Oriani . Marroni . Wattel (Eds.) Handbook on Hyperbaric Medicine Springer Berlin Heidelberg New York Barcelona Budapest Hong Kong London Milan Paris Santa Clara Singapore Tokyo G.Oriani · A. Marroni · F. Wattel (Eds.) Handbook on Hyperbaric Medicine With 169 Figures and 102 Tables Springer Editors: Prof. G. Oriani Anaesthesia, Intensive and Hyperbaric Care Department Istituto Ortopedico Galeazzi Via Riccardo Galeazzi 4 20161 Milano Italy Prof. A. Marroni Divers Alert Network Europe Via Puglie 82 64026 Roseto degli Abruzzi Italy Prof. F. Wattel Service de Reanimation Medicale et de Medicine Hyperbare Hopital Albert Calmette Blvd. du Prof. Leclercq 59037 Lille Cedex France ISBN 978-88-470-2200-3 Die Deutsche Bibliothek - CIP-Einheitsaufnahme Handbook on hyperbaric medicine: with tables 1 G. Oriani ... (ed.).- Berlin; Heidelberg; New York ; Barcelona; Budapest; Hong Kong; London; Milan; Paris; Santa Clara; Singapore; Tokyo: Springer, 1996 ISBN 978-88-470-2200-3 ISBN 978-88-470-2198-3 (eBookl DOl 10.1007/978-88-470-2198-3 NE: Oriani, G. [Hrsg.) This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concern- ed, specifically the rights of translation, reprinting, re-use of illustrations, recitation, broadcasting, reproduc- tion on microfilms or in other ways, and storase in data banks. Duplication of this publication or parts thereof is only permitted under the provisions of the German Copyright Law of September 9, 1965, in its current version, and a copyright fee must always be paid. Springer-Verlag Italia, Milano 1996 Softcover reprint of the hardcover 1st edition 1996 The use of registered names, trademarks, etc in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and there- fore free for general use. Product liability: the publishers cannot guarantee the accuracy of any information about dosage and appli- cation contained in this book. In every individual case the user must check such information by consulting the relevant literature. Production supervision: PRODUserv Springer Produktions-Gesellschaft, Berlin and Springer-Verlag Italia, Milano Typesetting: Fotosatz-Service Kohler OHG, Wiirzburg Preface Many years have passed since I first became interested in hyperbaric medicine and subsequently brought together my work in anesthesia and intensive care with that in the field of hyperbaric oxygen therapy. During my long career I have met people who have had a profound influence on me and my work. I should like to thank them all for their support and inspira- tion. First and foremost, my family for supporting me in all situations, good or bad, and for their understanding when we were separated due· to my studies and work. My dear friend Alessandro Marroni, co-editor of this book and a highly com- petent and motivated man, with whom I have shared several moments in both my professional and private life. I have the closest affinity with his ideas and views. Another dear friend, Francis Wattel, who also co-edited this book. He is not only an authority on intensive care medicine but has also been working with us in the European Committee for Hyperbaric Therapy. His suggestions and initiatives have always been pivotal to me and my work. Everyone who has contributed to the various chapters and who cooperated enthusiastically, despite their numerous other commitments, in the preparation and reading of the material. I have rarely encountered such enthusiasm and commitment. Last but not least, the people at Springer, both in Milan and Berlin, not only for their active support in editing and production but also for their many sugges- tions towards optimizing the final outcome. On the one hand, I hope the result of our joint endeavor