0
April 25, 1990, Vol 263, No. 16 >
ARTICLE | April 25, 1990

Hyperbaric Oxygen Therapy FREE

Pamela S. Grim, MD; Lawrence J. Gottlieb, MD; Allyn Boddie, RN; Eric Batson, MD
[+] Author Affiliations

The opinions in this article do not necessarily reflect the policies of the American Medical Association.

Reprint requests to Section of Plastic and Reconstructive Surgery, University of Chicago, 5841 S Maryland Ave, Box 269, Chicago, IL 60637 (Dr Grim).


JAMA. 1990;263(16):2216-2220. doi:10.1001/jama.1990.03440160078042
Text Size: A A A
Published online
Article
References

Hyperbaric oxygen therapy involves intermittent inhalation of 100% oxygen under a pressure greater than 1 atm. Despite over a century of use in medical settings, hyperbaric oxygen remains a controversial therapy. The last 20 years have seen a clarification of the mechanism of action of hyperbaric therapy and a greater understanding of its potential benefit. However, despite the substantial evidence that hyperbaric oxygen may have a therapeutic effect in certain carefully defined disease states, many practitioners remain unaware of these findings or are concerned about using hyperbaric therapy because of the controversy it has engendered. This review examines the indications currently considered appropriate for hyperbaric oxygen and briefly evaluates animal and clinical data substantiating these indications. Areas in which the mechanism of action of hyperbaric oxygen is still not well understood, as well as possible new areas of applications, are discussed.

(JAMA. 1990;263:2216-2220)

REFERENCES

1 +
Hyperbaric Oxygen Therapy: A Committee Report . Bethesda, Md: Undersea and Hyperbaric Medical Society; 1986;.
2 +
Francis TJ, Dutka AJ, Hallenbeck JM.  Pathophysiology of decompression sickness . In: Bove AA, Davis JC, eds. Diving Medicine . Philadelphia, Pa: WB Saunders Co; 1990;:170-187.
3 +
Gabb G, Robin ED.  Hyperbaric oxygen: a therapy in search of diseases . Chest. 1987;;92:1074-1082.
4 +
Boerema I, Meyne NG, Brummelkamp WK, et al.  Life without blood: a study of the influence of high atmospheric pressure and hypothermia on dilution of blood . J Cardiovasc Surg. 1960;;1:133-146.
5 +
Tally FP, Stewart PR, Sutter VL, Rosenblatt JE.  Oxygen tolerance of fresh clinical anaerobic bacteria . J Clin Microbiol. 1975;;1:161-164.
6 +
Badwey JA, Karnovsky ML.  Active oxygen species and the functions of phagocytic leukocytes . Ann Rev Biochem. 1980;;49:695-726.
7 +
Forman HJ, Thomas MJ.  Oxidant production and bactericidal activity of phagocytes . Ann Rev Physiol. 1986;;48:669-680.
8 +
Hohn DC, MacKay RD, Halliday B, Hunt TK.  The effect of O2 tension on the microbicidal function of leukocytes in wounds and in vitro . Surg Forum. 1976;;27:18-20.
9 +
Knighton DR, Halliday B, Hunt TK.  Oxygen as an antibiotic: the effect of inspired oxygen on infection . Arch Surg. 1984;;119:199-204.
10 +
Risber J, Tyssebotn I.  Hyperbaric exposure to a 5 ATA He-N2-O2 atmosphere affects the cardiac function and organ blood flow distribution in awake trained rats . Undersea Biomed Res. 1986;;13:77-90.
11 +
Nylander G, Lewis D, Nordstrom H, Larsson J.  Reduction of postischemic edema with hyperbaric oxygen . Plast Reconstr Surg. 1985;;76:596-601.
12 +
Bassett BE, Bennett PB.  Introduction to the physical and physiological bases of hyperbaric therapy . In: Davis JC, Hunt TK, eds. Hyperbaric Oxygen Therapy . Bethesda, Md: Undersea and Hyperbaric Medical Society; 1977;:11-24.
