Hyperbaric Oxygen as an Adjunct Treatment of Freezing Cold Injury
Abstract
Although there is general agreement that the initial treatment of freezing cold injury (FCI) should be rapid rewarming to prevent direct injury from intracellular ice formation and protein denaturation, there is less conformity in the clinical intervention after rewarming. Medical treatment is directed towards the prevention of additional injury due to microvascular damage. With the exception of freezing cold injury, hyperbaric oxygen therapy is now accepted as an adjunct therapy for the management of all other acute traumatic peripheral ischaemias, such as crush injuries, compartment syndrome, thermal burns, compromised skin grafts and flaps, and threatened replantations. The present report documents our experience of using HBO as an adjunct therapy in the treatment of 10 FCI patients. All patients were experienced alpinists, which received their injury during expeditions in the Alps, Andes, Himalayas, and Pamir. All received field medical attention upon returning to base camp, and regardless of location managed to return to Ljubljana within a few days to a week for further treatment, which also included HBO therapy (HBOT). During HBOT patients were compressed to 2.5 ATA for 90 min and breathed 100% oxygen via an oro-nasal mask. During the 90-min therapy, subjects inspired 100% oxygen for 25 min followed by a 5 min air break. This was repeated 3 times. Bone scintigraphy was performed prior to the HBO treatment protocol in 7 patients. The number of HBOTs ranged from 11 to 30 per patient. In all cases, patients presented with oedema in the afflicted digits. Some patients also had haemorrhagic blisters and/or some necrosis. The progression of their recovery, and results of HBOT are largely dependent on the time between injury to the onset of HBOT, the magnitude of the injury, and the field treatment. In general, oedema subsided by the 3rd to 5th day of HBOT, and revitalisation of the affected region was evident on the 2nd day of HBOT.
Document Details
- Document Type
- Technical Report
- Publication Date
- May 01, 2005
- Accession Number
- ADA454671
Entities
People
- Fajko Bajrovic
- Igor B. Mekjavic
- Jurij Gorjanc
- Metka Milcinski
- Polana J. Mekjavic
Organizations
- University of Ljubljana