Thursday, December 15, 2011

Hyperbaric Oxygenation in the complex treatment of patients with aneurysms of the cerebral vessels

From Rapid Recovery Hyperbarics

Hyperbaric Oxygenation in the complex treatment of patients with aneurysms of the cerebral vessels

Zh Vopr Neirokhir Im N N Burdenko 1980
Jul-Aug;(4): 49-54
[Article in Russian]

Ugriumov VM, Elinskii MP, Rafikov AM, Kesaev SA

Experience in the use of Hyperbaric Oxygenation (HBOT) in 56 neurosurgical patients with cerebral vascular aneurysms, mainly in the postoperative period, testifies to the expediency of including this method in the complex of therapeutic measures for these patients. The deep oxygenation of the body tissues, the brain included, produced by HBOT makes it possible to prevent in many cases the development of severe and stable neurological defects in the postoperative period and contributes to the normalization of vitally important functions.

Permission to print

Wednesday, December 7, 2011

New Study Reaffirms: Hyperbaric Oxygen Therapy Should Be Standard Treatment for Veterans

- Welcome to the Alliance for Natural Health – USA - -
New Study Reaffirms: Hyperbaric Oxygen Therapy Should Be Standard Treatment for Veterans
Posted By ANH-USA On December 6, 2011 @ 1:00 pm In Uncategorized | 15 Comments
So why does the government keep blocking its use?
Research from health pioneer (and former ANH-USA board member) Dr. Paul G. Harch published in the Journal of Neurotrauma [1] indicates that hyperbaric oxygen therapy, or HBOT, is able to dramatically help veterans with post-concussion syndrome (a form of traumatic brain injury) and post-traumatic stress disorder (PTSD). Dr. Harch is an associate clinical professor of medicine at Louisiana State University in New Orleans.
Since January 2007, ANH-USA has been bringing attention to a project to have veterans treated with HBOT [2]. In HBOT, the patient is put in a hyperbaric oxygen chamber, which saturates the tissues with twelve times more oxygen than can be absorbed by breathing. This greatly enhances the body’s own healing process.
Under normal circumstances, oxygen is transported throughout the body only by red blood cells. With HBOT, oxygen is dissolved into all of the body’s fluids, the plasma, the central nervous system fluids, the lymph, and the bone, and can be carried to areas where circulation is diminished or blocked. In this way, extra oxygen can reach all of the damaged tissues and the body can support its own healing process. The increased oxygen greatly enhances the ability of white blood cells to kill bacteria, reduces swelling, and allows new blood vessels to grow more rapidly into the affected areas. It is a simple, non-invasive, and painless treatment.
According to Dr. Harch’s new study [3], even three years after the vets sustained brain injury, one month of HBOT was able to induce improvements in brain blood flow, cognition, symptoms, and quality of life, while the veterans experienced fewer suicidal thoughts.
Specifically, improvements were seen in 92% of vets experiencing short-term memory problems, 87% of those complaining of headaches, 93% of those with cognitive deficits, 75% with sleep disruption, and 93% with depression. There were also improvements in irritability, mood swings, impulsivity, balance, motor function, IQ, and blood flow in the brain, as well as the reduction in PTSD symptoms and suicidal thoughts. And there was
a reduction in—or complete elimination of—psychoactive and narcotic prescription medication usage in 64% of those previously prescribed the medication.
One major problem is that the HBOT treatment is currently “off-label.” In other words, it is an FDA-approved treatment for some conditions [4]—but not for traumatic brain injury (TBI) or PTSD. Because of this, the Department of Defense does not allow HBOT to be prescribed for its veterans—they say they don’t prescribe off-label medications and treatments for these diagnoses, and claim that they can only use HBOT after it has been approved by the FDA for this use [5].
This is a completely false and misleading statement! The Department of Defense often uses off-label antipsychotic drugs for treatment of TBI and PTSD. This should not surprise us. The FDA receives a large proportion of its budget from pharmaceutical manufacturers. And the government turns to drugs, often very inappropriate and damaging drugs, to treat damaged veterans without even considering alternatives.
Nearly 280,000 individuals received antipsychotic medication [6] in 2007. Yet over 60% of them had no record of a diagnosis for which these drugs are approved. Antipsychotic drugs were prescribed off-label for PTSD (42% of the patients), minor depression (40%), major depression (23%), and anxiety disorder (20%)—with about 20% having more than one condition. About 20% of veterans diagnosed with PTSD [7]—or nearly 87,000 patients—are prescribed an antipsychotic each year even though it is an off-label use.
TBI and PTSD severely and disproportionally affect military who have served in Iraq and Afghanistan—approximately 546,000 have TBI, post-concussion syndrome (PCS), and PTSD [3], and yet their treatment options are limited. HBOT is an effective and economical treatment for PCS and PTSD, without the very dangerous and negative side effects of antipsychotic medication.
The off-label use of HBOT is a huge freedom of choice issue in medicine. But even more important, if we really want to support our troops rather than just pay lip service, don’t we need to give them the safest, most economical, and most effective treatment for their traumatic brain injuries and PTSD?
Article printed from Welcome to the Alliance for Natural Health – USA:
URL to article:
URLs in this post:
[1] published in the Journal of Neurotrauma:
[2] a project to have veterans treated with HBOT:
[3] According to Dr. Harch’s new study:
[4] an FDA-approved treatment for some conditions:
[5] claim that they can only use HBOT after it has been approved by the FDA for this use:
[6] Nearly 280,000 individuals received antipsychotic medication:
[7] 20% of veterans diagnosed with PTSD:

New Study on Brain Injury

New Study on Brain Injury!

