일산화탄소 중독환자에서 고압산소치료 적응증에 관한 비교평가

유수진,박재황 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Study objective: To comparative study the results between hyperbaric oxygen therapy and non-hyperbaric oxygen therapy in the these patients, because controversy exists regarding hyperbaric therapy in the drowsy patient with carbon monoxide intoxication. Design: Tetrospective study Setting: The WonKwang university hospital emergency department during january first 1991 through June 31th 1995 Method and result: According to history and carboxyhemoglobin level, we experienced 105 patients of carbon monoxide intoxication admitted to emergency department. Patients intoxicated by other gases and death patients before admission was excluded. According to the indication of the hyperbaric oxygen therapy on carbon monoxide intoxication, 15 patients among 16 patients with coma, semicoma, and stuporous mental state was done. Patient with drowsy mental state was 23 patients, 6 of these patients was done hyperbaric oxygen therapy and remainder was not. Charts of patients with carbon monoxide intoxication including patients with drowsy mental state was reviewed to determine the result between hyperbaric oxygen therapy and non-hyperbaric oxygen therapy. According to clinical features, we found sex ratio(1:1.6), mean age(35.1±19.4years), age range from 1 to 85 years old, 41cases(39%) in 1991, 66cases(62.9%) in alert mental state and 23cases(21.9%) in drowsy mental state The exposure time and time until alert mental status by mental status were 9.5±0.67hours, 18.8±28.3hours in coma mental status. The early laboratory findings were leukocytosis in 39cases(37.1%), increased hematocrit in 20cases(19.1%), increased GOT in 14cases(13.3%), increased GPT in 12cases(11.4%), increased creatinine in 10 cases(9.5%), glucosuria in 17cases(16.2%) and normal arterial blood gas analysis findings except acidemia in drowsy and coma mental status, and most common abnormal findings were seen in stuporous mental status. The exposure time and time until alert mental status by carboxyhemoglobin concentration were no significant statistical result, and time until alert mental status between drowsy and stuporous mental status with hyperbaric oxygen therapy were 3.9±3.04hours. In patients with drowsy mental status, the patients with hyperbaric oxygen therapy that was 3.9±3.04hours in time until alert mental status, 1cases(17%) in carboxyhemoglobin concentration(≥20%), 5cases(83%) in carboxyhemoglobin concentration(< 20%), 1.432.11days in admission period, and patients without hyperbaric oxygen therapy were 9.9±6.04hous in the time until alert mental status. Arterial blood gas analysis between patients with and without hyperbaric oxygen therapy in drowsy mental status were normal findings except acidemia before hyperbaric oxygen therapy. The comparison between hyperbaric oxygen therapy and non-hyperbaric oxygen therapy in patients with drowsy mental status were significant statistical result in time until alert mental status. Conclusion: Although hyperbaric oxygen therapy was done according to the indication in carbon monoxide poisoning, theirs result imply that hyperbaric oxygen therapy is more important than the pure oxygen therapy in patients with drowsy mental status.

잠수병의 방사선학적 소견 및 치료에 대한 연구

허재택 대한응급의학회 1999 대한응급의학회지 Vol.10 No.4

Background : The aim of this study are to detect the radiological findings of decompression sickness that could elucidate the pathogenesis of decompression sickness and to evaluate the results of management of decompression sickness with hyperbaric oxygen therapy. Methods : Forty nine patients(42 men and 7 women; 23-51, mean 32 years) were referred to the Hyperbaric Oxygen Therapy Center of Dong-A University Hospital for diving related injuries. All patients were studied neurologically and radiologically. Forty patients(81.6%) were type 1 decompression sickness who complained pains in various sites. Eight patients(16.3%) were type 2 decompression sickness with spinal cord involvement and underwent MR examination of the spinal cord. One patient(2.0%) was type 2 decompression sickness with chest involvement. Two patients(4.1%) among nine patients of type 2 decompression sickness were combined with type 3 decompression sickness who was suspected of cerebral embolization. All patients of type 1 were treated with therapeutic hyperbaric recompressions of US Navy treatment table 5 and auxiliary therapy. Six patients of type 2 were treated with US Navy treatment table 6 and two patients of type 3 were treated with US Navy treatment table 6A. Results : Magnetic Resonance Image(MRI) demonstrated patchy areas of increased signal intensity in the spinal cord on both T2-weighted and fast SE T2-weighted images in five patients with symptoms of spinal cord injury, corresponding to an area of the cord believed to be clinically involved. Chest X-ray and spiral computed tomogrphy(CT)scan demonstrated patchy area in right middle lobe of lung in type 2 decopmression sickness of chest involvement and disappeared two weeks later with hyperbaric oxygen therapy. All patients of type Ⅰ decompression sickness were improved with hyperbaric oxygen therapy and auxiliary therapy. Motor weakness of extrimities were improved immediately during hyperbaric therapy within hyperbaric chamber in six patients among eight patients of type 2 decompression sickness with spinal cord involvementbut. Two patients who were not improved during first time of hyperbaric oxygen therapy were remained neurological deficit 6 months later. One patient of type 2 decompression sickness with chest involvement were also improved with hyperbaric oxygen therapy and auxiliary therapy. Two patients of type 3 decompression sickness combined with hype 2 were also improved neurologically after hyperbaric oxygen therapy with auxiliary therapy. Conclusion : MRI has proved to be reliable in the detection of spinal cord involvement due to decompression sickness that were previously undetectable by other neuroradiological investigations(such as myelography, CT, angiography, isotopic tests) and its pathologic findings might be corresponded to ischemic injury of spinal cord. Patch area which was demonstrated by chest spiral CT and chest P-A of type 2 decompression sickness might be related to hemorrhage of lung parenchyme due to alveolar rupture which was resolved two weeks later. Therapeutic hyperbaric recompression is very effective in the management of decompresion sickness.

