Van Meter Keith W
Section of Emergency Medicine, Department of Medicine, LSU School of Medicine, New Orleans, LA, United States.
Front Med (Lausanne). 2024 Oct 8;11:1408816. doi: 10.3389/fmed.2024.1408816. eCollection 2024.
For short periods, even without the presence of red blood cells, hyperbaric oxygen can safely allow plasma to meet the oxygen delivery requirements of a human at rest. By this means, hyperbaric oxygen, in special instances, may be used as a bridge to lessen blood transfusion requirements. Hyperbaric oxygen, applied intermittently, can readily avert oxygen toxicity while meeting the body's oxygen requirements. In acute injury or illness, accumulated oxygen debt is shadowed by adenosine triphosphate debt. Hyperbaric oxygen efficiently provides superior diffusion distances of oxygen in tissue compared to those provided by breathing normobaric oxygen. Intermittent application of hyperbaric oxygen can resupply adenosine triphosphate for energy for gene expression and reparative and anti-inflammatory cellular function. This advantageous effect is termed the hyperbaric oxygen paradox. Similarly, the normobaric oxygen paradox has been used to elicit erythropoietin expression. Referfusion injury after an ischemic insult can be ameliorated by hyperbaric oxygen administration. Oxygen toxicity can be averted by short hyperbaric oxygen exposure times with air breaks during treatments and also by lengthening the time between hyperbaric oxygen sessions as the treatment advances. Hyperbaric chambers can be assembled to provide everything available to a patient in modern-day intensive care units. The complication rate of hyperbaric oxygen therapy is very low. Accordingly, hyperbaric oxygen, when safely available in hospital settings, should be considered as an adjunct for the management of critically injured or ill patients with disabling anemia.
在短时间内，即使没有红细胞存在，高压氧也能安全地使血浆满足人体静息时的氧输送需求。通过这种方式，在特殊情况下，高压氧可作为一种桥梁来减少输血需求。间歇性应用高压氧，在满足身体氧需求的同时能轻易避免氧中毒。在急性损伤或疾病中，累积的氧债伴随着三磷酸腺苷债。与常压吸氧相比，高压氧能有效地在组织中提供更长的氧扩散距离。间歇性应用高压氧可为基因表达以及修复和抗炎细胞功能的能量供应补充三磷酸腺苷。这种有利效应被称为高压氧悖论。同样，常压氧悖论已被用于引发促红细胞生成素的表达。缺血性损伤后的再灌注损伤可通过给予高压氧来改善。通过在治疗期间进行短暂的高压氧暴露并间隔空气时段，以及随着治疗进展延长高压氧治疗疗程之间的时间间隔，可避免氧中毒。高压氧舱可以组装成能提供现代重症监护病房中患者所需的一切条件。高压氧治疗的并发症发生率非常低。因此，当医院环境中安全可用时，高压氧应被视为管理严重受伤或患有致残性贫血的重症患者的辅助手段。
