ABSTRACT
Durante el periodo inicial de la pandemia de COVID-19, y debido a la saturación del sistema asistencial se planteó administrar tratamiento con oxigenoterapia hiperbárica (OHB) a pacientes con PCR + para COVID-19 o con alta sospecha clínica, radiológica y analítica en el Servicio de Medicina Hiperbárica (SMHB) del Hospital Central de la Defensa «Gómez Ulla» (HCD). OBJETIVOS: asistir a pacientes que no respondían a tratamiento, así como comprobar la eficacia de la OHB como una herramienta útil para el tratamiento del COVID-19. MATERIAL Y MÉTODOS: Se valoraron 11 peticiones de tratamiento con OHB, de pacientes procedentes de plantas COVID-19 y UCI, de los cuales finalmente se trataron únicamente a 6 pacientes. Se procedió al tratamiento en cámara multiplaza, entre 1,6 y 2 atmósferas de presión absoluta (ATA) y tiempo de exposición entre 90 y 105 minutos, con la presencia en todo momento de acompañante. Se diseñaron protocolos de protección biológica respiratoria y de contacto frente al coronavirus. Se realizaron controles analíticos y pruebas de imagen. Resultado y conclusiones: Se completaron 35 sesiones de tratamiento. Los pacientes recibieron entre 1 y 14 sesiones No se produjo ningún caso de infección entre los sanitarios del servicio. Los pacientes que por su estado pudieron recibir más de 5 sesiones de OHB tuvieron una mejor evolución clínica. Se observaron reflejos de desaturación postratamiento con OHB
During the first period of the COVID-19 pandemic and due to saturation of the health care system, it was necessary to treat with hyperbaric oxygen therapy (HBO) (in the Hyperbaric Medicine Service at the Defence Central Hospital «Gómez Ulla» (HCD)), some patients with PCR (+) for COVID -19, or with clinical, radiological or analytical high indicative data. OBJECTIVES: to treat patients without positive answer to regular treatment and to check the effectiveness of HBO as useful therapy for COVID-19. MATERIAL AND METHOD: There were valued 11 requests for treatment from COVID-9 wards and the Intensive Care Department. Eventually 6 of those patients were treated. These patients were treated in a multiplace hyperbaric chamber between 1.6 and 2 ATAs and for 90 to 105 minutes of time, with ancillary personnel inside the chamber the whole sessions. There were also developed security protocols to prevent COVID-19 infection. Image and analytics controls were followed. RESULTS AND CONCLUSIONS: 35 sessions of treatment were completed. The patients received from 1 to 14 sessions. It did not happen any case of infection on the medical personnel of the HBO Department. The patients which (due to their physical status) could receive 5 or more sessions had a better clinical evolution. Some desaturation reflexes were observed
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Hyperbaric Oxygenation/methods , Betacoronavirus , Coronavirus Infections/therapy , Pneumonia, Viral/therapy , Hyperbaric Oxygenation/instrumentation , Pandemics , Respiration, Artificial , Oxygen Inhalation Therapy/methods , Cystitis/therapyABSTRACT
Se presenta el caso clínico de un buceador, varón de 33 años que realizando una inmersión a gran profundidad (87 metros) y empleando mezclas respirables helio-oxígeno presenta de forma brusca al concluir la inmersión una enfermedad descompresiva con dolor músculo esquelético, que obliga a la recompresión urgente y a la aplicación de tratamiento recompresivo, tabla Comex 12. El buceador una vez concluido el tratamiento recompresivo regresa a superficie con una completa resolución de su sintomatología. Se revisan los factores individuales y ambientales que pueden predisponer a presentar una enfermedad descompresiva (AU)
Subject(s)
Adult , Male , Humans , Barotrauma/therapy , Decompression Sickness/therapy , Disease Susceptibility/diagnosis , Risk Factors , Atmosphere Exposure ChambersABSTRACT
One hundred and twenty-one subjects with decompression disease (DD) treated by the Spanish Navy between 1969 and 1986 are reported. The mean age of the victims was 31.4 +/- 7.2 years. The leading cause of DD was the partial or complete omission of decompression. The development of type I DD (57%) (basically joint pain) was more common than type II (43%) (neurological vestibular and/or pulmonary features). In 84.3% of cases the clinical features began within 6 hours of the end of immersion, although only 61.5% were treated during the initial 6 hours. When therapy was delayed for longer than 6 hours, the rate of sequelae was considerably increased. The rate of complete recovery after treatment in a compression chamber was 92.7% for type I DD and 71.1% for type II DD.
