HBOT is probably most underutilized in problems effecting infants. If a child has any kind of injury, brain or otherwise, HBOT should be the first choice and should be used as soon as possible. Treating early will prevent a huge number of problems later in the child’s life. I am always saddened to see older children and adults with health problems that could have been avoided had they received HBOT at an early age. Note that many of the studies listed below were done in other countries, where HBOT is used much more frequently than in the U.S. for these issues.
HBOT in treatment of fetal growth deficiencies
Hyperbaric oxygen is really important in the sanitary emergency of acute care, in which its role is best defined. Present indications in obstetric pathology date back to about 15 years ago, when some soviet authors (1,4,8,9,11,13), for the first time tried to treat with HBO both acute hypoxia in labor and fetal growth delay due to placental insufficiency. Other researchers as well as ourselves proved that for this kind of affection, HBO is irreplaceable in improving both placental blood flow and O2 diffusion at the cellular level. In fact, the indications of HBO in pregnancy are represented by events with a different pathogenesis which interfere with normal supply of O2 to the fetus: some affections exist earlier than pregnancy and some others a rise as a result of pregnancy itself. Other indications depend on morbid moments close to the various apparatus of the pregnant woman’s organism (Table 1).
Table 1. HBO indications during pregnancy
a.. Hypochromic or hemolytic anemia
b.. Uterine pathology involving a reduction of the placental implantation surface
c.. Cardiopathy of various origin and cyanogen
d.. Pulmonary lesions HBO-compatible
a.. Hypertensive preeclampsia syndrome
b.. Placental alterations reducing the exchanging function between the fetus/placenta
Intercurrent pathogenic causes
Various affections: atonic ulcer, wound-healing delay, badly united fractures, etc.
Carbon monoxide intoxication, etc.
1.. Aksenova T.A.: “L’impiego dell’O.T.I. nel trattamento della sindrome ipossica in gravidanza.” Akush. Y. Ginecol. 6, 1979.
2.. Arduini D. et al.: “Fetal haemodynamic response to acute maternal hyperoxygenation as predictor of fetal distress in intrauterine growth retardation.” B.M.J. vol. 298, June 1989.
3.. Arduini D. et al.: “Short term effects of maternal oxygen administration of blood flow velocity waveform healthy and growth-retarded fetus.” Am. J. Obstet. Gynec., 159, 1077-80, 1988.
4.. Bakkevig M.K., et al.: “Diving during pregnancy.” Proceeding of the Annual Meeting of the EUBS. Eilat, Israel, pp. 137-142, 1989.
5.. Bird A.D., Tefler M.B.: “Effect of hyperbaric oxygen on limb circulation.” Lancet, 1, 355, 1965.
6.. Luongo C., Balbi C., Vicario C. et al.: “Primi risultati sull’applicazione dell’ossigenoterapia iperbarica nei ritardi di crescita e sofferenza fetale.” Atti del 43° Congresso Nazionale S.I.A.A.R.T.I., Modena 8-11 giugno, 1990.
7.. Maneschi M.: “Comunicazione personale.” 1987.
8.. Mozalninov E.V., et al.: “L’ossigenazione iperbarica in ostetricia e neonatologia.” Atti 7° Cong. Intern. Med. Iperb., 49, Mosca 1981.
9.. Nicolaides K.H. et. al.: “Maternal oxygen therapy for intrauterine growth retardation.” Lancet, april 25, 1987.
10.. Oppo G.T., Ficini M., Oppo G.M.: “Proposta di impiego dell’ossigeno-terapia iperbarica (O.T.I.) in patologia ostetrica.” Riv. Ost. Gin. Perin. 4, 370, 1988.
11.. Petrovsckij B.V., Efuni S.N.: “L’O.T.I. in ostetricia e neonatologia.” Atti 7° Congr. Int. Med. Iper., 5, Mosca, 1981.
12.. Sansone A., Sparacia B.: “Short notes on HBO and cerebral blood flow dtermination in the ischemic brain damage.” Minerva Anestesiologica, Vol. 59, Suppl. 1 N° 10, pp. 449-451, Ottobre 1993.
13.. Sparacia A., Sparacia B.: “Recenti acquisizioni fisiologiche sull’ossigeno in iperbarismo.” Minerva Anestesiologica, 57, 187-204, 1991.
14.. Sparacia B., et coll.: “Nota preliminare sul trattamento dell’eclampsia con O.T.I.” Acta Chirurgica Mediterranea, 6: 5, 1990.
15.. Sparacia B., Sansone A., Sparacia G.V.: “Short notes on HBO and cerebral blood flow dtermination in the ischemic brain damage.” XIXth Annual Meeting of EUBS on diving and Hyperbaric Medicine in Trondheim, Norway 17-20 August, pp. 221-224, 1993.
16.. Sparacia B., Sansone A.: “Osteoporosi e fratture. (Sull’azione preventiva dell’Ossigenoterapia Iperbarica e contemporanea somministrazione di calcitonina spray nasale.)” In corso di stampa su Archivio Siciliano di Medicina e Chirurgia.
17.. Sparacia B., Sansone A.: “Possibilità applicative dell’ossiiperbaroterapia nel trattamento delle sindromi preeclamptiche.” Minerva Anestesiologica, Vol. 59, Suppl. 1 N° 10, pp. 463-465, Ottobre 1993.
18.. Sparacia B., Sparacia G.V., Sansone A.: “Hyperbaric oxygen theraphy in the treatment of postmenopausal osteoporosis.” XI International Congress on Hyperbaric Medicine. September 6-10, 1993, Fuzhon, China.
19.. Sparacia B., Sparacia G.V., Sansone A.: “Hyperbaric oxygen therapy in the treatment of postmenopausal osteoporosis.” XIXth Annual Meeting of EUBS on diving and Hyperbaric Medicine in Trondheim, Norway 17-20 August, pp. 207-208, 1993.
20.. Sparacia B., Sansone A., Sparacia G.V., Di Chiara A.: “L’O.T.I. nel trattamento dei ritardi di accrescimento fetale.” Acta Pediatrica Mediterranea 8, 23-26, 1992.
21.. Sparacia B., Sparacia G.V.: “H.B.O. in the treatment of delayed fetal growth.” Recent Advances in Anaesthesia, Pain, Intensive Care and Emergency, 210-217, 1991.
22.. Sparacia B., Sparacia G.V., Sansone A.: “L’Ossigeno Terapia Iperbarica nel trattamento dell’osteoporosi post-menopausale.” Minerva Anestesiologica, Vol. 59, Suppl. 2 N° 10, p. 129, Ottobre 1993.
23.. Stepanyants N.A., et al.: “L’O.T.I. nel trattamento globale delle gestosi tardive.” Atti 7° Cong. Int. HBO Med., 359, Mosca 1981.