The Magic Number

The Magic Number 40

Forty sessions has come to be a benchmark in this therapy, not solely in the treatment of ASD, but rather in treating all conditions characterized by hypoxic tissue. It is theorized that this is the number of treatments necessary to ensure angiogenesis has occurred. In the past, physicians would notice “backsliding” or regression with most patients who had undergone less that thirty sessions. On the other hand, patients having undergone forty sessions would not display symptoms of “backsliding”. Today, with new knowledge regarding increased stem cell activity and sophisticated brain imaging equipment, it is easy to paint a picture as to what was occurring. Recent research has demonstrated that after only ten sessions an eight fold increase in stem cell activity can be measured; in particular, CD34 stem cells which will produce new capillaries. The formation of such capillaries can be seen between 15-20 sessions and the completion of such capillaries appears to occur between 30-40 sessions; hence the Magic Number 40. Of course, this process is continually underway and new capillaries are just beginning at 20 sessions, 30 sessions, 40 sessions, etc. One would assume that as long as hypoxic tissue remains in the body; stem cell activity would remain heightened, angiogenesis would continue, and tissue perfusion would continue to normalize. In fact, in a study conducted with CP, stroke, and traumatic brain injury patients; it was demonstrated that throughout 70 sessions the rate of improvement in cerebral oxygenation increased during the last 35 treatments. For this reason, it is not uncommon to see treatment protocols continue beyond the initial forty-session sequence; parents are often advised 60-80 initial sessions prior to pausing, ending, or lessening the frequency of treatment.

Frequency is Key and OXYGEN Pressure and Depth!~

There is much debate surrounding the optimal pressure in treating cerebral hypoperfusion related conditions such as Autism. Case histories and research both report positive findings from pressures ranging 1.2 ATA to 2.0 ATA. In addition, it becomes even more confusing as 100% oxygen is delivered Best results have been demonstrated through daily and twice daily treatment protocols.

Different Depths are designed for many disorders:

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Monday, December 5, 2011

CRPS- Balance Health Today Article 2009

Balance Health Today Article 2009

Susan Rodriguez, a certified hyperbaric specialist from San Bernardino, California, believes that to understand how HBOT works for CRPS, you need to understand the disease itself. “CRPS is neurological in nature and yet it manifests itself in physical symptoms,” she says. “What that means is that the disease needs to be treated with two approaches. One goal is to restore circulation, reduce inflammation or edema, and remove the swelling in affected limbs so the limbs can live. The other goal—if you want to eliminate the disease—is to work on the brain.”

If you were to stub your toe, for example, the central nervous system would tell your brain that your toe hurts. This pain is rooted in a physical injury. But sometimes trauma and inflammation mysteriously trigger a reaction from the sympathetic nervous system, which is a different part of the brain. With CRPS, pain is read through sensors in the sympathetic nervous system. (The sympathetic nervous system is what is activated in phantom leg pain, for example.) “Hyperbaric Oxygenation Therapy, however, can make the switch in the brain back to the central nervous system,” Rodriguez says. Under a doctor’s direction, she treats both the affected limb and the brain by different atmospheric pressures when the patient is inside the chamber.

“Different undersea depths work on different parts of the body,” she explains. “Deeper depths (up to 33 to 45 feet undersea) work more on tissue and bone, while milder hyperbarics (such as 18 to 24 feet undersea) work on the brain. Since we are working on both things, I take patients to all those levels. Almost always, the first symptom to come is the last to go. And then the symptoms are gone!”

Rodriguez learned about the effectiveness of HBOT therapy in treating CRPS first hand, when her husband Patrick was diagnosed in the mid-1990s following surgery. Because she had already been working in this field, they decided to try Hyperbaric Oxygenation Therapy to treat his CRPS. Not only is Patrick working today, but he has become a certified hyperbaric technician. The couple opened Rapid Recover Hyperbarics in 1998, with Donald Underwood, DO, MD, JD, serving as medical director.

A physician should review all aspects of a patient’s medical history before starting therapy. There are a few medical conditions that may prevent an individual from receiving HBOT — either permanently (certain lung and heart disorders) or temporarily (sinus infections, fevers).

“I have seen some very dramatic improvements,” says Rodriguez. “In some cases we have seen improvements to the point of a remission.” she says. “Nothing works for everyone, but I’ve seen this work for many people if they stick with it.”

