[abstract] HYPERBARIC OXYGEN: WHAT IS THE CORRECT DOSE?

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[abstract] HYPERBARIC OXYGEN: WHAT IS THE CORRECT DOSE?

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Title: [abstract] HYPERBARIC OXYGEN: WHAT IS THE CORRECT DOSE?
Author: Sheffield, P
Abstract: Introduction: The purpose of this presentation is to describe how the Davis 2.36 ATA Wound Healing Treatment Table was established (1). It was created in 1974 at the USAF Hyperbaric Center at Brooks AFB, Texas, under the direction of Col Jefferson C. Davis, MD, and implemented for the purpose of determining if there was a role for hyperbaric oxygen (HBO2) in the treatment of war related injuries (2). Methods: The Davis 2.36 ATA Wound Healing Treatment Table consisted of intermittent oxygen administered by mask at 2.36 ata (45 fsw) for 90 min. The 90-min duration was chosen based on the original work of Boerema and associates who used 90-min HBO2 at 3 ata for treating gas gangrene (3). However, the Boerema Gas Gangrene Protocol was ruled out for wound healing enhancement because the risk of CNS oxygen toxicity at 3 ata was unacceptable. There were several HBO2 physiological studies in Europe and North America that suggested a treatment pressure of at least 2 ata. Based on mass spec studies of the oxygen mask delivery system, Davis felt that a pressure above 2 ata should be selected because patients with facial deformities or improperly fitted masks might not receive 100% oxygen (4). He initially chose 2.5 ata (49.5 fsw) but the chamber pressure gauge made it difficult for the chamber operator so the pressure was backed off to 45 fsw (2.36 ata) to reduce the risk of decompression sickness in inside attendants. Intermittent air breaks (20 min O2, 5 min air) were given to reduce the risk of pulmonary oxygen toxicity (5). Initially, 5-min air breaks were based on the US Navy treatment tables. When the Duke Hood Oxygen Assembly was introduced in 1976, the intermittent air breaks became 10 min in duration (30 min O2, 10 min air). Conclusion: Over the years, the Davis Wound Healing Protocol has become the standard for multiplace hyperbaric facilities. References: 1. Sheffield PJ. How the Davis 2.36 ATA wound healing enhancement treatment table was established. Undersea Hyperb Med. 2004; 31(2):193-4. 2. Davis JC, Sheffield, PJ. Hyperbaric Oxygen Therapy. Medical Service Digest, 1976; 27(5):5-11. 3. Brummelkamp WH, Hogendijk L, Boerema I. Treatment of anaerobic infections (clostridial myositis) by drenching the tissues with oxygen under high atmospheric pressure. Surgery, 1961; 49:299-302. 4. Sheffield PJ, Stork RL, Morgan TR. Efficient oxygen mask for patients undergoing hyperbaric oxygen therapy. Aviat, Space & Environ Med, 1977;48(2): 132-137. 5. Hendricks PL, Hall DA, Hunter WH Jr, Haley PJ. Extension of pulmonary oxygen toxicity in man at 2 ata by intermittent oxygen exposure. J Appl Physiol 1977;42:593-599. __________________________________ Neil Hampson, MD Virginia Mason Medical Center, Seattle, WA
Description: Abstract of the Undersea and Hyperbaric Medical Society, Inc. Annual Scientific Meeting, St Pete Beach, Florida, USA. (http://www.uhms.org)
URI: http://archive.rubicon-foundation.org/9287
Date: 2010

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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