13 +
Bond GF.  Arterial gas embolism . In: Davis JC, Hunt, TK, eds. Hyperbaric Oxygen Therapy . Bethesda, Md: Undersea and Hyperbaric Medical Society; 1977;:141-152.
14 +
Davis JC, Dunn JM, Heimbach RD.  Hyperbaric medicine: patient selection, treatment procedures, and side effects . In: Davis JC, Hunt TK, eds. Problem Wounds: The Role of Oxygen . New York, NY: Elsevier Science Publishing Co Inc; 1988;:225-235.
15 +
Clark JM, Lambertson CJ.  Pulmonary oxygen toxicity: a review . Pharmacol Rev. 1971;;23:37-133.
16 +
Nichols CW, Lambertsen CJ.  Effects of high oxygen pressures on the eye . N Engl J Med. 1969;;291:25-30.
17 +
Palmquist BM, Phillipson B, Barr PO.  Nuclear cataract and myopia during hyperbaric oxygen therapy . Br J Ophthalmol. 1984;;68:113-117.
18 +
Kindwall EP, Goldman RW, eds. Hyperbaric Medical Procedures . Milwaukee, Wis: Saint Lukes Medical Center; 1988;.
19 +
Lynch PR, Brigham M, Tuma R, Wiedeman MP.  Origin and time course of gas bubbles following rapid decompression in the hamster . Undersea Biomed Res. 1985;;12:105-114.
20 +
Whitecraft DD, Karas S.  Air embolism and decompression sickness in scuba divers . JACEP. 1976;;5:355-361.
21 +
Tanoue K, Mano Y, Kuroiwa K, Suzuki H, Shibayama M, Yamazaki H.  Consumption of platelets in decompression sickness of rabbits . J Appl Physiol. 1987;;62:1772-1779.
22 +
Kizer KW.  Delayed treatment of dysbarism: a retrospective review of 50 cases . JAMA. 1982;; 247:2555-2558.
23 +
Green RD, Leitch DR.  Twenty years of treating decompression sickness . Aviat Space Environ Med. 1987;;58:362-366.
24 +
Thomatis L, Nemiroff M, Riahi M, et al.  Massive arterial air embolism due to rupture of pulsatile assist device: successful treatment in the hyperbaric chamber . Ann Thorac Surg. 1981;;32:604-608.
25 +
Peirce EC II.  Specific therapy for arterial air embolism . Ann Thorac Surg. 1980;;29:300-303.
26 +
Cianci P, Posin JP, Shimshak RR, Singzon J.  Air embolism complicating percutaneous thin needle biopsy of lung . Chest. 1987;;92:749-750.
27 +
Baskin FE, Wozniak RL.  Hyperbaric oxygenation in the treatment of hemodialysis associated air embolism . NEngl J Med. 1975;;293:184-185.
28 +
Murphy BP, Hartford FJ, Cramer FS.  Cerebral air embolism resulting from invasive medical procedures: treatment with hyperbaric oxygen . Ann Surg. 1985;;201:242-245.
29 +
Myers RAM, Snyder SK, Linberg S, Cowley RA.  Value of hyperbaric oxygen in suspected carbon monoxide poisoning . JAMA. 1981;;246:2478-2480.
30 +
Norkool DM, Kirkpatrick JN.  Treatment of acute carbon monoxide poisoning with hyperbaric oxygen: a review of 115 cases . Ann Emerg Med. 1985;;14:1168-1171.
31 +
Goldbaum LR, Ramirez RG, Absalom KB.  What is the mechanism of carbon monoxide toxicity? Aviat Space Environ Med. 1975;;46:1289-1291.
32 +
Jackson DL, Menges H.  Accidental carbon monoxide poisoning . JAMA. 1980;;243:772-774.
33 +
Kindwall EP.  Carbon monoxide poisoning treated with hyperbaric oxygen . Respir Ther. 1975;;5:29-33.
34 +
Peterson JE, Stewart RD.  Absorption and elimination of carbon monoxide by inactive young men . Arch Environ Health. 1970;;21:165-175.
35 +
Kindwall EP.  Carbon monoxide and cyanide poisoning . In: Davis JC, Hunt TK, eds. Problem Wounds: The Role of Oxygen. New York, NY: Elsevier Science Publishing Co Inc; 1988;:177-190.