Sunday, December 4, 2011

“Oxygen and the Dark Ages”

“Oxygen and the Dark Ages”

Contact us for more information

Astonishment at the reaction of doctors to the words 'hyperbaric', 'oxygen' and 'therapy' is frequently expressed on the lists. The public find most doctors dismissive and some openly hostile. This attempts an explanation.

The primary reason is that the teaching about oxygen in our medical schools is inadequate, especially in these areas.

  1. The importance of barometric pressure in determining oxygen dosage.
  2. Understanding that the plasma concentration alone determines the rate of transport of oxygen into tissue.
  3. The most essential function of blood flow is to transport oxygen.
  4. Oxygen not only acts in relation to metabolism it acts as a modulator of many cellular functions.
  5. That most diseases affect not only the cells of a tissue, but also the blood supply.
  6. That both a decrease and an increase in blood supply can cause hypoxia, defined as a deficiency in the level of oxygen required for normal function.
  7. That an adequate level of oxygen is essential to recovery in disease.

Educationally, Epictatus (3 BC) understood the problem; "It is impossible to learn something that we think we already know".

Regardless of the intellectual aspects, to admit ignorance about an issue of such central importance is very emotionally challenging. It is to admit that we are failing to use enough oxygen and that patients are suffering and dying unnecessarily from our failure to use a simple method of treatment, but we are truly in the dark ages.

Best wishes
Philip James MD

Wolfson Hyperbaric Medicine Unit
University of Dundee
Ninewells Hospital and Medical School
Dundee DD1 9SY

Sunday, November 13, 2011

Hyperbaric Oxygen Therapy & Stiff Person Syndrome

Hyperbaric Oxygen Therapy & Stiff Person Syndrome

Nov 9, 2011 | By Graham Rix

Based in the United Kingdom, Graham Rix has been writing on the arts, antiquing and other enthusiasms since 1987. He has been published in “The Observer” and “Cosmopolitan.” Rix holds a Master of Arts degree in English from Magdalen College, Oxford.

Hyperbaric Oxygen Therapy & Stiff Person Syndrome
Photo Credit Jupiterimages/liquidlibrary/Getty Images

Stiff-person or stiff-man syndrome is a rare neurological disorder that causes rigidity, primarily in the back and legs. Hyperbaric oxygen therapy may be of benefit in some cases in tackling the causes of the syndrome, but the symptoms need to be treated with various medications.

Stiff-person Syndrome

A rare disorder which is thought to affect as few as one in 1 million people, the exact causes of stiff-person syndrome are not known, but they are associated with malfunctions in the body's autoimmune system. Sufferers experience intervals of rigidity in their torso and extremities. Stressful situations and sudden noises such as car horns can trigger painful muscle spasms. The disorder puts sufferers at risk from further injury from falls and accidents.

Hyperbaric Oxygen Therapy

In hyperbaric oxygen therapy, a patient breathes pure oxygen inside a chamber where the air pressure is compressed to about 2.5 times normal atmospheric pressure. The increased pressure drives oxygen into the patient's tissues, increasing blood flow and triggering healing. HBOT is widely used in the treatment of ulcers, wounds and skin grafts.


Some evidence suggests that HBOT can be beneficial in treating stroke, cerebral palsy, multiple sclerosis and disorders such as SPS. The delivery of pure oxygen under increased atmospheric pressure is thought to have a rebalancing effect on the brain, startling it into running more smoothly. If you suffer from SPS, you might want to discuss HBOT with your health-care provider as a complement to standard drug therapy.

Drug Therapy

Although there is currently no cure for SPS, its symptoms generally respond well to drug therapy. These can include anti-anxiety medications, muscle relaxants, anti-convulsants and intravenous immunoglobulin treatment to lower sensitivity to negative stimuli. But note, once started upon a course of drugs, you shouldn't break off suddenly because doing so can result in severe spasms.

Read more:

Tuesday, November 8, 2011

Fast intervention with hyperbaric oxygen therapy helps student to retain eyesight

Fast intervention with hyperbaric oxygen therapy helps student to retain eyesight

Posted Nov. 3, 2011

Barbara McCullough and Alyssa Tait

Barbara McCullough and her daughter Alyssa Tate. Hyperbaric oxygen therapy and fast intervention by doctors and staff of the Christiana Care Wound Care & Hyperbaric Medicine Center helped Alyssa Tait retain some vision in her right eye, after the sudden onset of a rare medical condition similar to a stroke inside the eye.

Word of a young University of Delaware student’s rare medical condition affecting her eyesight reached Christiana Care in a roundabout way. But the emergent, unusual care she received at the Christiana Care Wound Care & Hyperbaric Medicine Center was far more direct.

According to her mother, Barbara McCullough, Alyssa Tait was at the Division of Motor Vehicles to take care of some business on a Monday morning several months ago when she stood up, got dizzy and suddenly lost most of the vision in her right eye.

“She went to a specialist in ophthalmology-surgery in Wilmington,” McCullough says. The diagnosis was a central retinal artery occlusion (CRAO), a blood clot in her eye capable of causing rapid and permanent vision loss.

