Hyperbaric Oxygen: Applications in Infectious Disease

Kaide, Colin G.; Khandelwal, Sorabh

doi:10.1016/j.emc.2008.01.005

Cited by 93 publications

(45 citation statements)

References 59 publications

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“…When the difference was significant, it was performed tests of multiple comparison (Tukey Test) to identify the differences (Table 2). The peritoneum infection is one of the main factors that interfere in the cicatrization of anastomosis performed in colon 28,29,31,35,36 .…”

Section: Discussionmentioning

confidence: 99%

Hyperbaric oxygen therapy and mechanical resistence of the colonics anastomosis in rats with peritonitis

et al. 2010

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Purpose:To analyze the effects of hyperbaric oxygen therapy (HBO) on the mechanical resistance of anastomosis performed in rats' distal colon presenting peritonitis induced by ligature and cecal punction using the Total Energy Rupture biomechanical test (ETR). Methods: It was used 45 rats divided into three groups of 15 animals each. In Control Group (CG), it was performed anastomosis in distal colon without peritonitis. In Peritonitis Group (PG), it was performed anastomosis six hours after the induction of peritonitis by ligature and cecal punction. In Hyperbaric Chamber Group (HCG), it was performed six hours after the induction of peritonitis by ligature and cecal punction. The animals on CG and PG were kept at place air while the animals on HCG were placed on an experimental hyperbaric chamber in order to inhale oxygen at 100%, two absolute atmospheres, for 120 minutes, for four consecutive days. Euthanasia took place on the fifth day of the experiment. All the animals underwent to Total Energy Rupture Biomechanical Resistance test (ETR). Total Energy Rupture was defined as the necessary internal energy stored up to promote the colon rupture after an external traction force imposition. Results: The Peritonitis Group presents smaller average ETR than Control Group. There was no statistical difference between Peritonitis Group and Hyberbaric Chamber Group. Conclusion: Hyperbaric oxygen therapy did not alter the mechanical resistance of anastomosis performed in distal colon of rats under the presence of peritonitis induced by ligature and cecal puncture. Key words: Anastomosis, Surgical. Colon. Hyperbaric Oxygenation. Peritonitis. Rats. RESUMO Objetivo:Analisar o efeito da oxigenoterapia hiperbárica (HBO) sobre a resistência mecânica de anastomoses realizadas em cólon distal de ratos na presença de peritonite induzida por ligadura e punção cecal utilizando o teste biomecânico de Energia Total de Ruptura (ETR). Métodos: Foram utilizados 45 ratos distribuídos em três grupos de 15 animais. No Grupo Controle (GC), realizou-se anastomose no cólon distal sem peritonite. No Grupo Peritonite (GP), realizou-se anastomose seis horas após a indução da peritonite por ligadura e punção cecal. No Grupo Câmara Hiperbárica (GCH), realizou-se anastomose seis horas após a indução da peritonite por ligadura e punção cecal. Os animais dos GC e GP foram mantidos em ar ambiente. Os animais do GCH foram colocados em uma câmara hiperbárica experimental para inalarem oxigênio a 100%, a duas atmosferas absolutas, durante 120 minutos, por quatro dias consecutivos. A eutanásia ocorreu no quinto dia do experimento. Todos os animais foram submetidos ao Teste de Resistência Biomecânico Energia Total de Ruptura (ETR). A Energia Total de Ruptura foi definida como a energia interna acumulada necessária para promover o rompimento do cólon após a imposição de uma força externa de tração. Resultados: O Grupo Peritonite apresentou menor média de ETR que o Grupo Controle. Não houve diferença estatística entre o Grupo Peritonite e o Grupo C...

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Section: Discussionmentioning

confidence: 99%

Hyperbaric oxygen therapy and mechanical resistence of the colonics anastomosis in rats with peritonitis

et al. 2010

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“…In addition, high concentrations of oxygen can inhibit the growth of Mucorales in vitro and improve the rate of wound healing by increasing the release of tissue growth factors. 67 However, this treatment has not been studied vigorously to determine efficacy and cannot be routinely recommended. Immune augmentation strategies are also considered in patients with refractory mycormycosis, including administration of cytokines (eg, granulocyte-macrophage colony-stimulating factor, interferon-␥).…”