36 +
Raphael JC, Elkharrat D, Jars-Guincestre MC, et al.  Trial of normobaric and hyperbaric oxygen for acute carbon monoxide intoxication . Lancet. 1989;;2:414-419.
37 +
Goulon M, Barois A, Rapin M, Nouailhat F, Grosbuis S, Labrousse J.  Carbon monoxide poisoning and acute anoxia . J Hyperbar Med. 1986;;1:23-41.
38 +
Van Unnik AJM.  Inhibition of toxin production in Clostridium perfringens in vitro by hyperbaric oxygen . Antonie von Leeuwenhoek. 1965;;31:181-186.
39 +
Holland JA, Hill GB, Wolfe WG, Osterhout S, Saltzman HA, Brown IW.  Experimental and clinical experience with hyperbaric oxygen in the treatment of clostridial myonecrosis . Surgery. 1975;; 77:75-85.
40 +
Hill GB, Osterhout S.  Experimental effects of hyperbaric oxygen on selected clostridial species, II: in vivo studies in mice . J Infect Dis. 1972;;125:26-35.
41 +
DeMello FJ, Haglin JJ, Hitchcock CR.  Comparative study of experimental Clostridium perfringens infection in dogs treated with antibiotic, surgery, and hyperbaric oxygen . Surgery. 1973;; 73:936-941.
42 +
Gibson A, Davis FM.  Hyperbaric oxygen therapy in the management of Clostridium perfringens infections . N Z Med J. 1986;;99:617-620.
43 +
Hart GB, Lamb RC, Strauss MB.  Gas gangrene, II: a 15-year experience with hyperbaric oxygen . J Trauma. 1983;;23:995-1000.
44 +
Schreiner A, Tonjum S, Digranes A.  Hyperbaric oxygen therapy in Bacteroides infections . Acta Chir Scand. 1974;;140:73-76.
45 +
Bakker DJ.  Necrotizing soft tissue infections . J Hyperbar Med. 1987;;2:161-169.
46 +
Miller JD.  The importance of early diagnosis and surgical treatment of necrotizing faciitis . Surg Gynecol Obstet. 1983;;157:197-200.
47 +
Davis JC, Heckman JD.  Compromised soft tissue wounds . In: Davis JC, Hunt TK, eds. Problem Wounds: The Role of Oxygen. New York, NY: Elsevier Science Publishing Co Inc; 1988;:125-142.
48 +
Loder RE.  Hyperbaric oxygen therapy in acute trauma . Ann R Coll Surg Engl. 1979;;61:472-473.
49 +
Monies-Chass I, Hashmonai M, Hoerer D, Kaufman T, Steiner E, Schramek A.  Hyperbaric oxygen treatment as an adjuvant to reconstructive vascular surgery in trauma . Injury. 1977;;8:274-277.
50 +
Strauss MB, Hargens AR, Gershuni DH, et al.  Reduction of skeletal muscle necrosis using intermittent hyperbaric oxygen in a model compartment syndrome . J Bone Joint Surg Am. 1983;;65:656-662.
51 +
Ewing J.  Radiation osteitis . Acta Radiol. 1926;;6:399-412.
52 +
Marx RE.  Osteoradionecrosis: a new concept of its pathophysiology . J Oral Maxillofac Surg. 1983;; 41:283-288.
53 +
Hunt TK, Dai MP.  The effect of varying ambient oxygen tensions on wound metabolism and collagen synthesis . Surg Gynecol Obstet. 1972;; 135:561-567.
54 +
Marx RE, Johnson RP.  Problem wounds in oral and maxillofacial surgery: the role of hyperbaric oxygen . In: Davis JC, Hunt TK, eds. Problem Wounds: The Role of Oxygen. New York, NY: Elsevier Science Publishing Co Inc; 1988;:65-124.
55 +
Obwegesser HB, Sailer HF.  Experience with intra-oral resection and immediate reconstruction in cases of radio-osteomyelitis of the mandible . J Maxillofac Surg. 1978;;6:257-261.