“CRAO is rare, comparable to a stroke in the retina, the part of the eye that enables us to see,” explains Wound Care Center Director Adrienne Abner, RN, MSN, CSW, MBA. “Vision loss from CRAO is usually dramatic and permanent.”

Hyperbaric oxygen therapy can decrease the swelling that causes the vision loss, Abner says. “Optimally, treatment guidelines for CRAO using hyperbaric oxygen therapy should occur within several hours.”

Word about Tait’s condition came through the community’s medical grapevine to the staff at Christiana Care, who reached out to the surgeon, Paula Ko, M.D. Tait was fast-tracked for an appointment to evaluate the potential benefit of hyperbaric oxygen therapy at the Lea Boulevard location in Wilmington. Medical Director Nicholas O. Biasotto, D.O., George Zlupko, M.D., who is certified in hyperbaric medicine, and John DeCarli, D.O., believed that hyperbaric oxygen therapy could help prevent further vision loss and even help restore some vision for Tait. With the support of Diversified Clinical Services Inc., a network of wound care and hyperbaric medicine centers, the Christiana Care staff had instant access to all evidence-based protocols for treating CRAO, as well as available consults from another hyperbaric-certified physician online. But both hyperbaric oxygen therapy chambers were booked for other patients on the day Tait was approved to begin therapy.

“We were able to get all the wheels in motion to have the patient start her first treatment Thursday evening instead of Friday morning as we first planned,” Abner says. “In a matter of hours we completed screening, evaluation, insurance approval and scheduling, which usually takes a week. So Alyssa began therapy in the chamber by 6 p.m. Thursday.”

This was no simple task given that the hyperbaric staff usually works weekdays from 8 a.m. to 4:30 p.m. The clinical window of opportunity to apply effective hyperbaric oxygen therapy was shrinking. Tait needed two treatments per day for 10 treatments.

“The nursing staff and doctors really scrambled to arrange for five straight days of therapy,” McCullough says. “They reshuffled personal priorities to do what they could to regain any portion of Alyssa’s vision loss.”

Tait noticed improvement in her peripheral vision the morning after her first treatment. After the sixth treatment, a repeat funduscopic exam showed a significant decrease in retinal swelling. Tait recovered a sliver of light in the middle of her field of vision.

“There is still permanent damage, but less significant than originally thought to be,” her mother says. “So far they have found no underlying medical conditions that caused the CRAO.”

As a mother, McCullough was concerned about how Alyssa would process the sudden vision loss and all the information—some of which could be hard to take.

“No one expects their 20-year old child to have a ministroke, but the Christiana Care staff was wonderful,” McCullough says. “They explained things in a simplistic and thorough way and sincerely cared enough to do whatever they could to make a difference for my daughter.”

