Tenenhaus M, Hansbrough J F, Zapata-Sirvent R, Neumann T
Department of Surgery, University of California, San Diego Medical Center.
Arch Surg. 1994 Dec;129(12):1338-42. doi: 10.1001/archsurg.1994.01420360128018.
Hyperbaric oxygen (HBO) is used but unproven for many conditions, including burns. We hypothesized that HBO therapy might increase oxygen delivery to intestine during burn shock and decrease mucosal injury.
University research laboratory.
We studied the effects of HBO therapy (100% oxygen at 2.4 atm absolute) on mesenteric bacterial colonies (MBCs) in mice following 32% total body surface area burns. MBCs were counted 24 or 48 hours postburn by culturing mesenteric tissue. Intestinal histologic features were examined, acid-base balance was measured, and pulmonary neutrophil deposition was estimated by lung myeloperoxidase content.
HBO delivered in a compression chamber.
Numbers of mice with MBCs.
With twice-daily HBO treatments, each treatment lasting 1.5 or 2 hours, fewer burned mice had MBCs. Three HBO treatments within 24 hours produced seizures, death, and increased numbers of mice with MBCs. Numbers of mice with MBCs were not influenced when compressed air (2.4 atm absolute) or 100% oxygen (1 atm absolute) was used. Villus histologic findings showed less damage in burned mice that received HBO therapy than in controls. Metabolic acidosis was not affected by HBO therapy, nor were lung myeloperoxidase levels.
HBO therapy was associated with reduced numbers of mice with MBCs after burn injury and reduced histologic evidence of mucosal damage, but lung myeloperoxidase levels and metabolic acidosis were not affected. HBO therapy may increase oxygen delivery to ischemic intestine and improve cellular metabolism; alternatively, increased tissue oxygen may augment killing of translocated bacteria by phagocytic cells. HBO deserves further investigation for burn treatment, but because of the narrow therapeutic window and continued neutrophil sequestration in the lungs, we should proceed cautiously.
高压氧（HBO）被用于多种病症，包括烧伤，但尚未得到证实。我们推测HBO疗法可能会增加烧伤休克期间肠道的氧气输送，并减少黏膜损伤。
大学研究实验室。
我们研究了HBO疗法（绝对压力2.4个大气压下的100%氧气）对全身表面积32%烧伤小鼠肠系膜细菌菌落（MBC）的影响。通过培养肠系膜组织在烧伤后24或48小时对MBC进行计数。检查肠道组织学特征，测量酸碱平衡，并通过肺髓过氧化物酶含量估计肺中性粒细胞沉积。
在加压舱内给予HBO。
有MBC的小鼠数量。
每天进行两次HBO治疗，每次治疗持续1.5或2小时，有MBC的烧伤小鼠数量减少。24小时内进行三次HBO治疗会导致癫痫发作、死亡以及有MBC的小鼠数量增加。使用压缩空气（绝对压力2.4个大气压）或100%氧气（绝对压力1个大气压）时，有MBC的小鼠数量不受影响。绒毛组织学检查结果显示，接受HBO治疗的烧伤小鼠比对照组的损伤更小。HBO疗法对代谢性酸中毒没有影响，对肺髓过氧化物酶水平也没有影响。
HBO疗法与烧伤后有MBC的小鼠数量减少以及黏膜损伤的组织学证据减少有关，但肺髓过氧化物酶水平和代谢性酸中毒不受影响。HBO疗法可能会增加向缺血肠道的氧气输送并改善细胞代谢；或者，增加的组织氧可能会增强吞噬细胞对易位细菌的杀伤作用。HBO在烧伤治疗方面值得进一步研究，但由于治疗窗狭窄且肺部持续存在中性粒细胞隔离，我们应谨慎进行。