56 +
Marx RE.  A new concept in the treatment of osteoradionecrosis . J Oral Maxillofac Surg. 1983;; 41:351-357.
57 +
Farmer JC Jr, Sheldon DL, Angelillo JD, Bennett PD, Hudson WR.  Treatment of radiation-induced tissue injury by hyperbaric oxygen . Ann Otol Rhinol Laryngol. 1978;;87:707-715.
58 +
Davis JC, Dunn JM, Gates GA, Heimbach RD.  Hyperbaric oxygen: a new adjunct in the management of radiation necrosis . Arch Otolaryngol Head Neck Surg. 1979;;105:58-61.
59 +
Weiss JP, Boland FP, Mori H, et al.  Treatment of radiation-induced cystitis with hyperbaric oxygen . J Urol. 1985;;134:352-354.
60 +
Ferguson BJ, Hudson WR, Farmer JC Jr.  Hyperbaric oxygen for laryngeal radionecrosis . Ann Otol Rhinol Laryngol. 1987;;96:1-6.
61 +
Marx RE, Johnson RP, Kline SN.  Prevention of osteoradionecrosis: a randomized prospective clinical trial of hyperbaric oxygen versus penicillin . J Am Dent Assoc. 1985;;111:49-54.
62 +
Kraut RA.  Prophylactic hyperbaric oxygen to avoid osteoradionecrosis when extractions follow radiation necrosis . Arch Otolaryngol Head Neck Surg. 1985;;7:17-20.
63 +
Triplett RG, Branham GB, Gillmore JD, Lorber M.  Experimental mandibular osteomyelitis: therapeutic trials with hyperbaric oxygen . J Oral Maxillofac Surg. 1982;;40:640-646.
64 +
Niinikoski J, Penttinen R, Kulonen E.  Effect of hyperbaric oxygen on fracture healing in the rat: a biochemical study . Calcif Tissue Res. 1970;; 4( (suppl) ):115-116.
65 +
Mader JT, Brown GL, Guskian JC.  A mechanism for the amelioration by hyperbaric oxygen of experimental Staphylococcus osteomyelitis in rabbits . J Infect Dis. 1980;;142:915-922.
66 +
Davis JC, Heckman JD, DeLee JC, Buckwold FJ.  Chronic nonhematogenous osteomyelitis treated with adjuvant hyperbaric oxygen . J Bone Joint Surg Am. 1986;;66:1210-1217.
67 +
Strauss MB.  Refractory osteomyelitis . J Hyperbar Med. 1987;;2:146-159.
68 +
Herman DS.  Hyperbaric oxygen therapy and its role in the treatment of chronic osteomylelitis: a preliminary report involving refractory osteomyelitis in the foot . J Foot Surg. 1985;;24:293-300.
69 +
Silver IA.  Local and systemic factors which affect the proliferation of fibroblasts . In: Kulonen E, Pikkarainen J, eds. The Biology of Fibroblast . Orlando, Fla: Academic Press Inc; 1973;:507-520.
70 +
Hohn DC, Ponce B, Burton RW, Hunt TK.  Antimicrobial systems of the surgical wound, I: a comparison of oxidative metabolism and microbicidal capacity of phagocytes from wounds and from periferal blood . Am J Surg. 1977;;133:597-600.
71 +
Kighton D, Silver I, Hunt TK.  Regulation of wound healing angiogenesis: effect of oxygen gradients and inspired oxygen concentration . Surgery. 1981;;90:262-270.
72 +
Wyrick WJ, Mader JT, Butler E, Hulet WH.  Hyperbaric oxygen in treatment of pyoderma gangrenosum . Arch Dermatol. 1978;;114:1232-1233.
73 +
Bass BH.  The treatment of varicose leg ulcers by hyperbaric oxygen . Postgrad Med. 1970;;46:407-408.
74 +
Davis JC, Buckley CJ, Barr PO.  Compromised soft tissue wounds: correction of wound hypoxia . In: Davis JC, Hunt TK, eds. Problem Wounds: The Role of Oxygen. New York, NY: Elsevier Science Publishing Co Inc; 1988;:143-152.