Thursday, November 3, 2011

Hyperbaric Oxygenation Increases Patients own Stem Cells By Eight-Fold

Hyperbaric Oxygenation Increases Patients own Stem Cells By Eight-Fold

... 2 hours HBOT at 2 ATA; doubles the patients own circulating stem cells
... 40-60 hours HBOT increases circulating stem cells by 8-fold (800%) !!
A scientific study completed at the University of Pennsylvania School of Medicine reports that Hyperbaric Oxygen Therapy (HBOT) are a safe and effective way to mobilize the patients own stem cells providing immediate benefit and further preparing the patient for future stem cell implantation related therapies.
In fact the population of CD34+ cells in the peripheral circulation of humans doubled in response to a single exposure to 2.0 atmospheres absolute (ATA) HBOT for 2 hours. Over a course of twenty treatments, circulating CD34+ cells increased eight-fold!
Stem cells, also called progenitor cells, are crucial to the repair of injured tissues and organs. Hyperbaric Oxygenation increases by eight-fold the number of circulating stem cells throughout the body. Healthy recovery of injured and diseased tissues is the ultimate goal and stem cells play an essential role.
In response to injury, stem cells are mobilized out of the bone marrow to the injured sites, where they differentiate into specialized cells that are important to the healing process. Stem cells from bone marrow are capable of providing specialized functions in many different organs and tissues throughout the body. This movement, or mobilization, of stem cells can be triggered by a variety of stimuli—including Hyperbaric Oxygenation.
While drugs are associated with a host of side effects, Hyperbaric Oxygenation treatments carry a significantly lower risk of such effects.
"This is the safest way clinically to increase stem cell circulation, far safer than any of the pharmaceutical options," said Stephen Thom, MD, Ph.D., Professor at the University of Pennsylvania School of Medicine and lead author of the study.
"This study provides information on the fundamental mechanisms for hyperbaric oxygen therapy and offers a new therapeutic option for mobilizing stem cells."
"We reproduced the observations from humans in animals in order to identify the mechanism for the hyperbaric oxygen effect," added Thom. "We found that hyperbaric oxygen mobilizes stem/progenitor cells because it increases synthesis of a molecule called nitric oxide in the bone marrow. This synthesis is thought to trigger enzymes that mediate stem/progenitor cell release."
Hyperbaric Oxygenation not only causes the release of the patients circulating stem cells but greatly facilitates future endeavors using stem cell related therapies which is costly and not an automatic guarantee in every patient.
It is hoped that future study of hyperbaric oxygen's role in mobilizing stem cells will provide a wide array of treatments for combating injury and chronic progressive disease.
The completed study is scheduled for publication in the April 2006 edition of the American Journal of Physiology – Heart and Circulatory Physiology.
Submitted on August 19, 2005; Accepted on November 7, 2005
Stem cell mobilization by hyperbaric oxygenation
Stephen R Thom1, Veena M Bhopale2, Omaida C Velazquez3, Lee J Goldstein3, Lynne H Thom2*, and Donald G Buerk4
1 Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA; Institute for Environmental Medicine, University of Pennsylvania, Philadelphia, PA, USA 2 Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA 3 Surgery, University of Pennsylvania, Philadelphia, PA, USA 4 Physiology, University of Pennsylvania, Philadelphia, PA, USA We hypothesized that exposure to hyperbaric oxygen (HBO2) would mobilize stem/progenitor cells from the bone marrow by a nitric oxide (.NO) dependent mechanism. The population of CD34+ cells in the peripheral circulation of humans doubled in response to a single exposure to 2.0 atmospheres absolute (ATA) O2 for 2 hours. Over a course of twenty treatments, circulating CD34+ cells increased eight-fold, although the over-all circulating white cell count was not significantly increased. The number of colony-forming cells (CFCs) increased from 16 ± 2 to 26 ± 3 CFCs/100,000 monocytes plated. Elevations in CFCs were entirely due to the CD34+ sub-population, but increased cell growth only occurred in samples obtained immediately post-treatment. A high proportion of progeny cells express receptors for vascular endothelial growth factor-2 and for stromal derived growth factor. In mice, HBO2 increased circulating stem cell factor by 50%, increased the number of circulating cells expressing stem cell antigen-1 and CD34 by 3.4-fold, and doubled the number of CFCs. Bone marrow .NO concentration increased by 1008 ± 255 nM in association with HBO2. Stem cell mobilization did not occur in knock out mice lacking genes for endothelial .NO synthase. Moreover, pre-treatment of wild type mice with a nitric oxide (.NO) synthase inhibitor prevented the HBO2-induced elevation in stem cell factor and circulating stem cells. We conclude that HBO2 mobilizes stem/progenitor cells by stimulating .NO synthesis.

Wednesday, October 26, 2011

Pure oxygen used in treating brain injuries Rapid Recovery Hyperbarics 909-477-4545

Pure oxygen used in treating brain injuries

Active-duty Marines will undergo trials at Pendleton, Lejeune naval hospitals

By Gidget Fuentes - Staff writer
Posted : Saturday Oct 22, 2011 9:18:14 EDT

Marines are participating in a study to see whether treatments of pure oxygen will help heal service members with mild traumatic brain injuries, one of the most common wounds of the wars in Iraq and Afghanistan.

Medical investigators plan for 96 Marines, sailors and other service members to participate in the initial 10-week trial involving treatments of hyperbaric oxygen therapy, with 24 participants each at Camp Pendleton Naval Hospital, Calif., and Camp Lejeune Naval Hospital, N.C. The Army Medical Research and Materiel Command oversees the study, which also includes Army hospitals at Fort Gordon, Ga., and Fort Carson, Colo.

The trial began in early October and should be completed by year’s end. If the results are positive, it may lead to a larger study involving 300 to 400 participants, said Cmdr. James Caviness, an occupational and environmental medicine physician and principal investigator for the study at Camp Pendleton Naval Hospital.

“Hopefully this will be another tool in the arsenal” to help sufferers, said Caviness, the hospital’s occupational health department head.

Trial participants must have suffered a mild TBI while on active duty operating in the U.S. Central Command region, and they must live or be stationed near a study site.

While most people recover from concussions, or mild TBI, some later suffer what doctors call persistent post-concussive injuries. “They develop some chronic problems,” such as headaches, irritability, poor sleep, memory loss and imbalance, Caviness said. “That’s the group that we have trouble with in our current treatment program.”

Medical researchers suspect that pure oxygen might help heal those injured brain cells, and other recent studies show promising results for concussion sufferers.

“Everything in our body works on oxygen,” which acts as something like a fuel for cellular activity, Caviness said. “But no one knows” definitely if pure oxygen could help heal a bruised brain, he said. “That’s just a theory.”

For this study, some of the participants will breathe air in a hyperbaric chamber, provided and operated by a contractor, over a course of treatments and batteries of tests, while others will receive regular care for mild TBI, Caviness said. The trial is a double-blind, randomized study, so participants won’t know whether they are getting treated with pure oxygen or normal pressurized air. “They don’t know, and we don’t know,” he said.

Interested Marines — active-duty only — can contact the study coordination screening center at 877-445-3199.

