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Crush Injury with Acute Traumatic Ischemia


HBO2T is an adjunct to standard surgical treatment, including vascular repair as indicated. Must be initiated within 48 hours of injury.


An excellent review of this subject with 48 reference was published in 1981 by Strauss. He emphasized the importance of the level of arterial damage. Even high arterial pO2 achievable with hyperbaric oxygen will not be of value in cases of large vessel occlusion without adequate collateral circulation, but may be of considerable value in supporting partially ischemic tissue in a wound with areas of occlusion in smaller peripheral vessels or with marginal collateral circulation. Guyton points out that "oxygen transport to the tissue is the most nearly flow limited of all common physiologically important substances transported by the blood." With oxygen inhalation at 2 ATA or greater, plasma dissolved oxygen is delivered to marginally perfused tissues in a wound to support tissue viability. Hyperbaric oxygen must be used in close coordination with surgical care.

There is further rationale for value as intermittent elevation of wound oxygen tension improves leukocyte bacterial killing. It is preferable that these wounds be treated within eight hours of occurrence, but benefit has been reported in cases started as late as 48 hours after injury.

Cost Impact

Considerable decrease in morbidity and resultant hospitalization is anticipated with a cost savings.

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