Hyperbaric Oxygen Therapy

(HBOT)
Hyperbaric Oxygen Therapy (HBOT)

 Hyperbaric Oxygen Therapy / Terapi Hiperbarik Oksigen adalah sebuah terapi sistemik
yang menggunakan oksigen murni (100%) dan tekanan > 1 atm
 Terapi diberikan di sebuah tempat khusus untuk 1 orang (mono-place chamber) atau
banyak orang sekaligus (multi-place chamber) yang diberi tekanan tinggi
Inspired O2 by Mask and Hood
Enhanced Atmospheric Pressure vs
FiO2, PAO2, PaO2, HbO2, CaO2

Pb (ata) 1.0 1.0 2.0 3.0

FiO2 (%) 0,21 1.0 1.0 1.0

PAO2 (mmHg) 104 673 1433 2195

PaO2 (mmHg) 100 627 1267 2000

HbO2 (%) 19,7 20,1 20.1 20.1

CaO2 (ml/100ml) 0,3 1,88 3.8 6.0

The Pivotal therapeutic effect of HBOT

1. Mechanical therapeutic effect of the increased barometric pressure (Boyle’s law)

2. Bio-molecular therapeutic effects of enhanced oxygen pressure pressure. The initial effects
that occur due to increased production ROS (H2O2 ) and RNS (NO)
Oxygen Saturation Curve

6.0 ml O2/100ml plasm

[%]
3,8 ml O2/100ml plasm
PLASM
20,1
19,7 HbO2

21% O2

100% O2 100% O2

1.0 2.0 3.0 [Guritno, 1984]

The Biological Therapeutic Effects (A)

 Reverse hypoxia

 Alter ischemic effect

 Influence vascular reactivity

 Reduce edema

 Modulate NO production

 Modify growth factor & cytokine effect by regulating their level and/or receptor

 Induce changes in membrane proteins affecting ions exchange and gating mechanism
The Biological Therapeutic Effects (B)

 Promote cellular proliferation

 Accelerate collagen deposition
 Stimulate capillary budding and arborization
 Accelerate micro bio-oxidative killing
 Improve select antibiotic exchange across membranes
 Interfere with bacterial disease propagation by denaturing toxins
 Modulate the immune system response
 Enhance oxygen radical scavengers thereby decreasing ischemia-reperfusion injury
Therapeutic Procedure

 Informed Consent
 Medical record check (avoiding contraindication and side effect)
 Physical examination and laboratory studies
 Radiological check-up (MRI, X-ray, etc)
 HBOT Procedure
Contraindications

 Absolute  Relative Contraindication

Untreated Pneumothorax Upper respiratory infections
Chronic sinusitis
Seizure disorders
High fever
History of spontaneous
pneumothorax
History of thoracic surgery
History of surgery for
osteosclerosis
Viral infections
Congenital spherocytosis
Side Effect

 Barotrauma
 Oxygen Toxicity
 Hypoglycemia (Diabetic Patient)
 Confinement Anxiety
 Decompression Sickness for Inside Attendants