Saturday, October 15, 2011


Dear Susan,
Since the health care system is insurance based, until the procedure is recognized as a proper modality for a spectrum of treatments instead of the narrow set presently covered, it will only be people like you who are salvation for many otherwise untreated individuals. Thank you for helping me stay healthy!

Franck XXXX

To Whom It May Concern,

The work that Susan Rodriguez and Rapid Recovery Hyperbarics is doing is commendable. While the academic world is mired in the tedious process of controlled, randomized studies, they are in the trenches treating people in need. The use of hyperbaric oxygen in neurologic conditions is the newest frontier in medicine and Ms. Rodriguez is one of the pioneers. I am certain that someday, when the use of hyperbaric oxygen is a standard of care for many neurologic conditions, the world will look back on these individuals as bold visionaries who ran where others feared to tread.

George Mychaskiw II, DO, FAAP, FACOP

George Mychaskiw II, DO, FAAP, FACOP
Professor and Chair, Department of Anesthesiology
Drexel University College of Medicine
Clinical Service Chief, Hahnemann University Hospital
Editor of UHMS

Sunday, October 9, 2011

Scan Detects Oxygen Levels in Tumors

April 23 (Health Day News) -- New research suggests that scientists are close to developing a simple way to measure oxygen levels in tumors, giving doctors a heads-up about what kind of treatment is best for individual patients.

The findings fit into an emerging trend of individualized treatment for patients with cancer instead of treating people the same way, said Dr. Mark Dewhirst, a professor of radiation oncology at Duke University Medical Center.

"If successful, [the trend] will revolutionize the way that we treat cancer," said Dewhirst, who co-wrote a commentary accompanying the new study, published April 22 in the Journal of Clinical Investigation.

Scientists began realizing the important role of oxygen in tumors about 50 years ago, said study co-author James Mitchell, branch chief of radiation biology at the U.S. National Cancer Institute's Center for Cancer Research. The scientists discovered that tumors with higher concentrations of oxygen were more susceptible to radiation, he said.

"Radiation damages cells by causing damage to DNA, and one particular type of damage renders the DNA molecule non-reparable," Mitchell said. But less oxygen in the tumor allows tumor cells to survive more easily by making the DNA destruction process more difficult, he said.

According to Dewhirst, the same is true for chemotherapy drugs, which also don't work as well when tumors have less oxygen.

Lower levels of oxygen create other problems, Dewhirst. "One would think at first that lack of oxygen would make tumors unhealthy and easy to kill," he said. "But actually, the opposite happens -- tumor cells that lack oxygen become more aggressive and more difficult to kill."

Tumors with lower oxygen levels even spread more easily through the body, he said.

Doctors can check oxygen levels in patients by inserting a needle. But doctors can't insert needles into some patients, and. in others, it's difficult to insert the needle deep enough, Mitchell said.

In the new study, the researchers tested a scanning technique called pulsed electron paramagnetic resonance imaging and used it in tandem with magnetic resonance imaging. The study authors said they were able to successfully measure oxygen levels in tumors in mice by using the non-invasive technology.

"The imaging that is described in this study provides all of the information necessary to evaluate oxygen levels in tumors as well as to examine underlying causes for the lack of oxygen," Dewhirst said. "The fact that all of the imaging is completely non-invasive provides the ability to perform this measurement more than once, (meaning) this could be used to monitor the effectiveness of cancer therapy."

There are caveats, however. The research hasn't reached the human testing level yet, and it may not work in people. "Scaling up the method to make it suitable for use in humans will be a significant challenge, but not impossible," Dewhirst said.

For now, the plan is to launch more studies with animals to see if the technique works as a way to test cancer drugs. Perspective

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Tuesday, October 4, 2011

Parents Can Detect, Contribute to, or be Affected by Critical Events During a Child's Hospitalization

Parents Can Detect, Contribute to, or be Affected by Critical Events During a Child's Hospitalization


Today, parents are often permitted around-the-clock visiting hours to stay with their hospitalized children, even in neonatal and pediatric intensive care units (ICUs). Many parents take advantage of this option and remain with their children as much as possible. For an ill child, this can be comforting and provides an important emotional benefit. At the same time, parents may be carefully watching and interacting with healthcare professionals, and observing the specialized equipment at their child's bedside, including infusion pumps, IV lines, and drainage systems. A study published by Frey et al. in 2009 suggests that parents who stay with their hospitalized children are inevitably involved in safety issues.[1] In particular, the study showed that parents can help detect critical (harmful or potentially harmful) events precipitated by healthcare professionals. However, the study also showed that parents can contribute to a critical event and are often adversely affected by a critical event.

The study was conducted over a 5½ year period in a neonatal-pediatric intensive care unit and a neonatal intermediate care unit in a university children's hospital. During the first 2 years of the study, visiting hours for parents were limited to afternoons and evenings; morning visitations were not allowed and overnight stays were strongly discouraged. Around-the-clock visiting hours were permitted during the last 3½ years of the study.