will find the apprecia- tion of the readers of the Handbook on Hyperbaric Medicine. On the other hand, I am sure that the rationality of the subject matter and the scientific rigor that has throughout the years been fundamental to this discipline will become apparent when reading this book. I hope that for many readers this book will be a starting point to enter into the fascinating world of hyperbaric medicine and that it will serve as a useful reference for those who already work in this field. I wish you all the best success in your work. December 1995 Giorgio Oriani Contents Physiology and Physiopathology of Hyperbaric Oxygen 1 G. Oriani, M. Michael, A. Marroni and C. Longoni Physiological Principles of Hyperbaric Oxygenation 35 E. M. Camporesi, M. F. Mascia and S. R. Thorn Toxic Effeds of Oxygen 59 G. De Martino, M. Luchetti and R. C. De Rosa Pulmonary Effects . . . . . . . . . . . . . . 75 A. Marroni, G. Oriani and C. Longoni HBO Dose Titration . . . . . . . . . . . . 81 A. Marroni, G. Oriani and C. Longoni Clinical Indications . . . . . . . . . . . . 95 G. Oriani, A. Marroni and F. Wattel Decompression Illness - Final Report . A.Marroni Acute Indications of HBO Therapy - Final Report ........... 99 G.Oriani Chronic Hyperbaric Oxygen Therapy Indications - Final Report . . . .. 110 D. J. Bakker and J. Niinikoski Recommendations of the Jury . . . . . . . . . . . . . . . . . . . . .. 125 E. M. Camporesi, A. Gasparetto, M. Gowon, 1. J. Greenbaum, E. P. Kindwa1l, M. Lamy, D. Linnarsson, J. M. Mantz, C. Perret, P. Pietropaoli, H. Takahashi and C. Voisin Decompression Illness . . . . . . . . . . . . . . . . . . . . . . . . . .. 135 F. Faralli VIII Contents Epidemiology of Decompression Accidents During Recreational Diving . 183 J. Seyer Pre-Hospital Treatment of Decompression Sickness in Recreational Divers 187 J. Seyer Hospital Medical Treatment of Decompression Sickness in Sport Scuba Diving . . . . . . . . .. ........... 192 B. Grandjean Hyperbaric Treatment of Decompression Accidents ........... 200 A. Barthelemy, E. Bergmann and J. M. Sainty Medical Specificities of Diving for Children and Women .. ... 207 J.1. Ducasse and Ph. Izard The Treatment of Decompression Sickness in Commercial Diving .... 216 P. B. James Effect of Gas Bubbles on the Blood . . . . . . . . . . . . . . . . . . .. 223 A. O. Brubakk Gas Embolism ............................... 229 R. E. Moon The Divers Alert Network: Epidemiology of Diving Accidents 249 Divers Alert Network and its Programs 249 C. J. Wachholz, P. B. Bennett, J. A. Dovenbarger and R. D. Vann The Divers Alert Network in Europe: Risk Evaluation and Problem Management in a European Recreational Divers Population . . .. 265 A.Marroni Divers Alert Network Japan Report ................... 277 Y. Mano, A. M. Sera, N. Yamami, M. Shibayama and T. Nakayami Carbon Monoxide Poisoning: Mechanism, Clinical Presentation and Management ............................. 281 D. Mathieu, F. Wattel, R. Neviere and M. Mathieu-Nolf Carbon Monoxide Poisoning in the United States ............ 297 N. B. Hampson Hyperbaric Oxygen Therapy for CO Intoxication During Pregnancy ... 305 E. M. Camporesi Contents IX Heart Damage Caused by Carbon Monoxide Poisoning ......... 312 C. Gandini, M. Broccolino, S. Scarpini, A. Travaglia, C. Pirovano and S. Brenna The CO-Poisoned Child . . . . . . . . . . . . . . . . . . . . . . . . .. 331 C. Pirovano, G. Oriani, C. Gandini, M. Michael, A. Peretti, D. Grioni, F. Triulzi and N. Colombo Soft Tissue Infections Including Clostridial Myonecrosis: Diagnosis and Treatment ......................... 343 D. J. Bakker and A. J. van der Kleij Clostridial Myonecrosis ......................... 362 D. J. Bakker and A. J. van der Kleij Radionecrosis ............................... 387 J. P. R. van Merkesteyn, D. J. Bakker and R. Kooijman Brain Injuries and HBO . . . . . . . . . . . . . . . . . . . . . . . . . . . 403 J. L. Ducasse and B. Cathala HBO in Orthopedic Disorders 409 F. Malerba, G. Oriani and A. Farnetti Hyperbaric Oxygen Therapy in Crush Injuries 428 G. Bouachour and P. Cronier Applications of Hyperbaric Oxygen Therapy in Plastic Surgery . . . . . . 443 W. A. Zamboni Oxygen and Healing Wounds: Tissue-Bone Repair Enhancement . . . .. 485 J. Niinikoski and T. K. Hunt HBO Therapy in Burns and Smoke Inhalation Injury ........... 509 F.Lind Hyperbaric Oxygen Therapy and Diabetic Problems ........... 531 Diabetes Mellitus: Diagnosis, Epidemiology, Therapy and Long-Term Complications . . . . . . . . . . . . . . . . . . . . .. 531 P. Calia and A. Quarantiello X Contents Hyperbaric Oxygen Therapy in Diabetic Foot Ulcer and Gangrene ... 542 E. Faglia, F. Favales, G. Oriani and M. Michael Vascular Diseases and HBO .................. 569 G. Giuffrida Hyperbaric Oxygen Therapy in Ophthalmology . . . . . . . . . . . . .. 595 R. Magni and G. Oriani Pigmentous Retinopathy (PR) and Hyperbaric Oxygen Therapy (HBO) . 608 G. C. Modugno Hearing Disorders . • • . . . • • • . • • • • • • • • • • •• 611 R. Gaini, T. Zurlo and E. Brenna Monitoring of Clinical Parameters in Hyperbaric Chamber . . . . . . .. 625 M. Rossetti, G. Oriani and I. Pahle Management of HBO Patients . . . . . . . . . . . . . . . . . . . . . . . 647 F. Wattel, D. Mathieu and R. Neviere Transcutaneous Oxymetry . . . . . . . . . . . . . . . . . . . . . .. 661 G. Oriani, P. Campagnoli and C. Longoni Oxymetry ................................ 670 A. J. van der Kleij and D. J. Bakker Transcutaneous Oxymetry in Hyperbaric Medicine ........... 686 D. Mathieu, R. Neviere and F. Wattel Effect of Hyperbaric Oxygen on Activity of Antibacterial Agents . . . . . 699 L. Marzella and G. Vezzani Safety and HBO Therapy . . . . . . . . . . . . . . . . .. 715 P. Pelaia, M. Rocco, E. Di Lauro and G. Spadetta Future Prospects in Research for Hyperbaric Oxygen . . . . . . . . . .. 737 D. Mathieu and F. Wattel Contents XI Adapting the Hyperbaric Chamber to the Health Care Environment: History and Future Trends . . . . . . . . . . . . . . . . . . . . . . . .. 741 C. Longoni and G. Marchesi New Frontiers ............................... 765 New Frontiers: Hyperbaric Oxygen Therapy (HBO) in Open Heart Surgery's Complications . . . . . . . . . . . . . . . . . . . . . . . .. 765 M. Botta, M. Lemma and C. Santoli New Frontiers: Dermatology . . . . . . . . . . . . . . . . . . . . . .. 781 C.Luongo New Frontiers: HBO in Treatment of Fetal Growth Deficiencis ...... 791 B. Sparacia New Frontiers: Obstetrical Indications for Hyperbaric Oxygen Therapy . 798 E. Bergmann, A. Barthelemy and J. M. Sainty New Frontiers: Use of Combined Hyperbaric Oxygenation and In-Water Rehabilitation for Neurological Conditions due to Stroke and to Spinal Decompression Sickness . . . . . . . . . . . . . . . . . . 809 A.Marroni New Frontiers: Treatment of Radiation-Induced Xerostomia with Hyperbaric Oxygen: Is There a Room for such a Complicated Treatment? 812 J.Schmutz New Frontiers: Tumor Oxygenation and Radiotherapy ......... 817 A. J. van der Kleij, D. J. Bakker and P. A. Voute New Frontiers: Sickle Cell Anemia .................... 830 H. Mehdaoui and L. Elisabeth New Frontiers: Brain Abscess ...................... 834 G. Frey and L. Lampl New Frontiers: Endothelin 1 and HBO .................. 846 M. Scardia, D. Puscio and E. Pedaci Medical Oxygen: Characteristics, Use, Safety Guidelines ......... 849 V. Nistrio