Hyperbaric Oxygen Therapy in Systemic Inflammatory Response Syndrome
Abstract
:1. Introduction
2. Materials and Methods
2.1. Admission Consultation
2.2. HBOT Protocol
- Physical examination of the animal, verifying the absence of counterindications for HBOT, and, later, removal of bandages and collars that are not advised during HBOT. IV catheters, 100% protected by cotton bandages, were also placed.
- Switching on the hyperbaric chamber, testing the ground connection (demonstrating values between 0 and 1 Ω) to ensure safe use and opening of the O2 tap, after verification of the O2 levels in the cylinders.
- Placement of the dog inside the chamber, after humidifying its skin with a sprayer or a wet cloth, and closure of the door, and making sure there are no air leakages (Figure 2).
- Compression phase: opening of the O2 valve and increase of the pressure to 5 psi, followed by a 2-psi increase per minute, until a maximum of 30 psi, or until the animal shows signs of discomfort, to correct major or minor secondary effects that may occur.
- Treatment phase: maintenance of the pressure between 2.4 and 2.8 ATA for 30–45 min, except when minor secondary effects are shown.
- Decompression phase: closure of the O2 valve and slow decompression of the chamber. When the pressure is close to 0 psi, two cranks are slightly opened to let out some of the air, followed by the total opening of the door.
- Cleaning of the interior of the chamber with 50 mL of 4% chlorhexidine solution diluted in 1 L of NaCl. Closure of the safety oxygen tap, as well as the pressure regulator and the flux sensor pressure gauge.
2.3. Internal Medicine Protocol
2.4. Monitoring of Side Effects
2.5. Study Population Evaluation
2.6. Statistical Analysis
- Etiology and number of HBOT sessions;
- Etiology and number of days between the first and the last HBOT sessions;
- Etiology and number of days between the diagnosis and the first HBOT session;
- Etiology and clinical outcome.
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Cytokines | Increase of endothelin 1; vasoconstriction. |
Decrease of IL-1, IL-6 and TNF. | |
Increase of VEGF; angiogenesis. | |
Decrease of TNF-α after ischemia and reperfusion. | |
Up-regulation of FGF. | |
Prostaglandins | Decrease of PGE2 in macrophages, bone, gingiva, colon, and kidney. |
Nitric Oxide | Up-regulation of NO production. |
Heart Rate | >120 bpm |
Respiratory Rate | >20 bpm |
Temperature | <38 °C ou >39 °C |
Leucogramme | <6000/µL ou >16,000/µL ou >3% band neutrophils |
% | Mean | Mode | Median | SD (+/−) | SEM | |
---|---|---|---|---|---|---|
Breed | 59.2% known breed 40.8% mixed breed | ✗ | ✗ | ✗ | ✗ | ✗ |
Sex | 55.1% male 44.9% female | ✗ | ✗ | ✗ | ✗ | ✗ |
Etiology | 65.3% TSG 34.7% NTSG | ✗ | ✗ | ✗ | ✗ | ✗ |
Age | ✗ | 8.845 | 8 | 9 | 4.8719 | 0.6960 |
Weight | ✗ | 23.224 | 25 | 25 | 14.1705 | 2.0244 |
Minor Side Effects | Major Side Effects |
---|---|
Head shaking | Barotrauma |
Increase in respiratory frequency | Seizures |
Yawning | Syncope |
Ear scratching | Death |
Swallowing | |
Vocalizations | |
Anxious after 5–10 min of treatment |
t-Test | Chi-Square | Mann-Whitney | |
---|---|---|---|
Etiology and number of HBOT sessions. | ✓ | ✓ | ✓ |
Etiology and number of days between the first and the last HBOT sessions. | ✓ | ✓ | ✓ |
Etiology and number of days between the diagnosis and the first HBOT session. | ✓ | ✓ | ✗ |
Etiology and clinical outcome. | ✗ | ✓ | ✓ |
Number of Dogs n = 32 | Serum Lactate at Admission | Systolic Arterial Pressure at Admission | Modified Glasgow Scale at Admission | Monitorization |
---|---|---|---|---|
8 | N | N | 10 (n = 3) 9 (n = 5) | 13–15 (n = 8 after 48 h) |
4 | N | N | N | ✗ |
10 | N | 60–65 mmHg | N | N after fluid therapy resuscitation |
7 | >4 mg/dL | N | N | N Lact clearance (6 h of fluid therapy) |
3 | >10 mg/dL | N | N | Half of Lact clearence (6 h after fluid therapy), N Lact clearence (24 h) |
Side Effects | TSG (n = 32) | NTSG (n = 17) |
---|---|---|
Head shaking | 32 | 17 |
Increase in respiratory frequency | 21 | 17 |
Yawning | 14 | 17 |
Ear scratching | 14 | 12 |
Swallowing | 0 | 1 |
Vocalizations | 0 | 1 |
Anxious after 5–10 min of treatment | 2 | 7 |
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Gouveia, D.; Chichorro, M.; Cardoso, A.; Carvalho, C.; Silva, C.; Coelho, T.; Dias, I.; Ferreira, A.; Martins, Â. Hyperbaric Oxygen Therapy in Systemic Inflammatory Response Syndrome. Vet. Sci. 2022, 9, 33. https://doi.org/10.3390/vetsci9020033
Gouveia D, Chichorro M, Cardoso A, Carvalho C, Silva C, Coelho T, Dias I, Ferreira A, Martins Â. Hyperbaric Oxygen Therapy in Systemic Inflammatory Response Syndrome. Veterinary Sciences. 2022; 9(2):33. https://doi.org/10.3390/vetsci9020033
Chicago/Turabian StyleGouveia, Débora, Mariana Chichorro, Ana Cardoso, Carla Carvalho, Cátia Silva, Tiago Coelho, Isabel Dias, António Ferreira, and Ângela Martins. 2022. "Hyperbaric Oxygen Therapy in Systemic Inflammatory Response Syndrome" Veterinary Sciences 9, no. 2: 33. https://doi.org/10.3390/vetsci9020033