During the span of the study, a total of 2,494 critical events were recorded; 101 of these events directly involved parents. In 18 cases, a parent contributed to the critical event. In 11 cases, a parent detected a critical event. In the remaining 72 cases, a parent was one of the affected individuals. For each event, the actual and potential severity was determined to be minor (requiring no interventions), moderate (requiring routine therapy available outside a critical care unit), or major (requiring therapeutic interventions specific to critical care units, or resulted in death).

In the group of critical events that involved parents (n=101), medication events (38%) and line disconnections/reconnections (28%) were most prevalent. In the group of critical events that did not involve parents (n=2,393), events involving medications were again most prevalent (33%), but issues with line disconnections/reconnections (2.7%) were significantly lower. Most events precipitated by parents and subsequently detected by healthcare professionals caused actual harm determined to be of moderate severity, and some events had the potential to cause a high severity of harm. On the other hand, critical events detected by parents did not cause actual harm, although the events had the potential to cause harm of moderate severity. Further details about the study follow.

Parents Detecting Safety Problems

The most common safety problems detected by parents involved medication errors, tubes or drains that became disconnected, and respiratory distress. Examples include:

  • A mother who realized that a physician had prescribed a five-fold overdose of carvedilol for her child (5 mg BID instead of 1 mg BID)
  • A mother who noticed the wrong weight listed on her child's medical record used for prescribing medications
  • Parents who called attention to their child's respiratory distress or failure.

It took parents between 0–70 hours (median 10 hours) to detect a critical event precipitated by a healthcare professional. This suggests that without the parents' interventions, some critical events might have continued without correction. The authors determined the potential harm from continuation of the detected critical events to be severe in 4 cases, moderate in 6 cases, and minor in 1 case. All of the events detected by parents occurred only after around-the-clock visiting hours were made available. This observation suggests that it is easier for parents to detect safety problems if they spend more hours at their child's bedside, observing and participating in their care.

Parents Contributing to Safety Problems

The most common safety problems precipitated by parents involved the disconnection of tubes and drains, medication errors, and physical trauma. Examples include:

  • A mother accidentally disconnected a central venous line while breast feeding her baby
  • A mother accidentally disconnected a pleural drain while holding her infant
  • A father fell off a chair with his child on his lap.

All of the disconnected tubes and drains happened in young infants, from 4 days to 1½ years old. It took healthcare professionals between 0–29 hours (median 0.25 hours) to detect a critical event precipitated by a parent. The authors note that this finding suggests that healthcare professionals are providing appropriate supervision of parents and hospitalized children. Most of these events caused moderate harm (10 cases) before being detected. In all but one event, quick discovery of the problems averted severe harm.

Parents Affected by Safety Events

The most common types of problems affecting parents involved miscommunication and feeding mix-ups. One can expect parents to be emotionally affected by most critical events that involve their children, especially those leading to harm. However, with some critical events, parents were directly affected in ways that were not anticipated. One of the most common examples included mothers who were subjected to viral testing because their breast milk was accidentally fed to another child. Failures such as this increase parental stress during a child's hospitalization.

Safe Practice Recommendations

Consider the following recommendations to strengthen the partnership between the treatment team and a hospitalized child's parents, prevent parental contribution to critical events, promote parental detection of errors, and protect the hospitalized child from harm.

Educate Parents. Teach parents about the disease/condition, medical tests, and treatment plan for their hospitalized child. Specifically tell parents about all the medications their child is receiving, the prescribed doses (including the fact that it differs from the dose taken at home, if applicable), potential side effects, and when and how they are given. Write down important information for parents to reference as needed. Parents who know what to expect can help recognize when something is not right.

Update Parents. Provide parents with timely and comprehensive updates regarding their children in language they understand. Some children's hospitals encourage parents to be part of "family-centered" rounds, allowing them to gain a better understanding of their child's total treatment plan and current status since the entire medical team is available to answer questions and address concerns.

Anticipate Involvement. Be aware of increasingly independent parental involvement in the medical care of their children. A 2001 study by Hurst showed that parents continuously analyze hospital procedures and develop an action plan to protect their babies.[2] A fundamental challenge for mothers in this study was to increase their position of authority relative to the medical team, thereby safeguarding their babies. Parents may intervene during the care of their children, which can lead to prevention and detection of a critical event, or contribution to a critical event despite good intentions. Close parental involvement in the child's treatment plan should be encouraged, supervised, and monitored.

Encourage Parents to Speak up. Encourage parents to report any concerns or worries they have regarding their child's care. Frey et al. suggests periodically asking parents these two questions: "Are there aspects of your child's care that you find concerning?" and "What do you worry about when you leave your child?" Encourage parents to keep asking questions or voicing concerns until they receive an answer with which they are comfortable and fully understand. Remind parents that they know their child better than anyone on the medical team; thus, communication of their observations is extremely important.

