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Hyperbaric Oxygen Therapy

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Posted 12/3/2013

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Dr. Lon Keim describes the uses and benefits of hyberbaric oxygen therapy. Used in emergency situations to treat carbon monoxide poisoning, the therapy is also used to help heal problem wounds and damage to tiny blood vessels caused by radiation treatments. The hyberbaric oxygen unit at The Nebraska Medical Center in Omaha was opened in 1986. For more information or to set up an appointment, call 1-800-922-0000 or visit http://www.nebraskamed.com.

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What we can offer sometimes is a technology that is not available elsewhere. Some people use the term baromedicine as a specialty of medicine that deals with application of gases under pressure.

I like to define a problem wound as a wound that doesn’t heal like it should, but a common denominator of problem wounds is they’re all oxygen-deprived. Oxygen is the fuel that powers all living cells and various cells have a greater demand for oxygen than others.

The treatment for carbon monoxide is 100 percent oxygen. Number one – get them out of the environment where the carbon monoxide occurred in the first place and then 100 percent oxygen. It appears that through some studies that have been done in Utah, the use of hyperbaric has enhanced outcomes over just the application of 100 percent oxygen by facemask or non-re-breathing masks and that there’s less problems afterwards, perhaps even faster recovery. The use of hyperbaric for patients overcome when carbon monoxide intoxication is somewhat the gold standard for the treatment of acute carbon monoxide intoxication.

What we do is the ability of hyperbaric oxygen to reverse the vascular injury associated with radiation. Radiation is one of the main stages of cancer therapy and cancer protocols, but the whole purpose of radiation it to kill the cancer. Like everything in life and everything in medicine, you get some bad with the good. One of the consequences is the radiation can be quite the injurious to the lining cells of blood vessels and when you harm these so-called endothelial cells, they scar down and you get what we describe as a abide endovasculitis; you literally wipe out the micro pipes in zone or radiation field. If there is an obliteration of vasculature, you have no way to bring oxygen or antibiotics or glucose or insulin or growth factors or anything it takes to heal. What hyperbaric seems to be able to do is because you can profoundly increase total oxygen, pressure and concentration, with a course of treatment you can reestablish that vasculature in an area that has been a significant obliteration of the vascular bed and probably restore it to the tune of 85 or 92 percent.

This is our sechrist 3200 unit; it’s the biggest one that we have. It works by flow and there will be somewhere between the three and four hundred liters of oxygen that is blowing into the chamber, which then has a restricted outlet and that’s how pressure is increased within the chamber. So the patient is entirely enclosed and what we have here are monoplace chambers. They’re about the size of the old iron lungs; about 44 inches wide, eight feet long, clear acrylic plastic. They’ll lay on a gurney with pillows and they’ll be slid into the chamber on a gurney and then the doors closed. Then oxygen’s allowed to flow and increase, but it’s 100 percent oxygen and with breathing this 100 percent oxygen, you get oxygen higher concentrations in the blood and accordingly higher oxygen concentrations in the tissues. There’s a communication system that we can talk to them if necessary (tell them what to do, provide them any instructions, etc.).

Probably the symptom they experience most it’d be some pressure on their ears as one would experience they’re flying on a plane. To help them occupy the time, they can watch T.V., watch sports, we’ve got a whole library of movies that patients have donated to us over time and sometimes they’ll stop by a blockbuster and see the one that they’ve always wanted to see and never gotten around to it. Sometimes just patient: “Give me two hours where I can sleep and leave me alone and don’t bother me.” It’s sometimes uninterrupted time. They can listen to music. The total treatment time within the chamber is two hours and a treatment is at pressure or at depth from 90 minutes and then it takes about eight or 10 minutes to get down to pressure and eight or 10 minutes to come back up again.

The facility here started at Clarkson, now an integral part of The Nebraska Medical Center. It is the only facility between Denver and Des Moines and Sioux Falls and Kansas City. We have a wonderful opportunity to treat a number of patients.

It is covered by insurance and Medicare covers it. It’s indicated and covered for reimbursement for 12 conditions, most of the ones I just mentioned and it can be accepted by Medicare. It can be accepted by most other insurance intermediates.

It’s a very gratifying to see a limb saved, a patient saved, and the gratification of patients really are most appreciated.