고압산소 치료에 대한 일개 권역 응급센터의 최근 10년 경험 및 제언

윤정훈 ( Jung Hoon Yoon ),김기운 ( Gi Woon Kim ),정윤석 ( Yoon Seok Jung ),한철수 ( Cheol Soo Han ),민영기 ( Young Gi Min ),조준필 ( Joon Pil Cho ),최상천 ( Sang Cheon Choi ) 대한임상독성학회 2013 대한임상독성학회지 Vol.11 No.2

Purpose: The aim of this study is to investigate current status, indications, and complications of hyperbaric oxygen therapy. Methods: A retrospective investigation of patients who underwent hyperbaric oxygen therapy at a university medical center from September 2004 to August 2013 was conducted based on patients’ medical records and results of an email survey for 99 emergency centers. Results: During the study period, a total of 233 patients underwent hyperbaric oxygen therapy. Indications for hyperbaric oxygen treatment of illness or injury were as follows: 1) 151 cases of acute carbon monoxide poisoning( 65.4%), 2) flap wound management, including 42 cases(18.2%), 3) skin care transplanted, including 23 cases(10.4%), 4) Burger’s disease, including 5 five cases(2.1%), respectively. Total application time* frequency was 1,088 and total time was 1,239 hours. Among 233 patients who underwent hyperbaric oxygen therapy, 32 patients(13.7%) had complications: 1) otalgia in 21 cases(9.0%), 2) mastoiditis?in six cases(2.6%), 3) hemotympanum in five cases(2.1%), respectively. There were only 8 emergency centers that currently had an operational hyperbaric oxygen chamber in 77 emergency centers(10.4%). Conclusion: Indications identified through this study showed difference from current indications worldwide. It seems necessary that physicians’ perception regarding application of hyperbaric oxygen therapy for more indications be changed and improved. A hyperbaric chamber capable of providing respiratory assistance and intensive care is also needed. A good network for sharing treatment experiences and a specialized team for administration of hyperbaric oxygen therapy is also required.

고압산소요법이 생존이 위태로운 피판에 미치는 영향에 관한 임상적 연구

김동일,최준,송영주,백세민,백롱민,박성규 大韓成形外科學會 1994 Archives of Plastic Surgery Vol.21 No.6

From August,;989 to February,1993,75 patients recieved adjuvant hyperbaric oxygen therapy after surgery. retrospective review of these 75 patients was undertaken to determine the effectiveness of hyperbaric oxygen therapy to improve survival of compromised flaps. The indications for postopeative hyperbaric oxygen therapy has been marked congestion and ischemic change of flaps. The regimen consisted of two 60-minute treatments of 100% oxygen at 2.5 ATA per day until flap survival or eschar formation. Hyperbaric oxygen was given to 75 patients having compromised flaps including 15 cervicofacial flaps, 4 cervicopectoral flaps, 11 groin distant flaps, 8 traumatic avulsion flaps, 4 superficial temporal fascia flaps, and 33 various local flaps. Complete survival was noted in 52 flaps(70%) after 5-14 days (mean 10 days) treatment of hyperbaric oxygen. 19 flaps(25%) showed partial improvement and 4 flaps(5%) ended in failure. Complication associated with hyperbaric oxygen was negligible except for ear pain during hyperbaric oxygen therapy in 15 patients. These data clearly indicate that hyperbaric oxygen has provided definite clinical benefit with minimal complication although a matched series comparing the results with and without hyperbaric oxygen therapy may be required to improve the efficacy of this treatment regimen.