Respond to Parents' Queries Appropriately. Parents do not want to be labeled as being "difficult" or "demanding;" they fear no one will want to take care of their child if they are perceived this way.[2] Some may even view basic questions or requests for information about their child's condition as a slight to the medical team's competence. So, when parents do speak up, healthcare professionals should perceive and reflect their actions in a manner that fosters true collaboration and empowerment, and should encourage and reinforce the parents' role in making queries by providing thoughtful and complete answers.

Provide Access to a Rapid Response Team. Allow parents to activate a rapid response team if they feel no one is addressing their expressed concerns regarding their child's condition and/or medical treatment. Instruct parents, upon their child's admission, regarding the purpose of the rapid response team and how to activate it.

Establish Safe Handling Guidelines. To reduce the risk of tubing disconnections, establish guidelines for safe handling of infants and children with lines and drains, teach these guidelines to parents, and monitor adherence to the guidelines.

Teach Parents Not to Reconnect Tubes. Orient parents to the tubes or drains attached to their child. Teach them about the dangers of reconnecting tubes and drains themselves and how to call for immediate help from a healthcare professional if their child's tubes or drains become dislodged or disconnected.



1. Frey B, Ersch J, Bernet V, Baenziger O, et al. Involvement of parents in critical incidents in a neonatal-paediatric intensive care unit. QualSaf Health Care. 2009;18(6):446–449.

2. Hurst I. Vigilant watching over: mothers' actions to safeguard their premature babies in the newborn intensive care unit. J Perinat Neonatal Nurs. 2001;15(3):39–57.

ISMP Medication Safety Alert © 2011 Institute for Safe Medication Practices

Monday, October 3, 2011

Brain injury study under way at Camp Pendleton

MILITARY: Brain injury study under way at Camp Pendleton
MILITARY: Brain injury study under way at Camp Pendleton County Times Posted: Friday, September 30, 2011 8:00 pm

A hyperbaric chamber at Camp Pendleton is being used to treat troops with mild traumatic brain injuries in a trial program to see if it speeds their recovery. Courtesy photo
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Related: MILITARY: Brain-injured Marines to test new treatment
A half-dozen Marines with brain injuries from combat in Afghanistan or Iraq will crawl inside a hyperbaric chamber at Camp Pendleton next week to begin eight weeks of treatment breathing pure oxygen to see if it speeds their recovery.
Up to 100 base troops eventually are expected to take part in the study trying to find the best treatments for what is known as traumatic brain injury.
Many other troops suffering from post-traumatic stress disorder from their battlefield experiences also are expected to take part in the study to see if it helps them heal.
"I'm really hopeful that this potential treatment will help," said Navy Cmdr. James Caviness, head of occupational health services and the study's principal investigator at Naval Hospital Camp Pendleton.
"The anecdotal reports of hyperbaric chamber use in civilian settings are positive, and we need to rigorously look at this to see if we can use it," he added.
The troops taking part in the study are volunteers. Hundreds of others at the Marine Corps' Camp Lejeune in North Carolina and at Army bases at Fort Carson, Colo., and Fort Gordon, Ga., are taking part in similar studies.
Researchers will measure whether the use of the chamber can ease the headaches, memory loss and other ailments from mild traumatic brain injury, which are common after-effects for troops who are injured in roadside bomb attacks.
When the program was designed last year, U.S. Army Col. Richard Ricciardi at the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury described it as one of many commissioned by the Pentagon to improve brain injury care.
"It's one part of the arsenal of treatments being tested across the system to tackle this challenging problem and do the right thing for our warriors," he said.
Traumatic brain injury has emerged as a common injury among troops in Iraq and Afghanistan, where anti-government forces rely on homemade bombs as a primary weapon.
More than 134,000 U.S. troops have been treated for such injuries since the Afghanistan and Iraq wars began, according to Pentagon statistics.
Close to 1,400 service members have suffered concussions or traumatic brain injury so far this year, according to the Defense Department.
The malady is divided into three classifications. Mild cases involve loss of consciousness for up to 30 minutes and mild amnesia.
The hyperbaric chamber at Camp Pendleton is inside a trailer adjacent to the hospital. Pressure inside it will be equivalent to what divers experience at about 20 feet under water.
The pressurization forces pure oxygen into the cells. The experiment tests whether the repeated trips to the chamber speed healing.
Some troops breathe pure oxygen administered under a tentlike hood so no gas escapes. Others will get a lesser amount of pure oxygen, and a third group will breathe normal air under near-similar pressure conditions to test the results.
Camp Pendleton's role is to help establish the precise treatment regimen and baseline testing troops will undergo to see if the treatment helps.
"There are a lot of unknowns about traumatic brain injury, which has emerged as the 'signature injury' of the wars in Iraq and Afghanistan," Caviness said. "We need to learn a lot more, and this study will hopefully demonstrate it is something we can use."
Troops suffering from moderate or severe brain injuries are not part of the study because there is no evidence hyperbaric chambers speed their recovery.
Among the measurements technicians will use are batteries of memory, mood and motor function tests administered to troops before the study, as it takes place and at the end of the eight weeks.
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