Respiratory care clinics of North America
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Respir Care Clin N Am · Jun 1999
ReviewHyperbaric oxygen in the treatment of life-threatening soft-tissue infections.
Necrotizing soft-tissue infections are rapidly spreading bacterial infections that account for a relatively small proportion of infections, but are aggressive in nature and nearly uniformly fatal if left untreated. Prompt recognition, antibiotic therapy, aggressive surgical debridement, and hyperbaric oxygen (HBO) therapy have reduced the mortality resulting from these infections. ⋯ During the healing process, hyperoxia causes increased formation of capillaries for oxygen, nutrient, and antibiotic delivery, leading to increased efficacy of some antibiotics in the high oxygen environment, and possibly more rapid overall wound healing. Although there are no randomized trials of HBO in these infections, in vitro data and meta-analysis of clinical cases strongly support the use of HBO.
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Carbon monoxide (CO) poisoning is a common occurrence in today's society. Most such poisonings are a direct consequence of inhaling the toxic byproducts of combustion. ⋯ CO poisoning is associated primarily with injury to the brain and the heart because the gas binds to hemoglobin and interferes with these organs' need for a continuous supply of oxygen. Prompt recognition of CO poisoning and treatment of the patient with oxygen are essential to prevent long-term damage and delayed neurologic sequelae.