백서 하악골 골수염의 감염세균에 대한 고압산소요법의 억제효과에 관한 연구

한인주(In Joo Han),윤중호(Jung Ho Yoon) 대한구강악안면외과학회 1990 대한구강악안면외과학회지 Vol.18 No.4

The main objective of this study was to observe the antimicrobial effect of hyperbaric oxygen therapy (HBO) on the infected microorganisms, aerobic and anaerobic, of the mandibular osteomyelitis in Albino rats. The experimental osteomyelitis was induced by formation of bone hole into the medullary cavity and inoculation of Staphylococcus aureus as aerobic microorganism, and Bacteroides melaninogenicus as anaerobic microorganism separately. Author used 170 rats (Sprague-Dawley strain) dividing into a pilot study (30), aerobic osteomyelitis (80) and anaerobic osteomyelitis (60) groups. In aerobic osteomyelitis caused by S. aureus, the treatment regimen consisted of HBO (2hrs, daily at 2.4 atm.), cephalexin, a combination of both and/or no treatment control group, and in anaerobic osteomyelitis caused by B. melaninogenicus, the treatment regimen consisted of HBO once a day, HBO twice a day and/or no treatment control group, and the results were compared microbiologically. The obtained results were as follows; 1. In vitro study, hyperbaric oxygen therapy (HBO) on Staphylococcus aureus has no direct bacteriostatic effect compared with control group in ambient air, due to similar bacterial growth, and combination of HBO and antibiotic therapy revealed similar antimicrobial effect compared with antibiotic therapy alone. 2. In treatments on experimental osteomyelitis caused by Staphylococcus aureus, HBO is at least as effective as antibiotic therapy, and no significant difference was revealed between HBO group and a combination of HBO and antibiotic therapy group statistically. 3. In vitro study, antimicrobial effect of HBO on Bacteroides melaninogenicus revealed statistical significant difference compared with control group, and HBO twice a day for 4 hours was more effective than HBO once a day for 2 hours in bactericidal effect. 4. In treatment on experimental osteomyelitis caused by Bacteroides melaninogenicus, HOB group revealed high recovery rate compared with control group, while there was no significant difference between HBO once a day and HOB twice a day groups statistically. Hyperbaric oxygen therapy was effective in anaerobic osteomyelitis due to B. melaninogenicus by antibacterial activity and improvement of healing process, while it did not appear to be related to antibacterial activity in aerobic osteomyelitis due to S.aureus. Therapeutic effectiveness of hyperbaric oxygen therapy must be considered as an adjunctive treatment of refractory chronic osteomyelitis in respect that it is at least as effective as antibiotic therapy.

고압산소치료 효과에 따른 광용적센서와 자성 홀센서로 측정한 산소포화도와 맥진파형 변화 특성 연구

이상석,백광현,홍유식,최종구,HASAN MAHBUB,유준상,이우범 한국물리학회 2023 새물리 Vol.73 No.9

The effect of supplying insufficient oxygen to patients with cerebrovascular disease must be verified. Changes in oxygen saturation (SpO2) and pulse waveforms measured by photoplethysmogram and Hall element clip-type pulsimeter were compared before/during/after hyperbaric oxygen therapy. At a maintained high pressure of 1.5 atm in the chamber, high-purity oxygen was flowed around the respirator of the subject at a flow rate of 5 L/min. The change in SpO2 reached 100% within 2 min. Given the increase in SpO2, cardiac muscle activity caused changes in systolic blood pressure, which resulted in a blood pressure increase of 16 mmHg. In particular, the heart rate decreased considerably from 68.8 beats/min to 48.8 beats/min, which implies the stabilization of heart motion caused by hyperbaric oxygen therapy. Diagnostic and treatment indicators can be created through daily-life management-type data collection and processing analysis through the regular monitoring of pulse waveforms in patients with cerebrovascular diseases and who require hyperbaric oxygen therapy.

