Hyperbaric Tlenotherapy in WIM

W The WIM-PIB Clinical medicine Department is besides conducting investigation and cooperation with another medical and hyperbaric centres in the country and abroad, which resulted in, among others, the implementation of a non-commercial clinical trial entitled "Hybaric Tlenotherapy (HBOT) in the treatment of COVID-19" financed by the Medical investigation Agency.

Therapeutic indications for hyperbaric therapy are acute and chronic conditions.

Acute indication for hyperbaric oxygen therapy is decompression disease, carbon monoxide poisoning, gas embolism due to e.g. iatrogenic effects, musculoskeletal trauma, soft tissue necrosis (clostridium difficile), idiopathic deafness and acoustic injury.

Chronic diseases eligible for oxygen hyperbaric treatment include diabetic ft syndrome, amputational states, necrotic inflammatory conditions, sterile osteonecrosis, lesion, abscesses, any hard-to-healing wounds, radiation soft tissue necrosis, CRAO, second-degree burns, and many others whose replacement
exceeds the framework of this study.

In case of uncertainty about the anticipation of treating a peculiar condition and condition of the patient, we always urge contacting our doctors to find the course of treatment or the patient's qualifications for treatment in the Clinical Department of Hyperbaric Medicine.

The Clinical Department of Hyperbaric medicine provides services not only to patients of the Mazowieckie province, but to the full country. In the hyperbaric chamber, according to NFZ guidelines, we can treat acute and chronic patients

The sharp indications include:
- gas congestion
- diving accidents
- decompression illness of divers and pilots
- carbon monoxide poisoning
- necrotic soft tissue infections (anaerobic and mixed)
- acute soft tissue ischaemia
- muscle-skeletal injury (with a hazard of compartmental syndrome),
crush injury)
- thermal burns (second-degree burns > 10% in children and third-degree burns
> 20 % in adults)
- abrupt deafness
- acoustic injury

For chronic indications
- radiation harm to tissues and organs
- hard wounds
* diabetic ft syndromes
Infections and necrosis of the stump after amputation
* dermatitis and subcutaneous tissue
* spilling malignant external otitis
* Dependent ulcers
* lower limb trophic ulcers
- inflammation and osteonecrosis
- skin graft at hazard of necrosis
- Post-traumatic wound infection
- inflammation of the sternum
- postoperative mediastinitis
- Bridge instability
-Props
*Intracranial abscesses
* lung abscess
*pleural abscess8
Liver abscess
- Radius

We can treat patients with these diseases and any wellness and derivative modifications of these diseases.

Hyberbaric Oxygen Therapy (HBOT) is simply a treatment that involves subjecting the patient to gas mixtures containing advanced oxygen concentrations at elevated force conditions.

It is produced inside specially constructed steel rooms, called hyperbaric chambers, combined with force support systems. Both the construction of these devices and their first application have its sources in underwater medicine, dynamically developing in armies around the planet during the second half of the 20th century. Today, hyperbaric medicine entering civilian medicine in advanced clinical centers is simply a modern discipline branch from the borderline of medical engineering, intensive therapy and diving medicine. Its effectiveness is based on the treatment of patients under pressure, corresponding to that prevailing in the deep sea. Thanks to the usage of appropriate mixtures of respiratory gases inside the hyperbaric chamber, it is possible to get partial pressures of oxygen that are repeatedly higher than those that can be obtained under atmospheric conditions. The benefits of specified therapy are manifested in better penetration of oxygen molecules into damaged tissues, or lesions (e.g. in hard wounds, diabetic angiopathy), increased antibiotic efficacy, or support of the patient’s immune response. During the scheduled treatment, the patient has a series of therapeutic sessions in the hyperbaric chamber (one to respective dozen), the amount of which depends on the reason for the referral.

At the Military Medical Institute, the infrastructure of the Clinical Department of Hyperbaric medicine includes a number of installations and devices designed to treat the most severe patients. The centre has 1 of the largest multi-seat hyperbaric chambers in this part of Europe. The installation maintaining the environment of hypertension in its interior occupies respective separate rooms and extends both inside the main building and method buildings and outside infirmary facilities. As 1 of the fewer chambers in Europe, it has installations to execute pressures under force conditions of 11 ATA (absolute atmosphere).

The safety of treatment in the hyperbaric chamber requires strict adherence to rules and procedures akin to those commonly utilized in civilian aviation. The preparation of the hyperbaric session requires standard installation control personnel, the planning of the compression profile, the estimation of the available gas resources, and the calculation of the expected decompression. From the minute the force rises inside the chamber, all persons inside are isolated from the outside.

Due to advanced force values and increased oxygen content inside the hyperbaric chamber, the hazard of uncontrolled ignition increases. To minimise the hazard of life, it is strictly prohibited
bringing into the chamber objects that can origin sparks, or fire (cell phones, lighters, watches, clothes made of artificial materials and much more). Due to the circumstantial conditions in which hyperbaric oxygen therapy is conducted, safety is simply a priority. Each patient must read the applicable rules and strictly follow them during treatment. In order to increase safety, during each session in the chamber, there is simply a associate of the medical staff called the "medical examiner".

The hyperbaric chamber is simply a peculiar area where patients and medical personnel are present during surgery. It has the equipment and equipment essential for the safe conduct of hyperbaric oxygen therapy in all its stages, i.e.:
* Compression, or compression, by filling the chamber with air, administered under pressure, usually up to 2.5 times the atmospheric. Compression is accompanied by sound and a crucial increase in temperature inside the chamber. In the course of compression, all persons inside must equalise the force according to the instructions of the staff.
* Oh, my God * Patient stay under elevated force during which patients breathe 100% oxygen, supplied by the individual respiratory system. Oxygen respiration takes 1 hr with 2 fewer minute breaks during which patients breathe air without respiratory systems.
* Decompression, or expansion by gradually reducing the force in the chamber to atmospheric pressure. Decompression is accompanied by sound and a crucial simplification in indoor air temperature.

Patients who study to the Hyperbaric medicine Clinical Division due to chronic conditions should have a referral to the hyperbaric therapy centre, medical records and ECG results, RTGs (possibility to execute them in the ward).

Text: Mariusz Gierej/ WIM