75 +
Korn HN, Wheeler ES, Miller T.  Effect of hyperbaric oxygen on second-degree burn wound healing . Arch Surg. 1977;;112:732-737.
76 +
Cianci P, Lueders H, Lee H, et al.  Adjunctive hyperbaric oxygen reduces the need for surgery in 40-80% burns . J Hyperbar Med. 1988;;3:97-101.
77 +
Wiseman DH, Grossman AR.  Hyperbaric oxygen in the treatment of burns . Crit Care Clin. 1985;;1:129-145.
78 +
Niu AKC, Yang C, Lee HC, Chen SH, Chang LP.  Burns treated with adjunctive hyperbaric oxygen therapy: a comparative study in humans . J Hyperbar Med. 1987;;2:75-85.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Hyperbaric Oxygen Therapy: A Committee Report . Bethesda, Md: Undersea and Hyperbaric Medical Society; 1986;.
2 +
Francis TJ, Dutka AJ, Hallenbeck JM.  Pathophysiology of decompression sickness . In: Bove AA, Davis JC, eds. Diving Medicine . Philadelphia, Pa: WB Saunders Co; 1990;:170-187.
3 +
Gabb G, Robin ED.  Hyperbaric oxygen: a therapy in search of diseases . Chest. 1987;;92:1074-1082.
4 +
Boerema I, Meyne NG, Brummelkamp WK, et al.  Life without blood: a study of the influence of high atmospheric pressure and hypothermia on dilution of blood . J Cardiovasc Surg. 1960;;1:133-146.
5 +
Tally FP, Stewart PR, Sutter VL, Rosenblatt JE.  Oxygen tolerance of fresh clinical anaerobic bacteria . J Clin Microbiol. 1975;;1:161-164.
6 +
Badwey JA, Karnovsky ML.  Active oxygen species and the functions of phagocytic leukocytes . Ann Rev Biochem. 1980;;49:695-726.
7 +
Forman HJ, Thomas MJ.  Oxidant production and bactericidal activity of phagocytes . Ann Rev Physiol. 1986;;48:669-680.
8 +
Hohn DC, MacKay RD, Halliday B, Hunt TK.  The effect of O2 tension on the microbicidal function of leukocytes in wounds and in vitro . Surg Forum. 1976;;27:18-20.
9 +
Knighton DR, Halliday B, Hunt TK.  Oxygen as an antibiotic: the effect of inspired oxygen on infection . Arch Surg. 1984;;119:199-204.
10 +
Risber J, Tyssebotn I.  Hyperbaric exposure to a 5 ATA He-N2-O2 atmosphere affects the cardiac function and organ blood flow distribution in awake trained rats . Undersea Biomed Res. 1986;;13:77-90.
11 +
Nylander G, Lewis D, Nordstrom H, Larsson J.  Reduction of postischemic edema with hyperbaric oxygen . Plast Reconstr Surg. 1985;;76:596-601.
12 +
Bassett BE, Bennett PB.  Introduction to the physical and physiological bases of hyperbaric therapy . In: Davis JC, Hunt TK, eds. Hyperbaric Oxygen Therapy . Bethesda, Md: Undersea and Hyperbaric Medical Society; 1977;:11-24.
13 +
Bond GF.  Arterial gas embolism . In: Davis JC, Hunt, TK, eds. Hyperbaric Oxygen Therapy . Bethesda, Md: Undersea and Hyperbaric Medical Society; 1977;:141-152.
14 +
Davis JC, Dunn JM, Heimbach RD.  Hyperbaric medicine: patient selection, treatment procedures, and side effects . In: Davis JC, Hunt TK, eds. Problem Wounds: The Role of Oxygen . New York, NY: Elsevier Science Publishing Co Inc; 1988;:225-235.
15 +
Clark JM, Lambertson CJ.  Pulmonary oxygen toxicity: a review . Pharmacol Rev. 1971;;23:37-133.
16 +
Nichols CW, Lambertsen CJ.  Effects of high oxygen pressures on the eye . N Engl J Med. 1969;;291:25-30.
