From August 2008 to July 2009, a total of 740 cases were reported by the 82 hyperbaric facilities participating nationwide. Extensive epidemiologic information about CO poisoning in the United States has been collected, and the utility of partnering with a medical specialty society for disease-specific surveillance demonstrated.