Hyperbaric oxygen therapy.
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Biomedical subjects
Publications and source records attributed to V Larson-Lohr.
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Recently an outbreak of acute respiratory infection associated with the hantavirus occurred in the southwestern United States. Hantavirus pulmonary syndrome (HPS) is a life threatening illness that carries with it a high mortality rate. Patients with HPS experience prolonged periods of hypoxemia requiring mechanical ventilation and treatment in intensive care units. We have recently seen 2 survivors of HPS. A neuropsychological test battery was administered immediately following their acute hospitalization and at 1 year postrecovery from HPS. Both patients exhibited cognitive impairments immediately following HPS as well as persistent cognitive impairments at 1 year. The cognitive impairments seen in these two HPS survivors are similar to those seen in other patients who have experienced brain anoxia, including memory impairments. It is also possible that hantavirus may directly cause brain injury with concomitant cognitive impairments. Additional research needs to be carried out in order to determine the extent and severity of the cognitive impairments in survivors of HPS.
STUDY OBJECTIVE: To test the hypothesis that neuropsychologic test results and functional outcome will be abnormal if hyperbaric oxygen (HBO) is not used in patients with severe carbon monoxide (CO) poisoning. METHODS: For a 1-year interval, we retrospectively identified all CO-poisoned patients who were comatose on presentation at a large, urban tertiary hospital and did not receive HBO therapy. Prospectively, 6 and 12 months after CO poisoning, we administered standardized questionnaires to assess functional outcome. At 6 months, we performed extensive neuropsychologic testing. RESULTS: All four patients exhibited normal performance on a neuropsychologic test battery at 6 months. The Folstein Mini-Mental Status Examination was normal in all patients. All patients had normal functional outcomes. CONCLUSION: Normal neuropsychologic and functional outcomes are possible after severe CO poisoning without the use of HBO therapy.
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This report describes a patient with mucormycosis treated with hyperbaric oxygen therapy (HBO2). Arterial O2 tension (PaO2) during HBO2 was considerably lower (346 mm Hg) than expected (1,500 mm Hg) due to an inadvertent right main-stem intubation, which was not otherwise clinically evident. This case illustrates the influence of a large right-to-left shunt (Qs/Qt) on O2 loading during HBO2. We raise the question if routine hyperbaric treatment protocols are adequate to raise PaO2 in patients with large Qs/Qts.