17 +
Palmquist BM, Phillipson B, Barr PO.  Nuclear cataract and myopia during hyperbaric oxygen therapy . Br J Ophthalmol. 1984;;68:113-117.
18 +
Kindwall EP, Goldman RW, eds. Hyperbaric Medical Procedures . Milwaukee, Wis: Saint Lukes Medical Center; 1988;.
19 +
Lynch PR, Brigham M, Tuma R, Wiedeman MP.  Origin and time course of gas bubbles following rapid decompression in the hamster . Undersea Biomed Res. 1985;;12:105-114.
20 +
Whitecraft DD, Karas S.  Air embolism and decompression sickness in scuba divers . JACEP. 1976;;5:355-361.
21 +
Tanoue K, Mano Y, Kuroiwa K, Suzuki H, Shibayama M, Yamazaki H.  Consumption of platelets in decompression sickness of rabbits . J Appl Physiol. 1987;;62:1772-1779.
22 +
Kizer KW.  Delayed treatment of dysbarism: a retrospective review of 50 cases . JAMA. 1982;; 247:2555-2558.
23 +
Green RD, Leitch DR.  Twenty years of treating decompression sickness . Aviat Space Environ Med. 1987;;58:362-366.
24 +
Thomatis L, Nemiroff M, Riahi M, et al.  Massive arterial air embolism due to rupture of pulsatile assist device: successful treatment in the hyperbaric chamber . Ann Thorac Surg. 1981;;32:604-608.
25 +
Peirce EC II.  Specific therapy for arterial air embolism . Ann Thorac Surg. 1980;;29:300-303.
26 +
Cianci P, Posin JP, Shimshak RR, Singzon J.  Air embolism complicating percutaneous thin needle biopsy of lung . Chest. 1987;;92:749-750.
27 +
Baskin FE, Wozniak RL.  Hyperbaric oxygenation in the treatment of hemodialysis associated air embolism . NEngl J Med. 1975;;293:184-185.
28 +
Murphy BP, Hartford FJ, Cramer FS.  Cerebral air embolism resulting from invasive medical procedures: treatment with hyperbaric oxygen . Ann Surg. 1985;;201:242-245.
29 +
Myers RAM, Snyder SK, Linberg S, Cowley RA.  Value of hyperbaric oxygen in suspected carbon monoxide poisoning . JAMA. 1981;;246:2478-2480.
30 +
Norkool DM, Kirkpatrick JN.  Treatment of acute carbon monoxide poisoning with hyperbaric oxygen: a review of 115 cases . Ann Emerg Med. 1985;;14:1168-1171.
31 +
Goldbaum LR, Ramirez RG, Absalom KB.  What is the mechanism of carbon monoxide toxicity? Aviat Space Environ Med. 1975;;46:1289-1291.
32 +
Jackson DL, Menges H.  Accidental carbon monoxide poisoning . JAMA. 1980;;243:772-774.
33 +
Kindwall EP.  Carbon monoxide poisoning treated with hyperbaric oxygen . Respir Ther. 1975;;5:29-33.
34 +
Peterson JE, Stewart RD.  Absorption and elimination of carbon monoxide by inactive young men . Arch Environ Health. 1970;;21:165-175.
35 +
Kindwall EP.  Carbon monoxide and cyanide poisoning . In: Davis JC, Hunt TK, eds. Problem Wounds: The Role of Oxygen. New York, NY: Elsevier Science Publishing Co Inc; 1988;:177-190.
36 +
Raphael JC, Elkharrat D, Jars-Guincestre MC, et al.  Trial of normobaric and hyperbaric oxygen for acute carbon monoxide intoxication . Lancet. 1989;;2:414-419.
37 +
Goulon M, Barois A, Rapin M, Nouailhat F, Grosbuis S, Labrousse J.  Carbon monoxide poisoning and acute anoxia . J Hyperbar Med. 1986;;1:23-41.
38 +
Van Unnik AJM.  Inhibition of toxin production in Clostridium perfringens in vitro by hyperbaric oxygen . Antonie von Leeuwenhoek. 1965;;31:181-186.