임베디드시스템 기반 자동제어 기능의 삼단분리형 산소챔버 설계

조면균 중소기업융합학회 2018 융합정보논문지 Vol.8 No.3

본 논문에서는 환자의 산소 민감도와 선호패턴을 고려하여 개인별 산소치료 프로파일을 지정하고, 여기에 따라 자동적으로 시간별 산소압을 조정하여 제공하는 3단 분리형 단격실 산소챔버를 설계한다. 고압산소치료는 대기압보다 높은 100% 산소를 환자에게 제공하는 방법으로 개인에 따라 기압차에 따른 귀의 통증을 호소하는 단점이 있었다. 제안 시스템은 임베디드 시스템을 기반으로 환자의 산소치료 선호패턴 및 치료기록을 DB화하여 환자 맞춤형 산소치료 프로파일을 작성하 고, 환자의 이름만 입력하면 산소챔버가 자동적으로 작성된 프로파일 패턴에 따라 산소압을 자동적으로 조정함으로써 산소 치료 효과를 극대화 할 수 있다. 향후 관리자의 스마트폰과 연동하여 작동하는 산소챔버용 원격관리 시스템으로 확장함으로써 관리의 용이성 및 산소치료의 안전성을 제고하고 부가가치를 극대화 할 수 있기를 기대한다. In this paper, considering the oxygen sensitivity and preference pattern of the patient, the profile of the oxygen therapy of the individual is specified. And, we design a three-compartment, single compartment oxygen chamber that automatically adjusts the oxygen pressure according to the specified profile. Hyperbaric oxygen therapy is a method of providing patients with 100% oxygen higher than atmospheric pressure for therapeutic purposes. However, there is a disadvantage that the ear pain is caused by the pressure difference depending on the individual. Based on the embedded system, the proposed system creates a patient-tailored oxygen therapy profile by DB of patient's preference patterns and treatment records of oxygen therapy. If only the patient's name is entered, the oxygen chamber system can adjust the oxygen pressure automatically according to the profile pattern to maximize the oxygen treatment effect.

고압산소치료의 구강악안면영역에서의 임상적 이용에 관한 연구

류정호,엄기훈,배준수,유준영,장명진,김용관,Lyoo, Jung-Ho,Um, Ki-Hun,Bae, Jun-Su,You, Jun-Young,Jang, Myung-Jin,Kim, Yong Kwan 대한구강악안면외과학회 2001 대한구강악안면외과학회지 Vol.27 No.5

Hyperbaric oxygen therapy(HBO) is defined as breathing 100% oxygen while in an enclosed system pressurized to greater than on atmosphere(sea level). This increased oxygen delivery furthers your body's ability to kill germs and to increase healing. HBO is a supplemental therapy to be used in addition to the current medical and surgical therapy you are receiving. HBO typically is used to complement treatments of medical problems such as bone infections, complication of radiotherapy, and certain chronic, non-healing wounds. On an emergency basis, the chamber also is used to treat problems such as carbon monoxide poisoning and the decompression sickness. We analysed stastically cases which are treated by hyperbaric oxygen therapy in point of oral and maxillofacial region on the Kangnam General Hospital for aid in comprehension and application of this therapy. Total 760 patients were treated at Gangnam General Hospital from July 1996 to September 1999. They were classified by region to Decompression sickness(DCS), Carbon monoxide poisoning(CO), General surgery(GS), Orthopedics(OS), Oral and Maxillofacial surgery(OMFS), others. Patients of Oral and Maxillofacial surgery were divided by diseses to Osteomyelitis, Osteoradionecrosis, Reconstruction, Bone graft, Difficult wounds, others. The results were as follows. 1. This institute conducts HBO therapy for DCS which takes up 62% and 10.5% for OMF region. 2. In OMF region, Osteomyelitis is 40%, Osteoradionecrosis is next, Bone graft, and Reconstruction is a row. 3. According to our precious study, HBO has been frequently conducted in OMF region compared to past, however, it is less actively conducted in this area for research than other conturies. Therefore, We need further application to the clinical use.

정형외과영역에서 고압산소요법의 결과

권영호,조명래,강호상 고신대학교 의학부 1998 高神大學校 醫學部 論文集 Vol.13 No.1-2

In Korea, hyperbaric oxygen (HBO) therapy has been mainly used for treating CO poisoning and decompression sickness. It can also be used in many disorders in orthopedic field through the action of increasing oxygen tension of tissue. We have analyzed the 21 cases of orthopedic field treated by HBO at Kosin University Gospel Hospital from September 1996 to December 1997. The outline of result are follows ; 1. Crushing injuries, compromised wound, diabetic foot, chronic osteomyelitis, vascular disorder, and flap were treated by HBO and received 12.1 times of HB0 therapy on average. 2. Headache and otalgia were presented as side effect, and some old age complain difficulty of valsalva maneuver. HBO therapy can be applied to the many cases of the orthopedic surgery, as a adjuvant therapy. However, it is required to have long term follow up and double blind test with the control group in regared to the result of HBO therapy.

고압산소치료의 구강악안면영역에서의 임상적 이용에 관한 연구

류정호,엄기훈,배준수,유준영,장명진,김용관 大韓口腔外科學會 2003 大韓口腔外科學會誌 Vol.27 No.5