Role of hyperbaric oxygen therapy (HBOT) in recovery of cardiopulmonary function: survival of patients developing ARDS following closed chest trauma (CCT)

Full text

Many years mortality in ARDS, often complicating CCT, is still very high and reaches 70-80%. In ARDS patients, hypoxia is a result of a `vicious circle' when acute respiratory insufficiency intensifies acute cardiac insufficiency which, in turn, deepens respiratory failure.

Patients and methods

The study is based on the data obtained from 45 patients with moderate-severe CCT. During conventional treatment in ICU, after 48–72 h, in 21 patients (48%) an ARDS developed, and three of these patients were treated with HBOT in a mono-placed barochamber. All treatments were conducted under 1.6–2.0 ata for 40-60 min each every day during 4–15 days, depending on progress of the recovery. Monitoring of cardiac function was carried out using non-invasive impedance cardiography (IC). Stroke Volume Index (SVI) and Cardiac Output Index (COI) were calculated. Respiratory functions were checked using a gas-analyzer. All ARDS patients were divided into three groups: group A-4 surviving patients after conventional therapy; group B-14 deceased patients after conventional therapy, and group C-3 patients surviving after addition of HBOT.

Results

Obtained data was exposed to statistical analysis using Student's unpaired t-test and the results are presented in Table 1.

Conclusions

This study clearly shows that: 1) in ARDS patients after CCT the state of cardiac function is the factor determining development of respiratory hypoxia; 2) HBOT is a decisive treatment improving cardio-respiratory function which leads to the favorable outcome; 3) patients with CCT must be treated with HBOT just after the trauma, before ARDS has developed.

Table 1