39 +
Holland JA, Hill GB, Wolfe WG, Osterhout S, Saltzman HA, Brown IW.  Experimental and clinical experience with hyperbaric oxygen in the treatment of clostridial myonecrosis . Surgery. 1975;; 77:75-85.
40 +
Hill GB, Osterhout S.  Experimental effects of hyperbaric oxygen on selected clostridial species, II: in vivo studies in mice . J Infect Dis. 1972;;125:26-35.
41 +
DeMello FJ, Haglin JJ, Hitchcock CR.  Comparative study of experimental Clostridium perfringens infection in dogs treated with antibiotic, surgery, and hyperbaric oxygen . Surgery. 1973;; 73:936-941.
42 +
Gibson A, Davis FM.  Hyperbaric oxygen therapy in the management of Clostridium perfringens infections . N Z Med J. 1986;;99:617-620.
43 +
Hart GB, Lamb RC, Strauss MB.  Gas gangrene, II: a 15-year experience with hyperbaric oxygen . J Trauma. 1983;;23:995-1000.
44 +
Schreiner A, Tonjum S, Digranes A.  Hyperbaric oxygen therapy in Bacteroides infections . Acta Chir Scand. 1974;;140:73-76.
45 +
Bakker DJ.  Necrotizing soft tissue infections . J Hyperbar Med. 1987;;2:161-169.
46 +
Miller JD.  The importance of early diagnosis and surgical treatment of necrotizing faciitis . Surg Gynecol Obstet. 1983;;157:197-200.
47 +
Davis JC, Heckman JD.  Compromised soft tissue wounds . In: Davis JC, Hunt TK, eds. Problem Wounds: The Role of Oxygen. New York, NY: Elsevier Science Publishing Co Inc; 1988;:125-142.
48 +
Loder RE.  Hyperbaric oxygen therapy in acute trauma . Ann R Coll Surg Engl. 1979;;61:472-473.
49 +
Monies-Chass I, Hashmonai M, Hoerer D, Kaufman T, Steiner E, Schramek A.  Hyperbaric oxygen treatment as an adjuvant to reconstructive vascular surgery in trauma . Injury. 1977;;8:274-277.
50 +
Strauss MB, Hargens AR, Gershuni DH, et al.  Reduction of skeletal muscle necrosis using intermittent hyperbaric oxygen in a model compartment syndrome . J Bone Joint Surg Am. 1983;;65:656-662.
51 +
Ewing J.  Radiation osteitis . Acta Radiol. 1926;;6:399-412.
52 +
Marx RE.  Osteoradionecrosis: a new concept of its pathophysiology . J Oral Maxillofac Surg. 1983;; 41:283-288.
53 +
Hunt TK, Dai MP.  The effect of varying ambient oxygen tensions on wound metabolism and collagen synthesis . Surg Gynecol Obstet. 1972;; 135:561-567.
54 +
Marx RE, Johnson RP.  Problem wounds in oral and maxillofacial surgery: the role of hyperbaric oxygen . In: Davis JC, Hunt TK, eds. Problem Wounds: The Role of Oxygen. New York, NY: Elsevier Science Publishing Co Inc; 1988;:65-124.
55 +
Obwegesser HB, Sailer HF.  Experience with intra-oral resection and immediate reconstruction in cases of radio-osteomyelitis of the mandible . J Maxillofac Surg. 1978;;6:257-261.
56 +
Marx RE.  A new concept in the treatment of osteoradionecrosis . J Oral Maxillofac Surg. 1983;; 41:351-357.
57 +
Farmer JC Jr, Sheldon DL, Angelillo JD, Bennett PD, Hudson WR.  Treatment of radiation-induced tissue injury by hyperbaric oxygen . Ann Otol Rhinol Laryngol. 1978;;87:707-715.
58 +
Davis JC, Dunn JM, Gates GA, Heimbach RD.  Hyperbaric oxygen: a new adjunct in the management of radiation necrosis . Arch Otolaryngol Head Neck Surg. 1979;;105:58-61.
59 +
Weiss JP, Boland FP, Mori H, et al.  Treatment of radiation-induced cystitis with hyperbaric oxygen . J Urol. 1985;;134:352-354.
