Severe acute myocardial infarction treated with hyperbaric oxygen. Report on forty patients

Abstract

SummaryForty patients, aged , who had had an acute myocardial infarct in the preceding 24 hr, and who were seriously ill, were treated in a hyperbaric oxygen bed at 2 atm (atmospheres) absolute for sessions of 2 hr in and 1 hr out for an average period of 4 days.There were thirty-seven survivors after the treatment, giving an immediate mortality of 7 5 %, but three ofthose died later before leaving hospital, giving a total mortality of 15% in seriously ill patients.Pain and dyspnoea were usually improved in the first hyperbaric session, relapsed in air and progressively improved in successive sessions.Arrhythmias, including heart block, showed similar benefit. No case of cardiac arrest occurred while the patients were actually receiving hyperbaric o xygen.There was, in the opinion of the authors, during a period of over 2 years' experience, a consistent pattern of improvement over and above that expected as spontaneous improvement.The hyperbaric oxygen bed is a promising method of treatment for the acute phase of myocardial infarction, and it is simple to use. There will of course always be an irreducible minimum of patients who will die from obstruction of both coronary arteries or other structural lesions such as rupture or emboli. IntroductionAcute myocardial infarction is still one of the commonest lethal diseases remaining unchecked. Even of the patients who reach hospital, approximately 25 % die within the next 6 weeks. The circulatory crisis following infarction presents in several ways, and is sometimes remarkably delayed, but

Hyperbaric Oxygen and Thrombolysis in Myocardial Infarction: The ‘HOT MI’ Randomized Multicenter Study

“…In animal stud-ies, HBO also reduces the ischemic effects of coronary artery occlusion [7][8][9][10]. However, prior human trials detected little substantial benefit from HBO without concomitant thrombolysis [11][12][13][14]. The only controlled trial, done in the prethrombolytic era, revealed a trend but no statistically significant mortality benefit when standard methods of analysis were used [15].…”

The beneficial effects of 40% and 100% O2 inhalations on acutely-induced myocardial ischemia in dogs.

“…In particular, they found that the mortality rate for high-risk groups may have been reduced by 02 to about half. Ashfield and Gavey (1969) came to a similar conclusion using 40 patients with acute myocardial infarction. They found that 02 was beneficial in the more severe cases : the worse the pain the more 02 seemed to help.…”

Clinical use of the hyperbaric oxygen bed

“…Patients with acute myocardial infarction, which was our main interest, are described in more detail in the next paper (Ashfield & Gavey, 1969).…”