Department of Diving and Hyperbaric Medicine, Prince of Wales Hospital and University of New South Wales, Sydney, New South Wales, Australia.
Department of Anaesthesiology, University of Auckland Faculty of Medicine, Auckland, New Zealand.
Curr Opin Anaesthesiol. 2019 Dec;32(6):792-798. doi: 10.1097/ACO.0000000000000773.
To identify and discuss emerging trends in the therapeutic use of hyperbaric oxygen.
There has been a maturing of the clinical evidence to support the treatment of sudden hearing loss, a wide range of problematic chronic wound states and the prevention and treatment of end-organ damage associated with diabetes mellitus. On the other hand, the controversy continues concerning the use of hyperbaric oxygen therapy (HBOT) to treat sequelae of mild traumatic brain injury. HBOT remains poorly understood by many medical practitioners despite more than 50 years of clinical practice. Pharmacological actions arise from increased pressures of oxygen in the blood and tissues. Most therapeutic mechanisms identified are not the simple result of the reoxygenation of hypoxic tissue, but specific effects on immunological and metabolic pathways by this highly reactive element. HBOT remains controversial despite biological plausibility and a solid clinical evidence base in several disease states.
Multiple proposals for new indications for HBOT continue to emerge. Although many of these will likely prove of limited clinical importance, some show significant promise. Responsible practitioners remain acutely aware of the need for high-quality clinical evidence before introducing emerging indications into routine practice.
确定并讨论高压氧治疗应用的新趋势。
高压氧治疗突发性耳聋、多种慢性难愈性创面以及预防和治疗糖尿病相关终末器官损伤的临床证据不断成熟。另一方面，关于高压氧治疗（HBOT）治疗轻度创伤性脑损伤后遗症的争议仍在继续。尽管 HBOT 已经有 50 多年的临床实践，但仍有许多医学从业者对其知之甚少。其药理作用源于血液和组织中氧气压力的增加。大多数已确定的治疗机制并非简单地使缺氧组织再氧化，而是这种高反应性元素对免疫和代谢途径的特定影响。尽管生物学上有其合理性，且在多种疾病状态下有坚实的临床证据基础，但 HBOT 仍然存在争议。
HBOT 的新适应证不断涌现。尽管其中许多可能证明临床意义有限，但有些具有显著的应用前景。负责任的从业者在将新适应证引入常规实践之前，仍然敏锐地意识到需要高质量的临床证据。
Zotero 插件