60 +
Ferguson BJ, Hudson WR, Farmer JC Jr.  Hyperbaric oxygen for laryngeal radionecrosis . Ann Otol Rhinol Laryngol. 1987;;96:1-6.
61 +
Marx RE, Johnson RP, Kline SN.  Prevention of osteoradionecrosis: a randomized prospective clinical trial of hyperbaric oxygen versus penicillin . J Am Dent Assoc. 1985;;111:49-54.
62 +
Kraut RA.  Prophylactic hyperbaric oxygen to avoid osteoradionecrosis when extractions follow radiation necrosis . Arch Otolaryngol Head Neck Surg. 1985;;7:17-20.
63 +
Triplett RG, Branham GB, Gillmore JD, Lorber M.  Experimental mandibular osteomyelitis: therapeutic trials with hyperbaric oxygen . J Oral Maxillofac Surg. 1982;;40:640-646.
64 +
Niinikoski J, Penttinen R, Kulonen E.  Effect of hyperbaric oxygen on fracture healing in the rat: a biochemical study . Calcif Tissue Res. 1970;; 4( (suppl) ):115-116.
65 +
Mader JT, Brown GL, Guskian JC.  A mechanism for the amelioration by hyperbaric oxygen of experimental Staphylococcus osteomyelitis in rabbits . J Infect Dis. 1980;;142:915-922.
66 +
Davis JC, Heckman JD, DeLee JC, Buckwold FJ.  Chronic nonhematogenous osteomyelitis treated with adjuvant hyperbaric oxygen . J Bone Joint Surg Am. 1986;;66:1210-1217.
67 +
Strauss MB.  Refractory osteomyelitis . J Hyperbar Med. 1987;;2:146-159.
68 +
Herman DS.  Hyperbaric oxygen therapy and its role in the treatment of chronic osteomylelitis: a preliminary report involving refractory osteomyelitis in the foot . J Foot Surg. 1985;;24:293-300.
69 +
Silver IA.  Local and systemic factors which affect the proliferation of fibroblasts . In: Kulonen E, Pikkarainen J, eds. The Biology of Fibroblast . Orlando, Fla: Academic Press Inc; 1973;:507-520.
70 +
Hohn DC, Ponce B, Burton RW, Hunt TK.  Antimicrobial systems of the surgical wound, I: a comparison of oxidative metabolism and microbicidal capacity of phagocytes from wounds and from periferal blood . Am J Surg. 1977;;133:597-600.
71 +
Kighton D, Silver I, Hunt TK.  Regulation of wound healing angiogenesis: effect of oxygen gradients and inspired oxygen concentration . Surgery. 1981;;90:262-270.
72 +
Wyrick WJ, Mader JT, Butler E, Hulet WH.  Hyperbaric oxygen in treatment of pyoderma gangrenosum . Arch Dermatol. 1978;;114:1232-1233.
73 +
Bass BH.  The treatment of varicose leg ulcers by hyperbaric oxygen . Postgrad Med. 1970;;46:407-408.
74 +
Davis JC, Buckley CJ, Barr PO.  Compromised soft tissue wounds: correction of wound hypoxia . In: Davis JC, Hunt TK, eds. Problem Wounds: The Role of Oxygen. New York, NY: Elsevier Science Publishing Co Inc; 1988;:143-152.
75 +
Korn HN, Wheeler ES, Miller T.  Effect of hyperbaric oxygen on second-degree burn wound healing . Arch Surg. 1977;;112:732-737.
76 +
Cianci P, Lueders H, Lee H, et al.  Adjunctive hyperbaric oxygen reduces the need for surgery in 40-80% burns . J Hyperbar Med. 1988;;3:97-101.
77 +
Wiseman DH, Grossman AR.  Hyperbaric oxygen in the treatment of burns . Crit Care Clin. 1985;;1:129-145.
78 +
Niu AKC, Yang C, Lee HC, Chen SH, Chang LP.  Burns treated with adjunctive hyperbaric oxygen therapy: a comparative study in humans . J Hyperbar Med. 1987;;2:75-85.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems