Symptoms |
Rational for use of hyperbaric oxygen |
Cost / benefits analysis |
|---|---|---|
| In acute, early SCI neurovascular damage of the spinal cord results in decreased blood flow (ischemia) and reduced oxygen supply (hypoxia) causing swelling and inflammation that further reduce blood supply. This vicious circle causes further progressive neuronal damage. | Early oxygen therapy provides protection against progressive degeneration of post traumatic spinal cord injury | Shorter hospital stay and faster rehabilitation. |
| Inability to exercise due to excess concentrations of lactate, pyruvate and ammonia cause spasticity and fatigue | Improves metabolic circulatory function which reduces muscle spasm and increases muscle strength. Increases capacity for exercise and reduces fatigue | Improved neuromuscular function and faster recovery |
| headaches | Improves CSF (cerebral spinal fluid) dynamics, reduces intracranial pressure (ICP) and neurovascular deterioration. This would reduce migraine and cluster headache attacks and pains | Improved quality of life |
| Immobility can cause pressure sores (decubitus ulcer) - open wound caused by pressure on the skin. | Speeds up wound healing by promoting micro circulation and fibroblastic function of collagen synthesis | A few sessions of HBO can turn a hypoxic/ischemic non-healing wound into a healing wound. Cost of wound dressing alone can reach $4000-$5000 per year. |
| Inflammation – caused by reduced blood flow, leads to accumulation of toxic substances (ammonia and lactate). Consequent swelling further impairs blood supply causing pain. | Improved blood supply reduces inflammation and swelling which cause pain. | Improved quality of life |
| Bacterial infection promotes ischemia and hypoxic development which interferes with local perfusion. Hypoxia limits antibiotics therapeutic function. | Prevents and treats infection by: having direct bacteriostatic effect (kills most bacteria), improving function of white blood cells (phagocytosis), improves function of antibiotics. | Improved circulation in the wound bed allows for successful skin grafting. |
| Deep bone infection - osteomyelitis | Improves removal of necrotic (dead) bone, facilitates formation of a new bone tissue(osteogenesis) and strengthens the existing bone structure | If not responding to antibiotics osteomyelitis can cause death. (Christopher Reeves??) |
| Muscle weakness and pain | Relives pain by removing excess of ammonia, lactate and pyruvate. Reduces muscle spasm and increases muscle strength. Increases exercise capacity and range of movement, reduces weakness and fatigue | Faster recovery. Effect magnified when combined with physiotherapy and electrical stimulation. |
| Peripheral nerve damage | Facilitates nerve regeneration Improves sensitivity and decreases parasthesia (“pins and needles” sensation |
Faster recovery. Results even better when combined with functional electrical stimulation. |
| Central nerve damage – loss of control, inability to make a movement | Improved brain oxygenation and circulation. Improved permeability of blood brain barrier (BBB). Activation of the unaffected (dormant) neurons in the penumbra zone. | Faster recovery due to improved control of movement combined with improved neuromuscular function. |
| Bowel problems such as constipation, diarrhea and impaction that can lead to perineal fissure, fistulas and other complication. Soiled skin can be source of infection. | Regulates motility. Enhances closure of perineal fistulas and fissures. Prevents infections by improving skin microcirculation and strengthening immune system. |
Reduced/avoided hospital stay. |
| Bladder dysfunction (incontinence) – susceptibility to infection is due to retention of urine and frequent need for catheterization (causing bacteria that are normally on the skin to be pushed into the bladder) | Reduces bladder spasticity (muscle tension). Increases bladder capacity and improves bladder control of emptying. Urinary urgency and frequency is reduced. Prevents infections. | Reduced possibility of infections and open wounds (pressure sores). |
| Respiratory problem – reduced vital capacity, impaired cough reflex (aspiration pneumonia) | Increases vital capacity. Prevents respiratory tract infections. | Improved quality of life. |