Section: Adjunct Treatmentsmentioning

confidence: 99%

How I treat mucormycosis

Kontoyiannis

Lewis

2011

Blood

316

311

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Unlike invasive aspergillosis, the prognosis and outcome of hematologic malignancy patients who develop invasive mucormycosis have not significantly improved over the past decade as a majority of patients who develop the infection still die 12 weeks after diagnosis. However, early recognition and treatment of invasive mucormycosis syndromes, as well as individualized approaches to treatment and secondary prophylaxis, could improve the odds of survival, even in the most persistently immunosuppressed patient receiving chemotherapy and/or of stem cell transplantation. Herein, we describe the subtle clinical and radiographic clues that should alert the hematologist to the possibility of mucormycosis, and aggressive and timely treatment approaches that may limit the spread of infection before it becomes fatal. Hematology patients with this opportunistic infection require integrated care across several disciplines and frequently highly individualized and complex sequence of decision-making. We also offer perspectives for the use of 2 antifungals, amphotericin B products and posaconazole, with activity against Mucorales. The availability of posaconazole in an oral formulation that can be administered safely for prolonged periods makes it an attractive agent for long-term primary and secondary prophylaxis. However, serum drug concentration monitoring may be required to minimize breakthrough infection or relapsing mucormycosis associated with inadequate blood concentrations. (Blood. 2011;118(5):1216-1224) IntroductionMucormycosis is the unifying term used to describe infections caused by fungi belonging to the order Mucorales. Zygomycosis, an alternative term used to describe these life-threatening infections, has become less accurate based on a recent taxonomic reclassification (based on molecular identification) that abolished Zygomycetes as a class. [1][2][3][4] Rhizopus, Mucor, and Rhizomucor species account for up to 75% of mucormycosis cases encountered in hematologic malignancy patients. [5][6][7] Mucorales typically cause acute, aggressive, and frequently angioinvasive infections, especially in immunosuppressed hosts with hematologic malignancy and/or stem cell transplantation (SCT). 8,9 This opportunistic, geographically broad mycosis was highlighted as a sporadic cause of death in leukemia patients in the 1950s 10 until the mid 1990s where there has been an apparent increase in the documented cases in hematology units throughout the Westernized world ( Figure 1). [4][5][6][7]11 These cases are typically considered community-acquired, as nosocomial cases are less common in modern SCT and transplant units. 12 However, the true incidence of mucormycosis is not known and probably underestimated because of difficulties in antemortem diagnosis and the low autopsy rates in contemporary patients who die in the setting of leukemia or SCT. 13 The predisposing factors for mucormycosis in patients with hematologic cancer are similar to ones encountered in other opportunistic mold infections, such as aspergillosis, includi...

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“…These features support further research into HBO treatment as an adjunctive therapy candidate for a wide range of diseases (88). Observations drawn from human studies suggest that HBO might be useful in the treatment of some bacterial and fungal infections, like purpura fulminans (89) and necrotizing fasciitis (90).…”

Section: Hyperbaric Oxygenmentioning

confidence: 81%

Pathophysiological Mechanisms in Gaseous Therapies for Severe Malaria

et al. 2016

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cOver 200 million people worldwide suffer from malaria every year, a disease that causes 584,000 deaths annually. In recent years, significant improvements have been achieved on the treatment of severe malaria, with intravenous artesunate proving superior to quinine. However, mortality remains high, at 8% in children and 15% in adults in clinical trials, and even worse in the case of cerebral malaria (18% and 30%, respectively). Moreover, some individuals who do not succumb to severe malaria present longterm cognitive deficits. These observations indicate that strategies focused only on parasite killing fail to prevent neurological complications and deaths associated with severe malaria, possibly because clinical complications are associated in part with a cerebrovascular dysfunction. Consequently, different adjunctive therapies aimed at modulating malaria pathophysiological processes are currently being tested. However, none of these therapies has shown unequivocal evidence in improving patient clinical status. Recently, key studies have shown that gaseous therapies based mainly on nitric oxide (NO), carbon monoxide (CO), and hyperbaric (pressurized) oxygen (HBO) alter vascular endothelium dysfunction and modulate the host immune response to infection. Considering gaseous administration as a promising adjunctive treatment against severe malaria cases, we review here the pathophysiological mechanisms and the immunological aspects of such therapies. Malaria exerts a heavy burden over human populations, with an estimated 124 to 283 million cases and 584,000 deaths in 2013 (1). Currently, intravenous (i.v.) artesunate is the treatment of choice in severe malaria cases in children and adults (2, 3). However, despite the efficacy of intravenous artesunate, mortality from severe malaria in general and from cerebral malaria (CM) in particular remains high, at 18% for African children and 30% for adults in Southeast Asia (2, 3). In addition, 11% of children who survive CM show severe neurological deficits, and up to 25% can maintain long-term cognitive deficits (4-8). Therefore, strategies focusing only on parasite killing may not be sufficient to prevent neurological complications and deaths related to severe malaria. Accordingly, adjunctive therapies-defined as therapies administered in combination with antiparasitic drugs that modify pathophysiological processes caused by malaria-are being sought in order to mitigate complications caused by severe malaria (9). Considering the fact that currently administered antimalarial drugs often take 12 to 18 h to kill parasites, adjunctive therapies could reduce the risk of neurocognitive sequelae and mortality, particularly in patients with CM (10).Different adjunctive therapies have been or are being tested, including treatments aimed at modulation of the immune response to infection (dexamethasone, intravenous immunoglobulin), reduction of iron burden, reduction of oxidative stress, modulation of the prothrombotic state, and reduction of parasitemia (blood transfusion), amon...

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Hyperbaric Oxygen: Applications in Infectious Disease

Cited by 93 publications

References 59 publications

Hyperbaric oxygen therapy and mechanical resistence of the colonics anastomosis in rats with peritonitis

Hyperbaric oxygen therapy and mechanical resistence of the colonics anastomosis in rats with peritonitis

How I treat mucormycosis

Pathophysiological Mechanisms in Gaseous Therapies for Severe Malaria

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