Van Meter KW
Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, In.... Date of publication 2012 Sep 1;volume 39(5):937-42.
1. Undersea Hyperb Med. 2012 Sep-Oct;39(5):937-42.
The effect of hyperbaric oxygen on severe anemia.
Van Meter KW(1).
Author information:
(1)Louisiana State University-Health Sciences Center, Department of Medicine,
Section of Emergency Medicine, New Orleans, Louisiana, USA. kwvanmeter@gmail.com
As a respiratory pigment, hemoglobin allows blood to carry unnaturally high
levels of nascent, molecular oxygen at one atmosphere of pressure in chemical
solution to capillary beds and post-capillary venules supplying parenchymal cells
of all organ systems in the body. When hemoglobin drops to critical levels to
disallow proper oxygen delivery, hyperbaric oxygen therapy may be used as bridge
therapy to emergently supply oxygen. Hyperbaric-administered oxygen allows oxygen
to be dissolved in increased concentration in red blood cell-poor plasma or
crystalloid/ colloid-diluted intravascular fluids in a volume-resuscitated
patient. Additionally in both subacutely and chronically anemic patients, pulsed,
intermittently provided normobaric or hyperbaric oxygen induces an increase in
red blood cell/hemoglobic mass. Transfusions of separate donor red blood cells
are transplantations of tissue not uncomplicated by immunomodulatory reactions.
In the long term, autologous blood products may be less problematic than
transfused, homologous packed red blood cells to reduce patient oxygen debt in
illness or injury. Hyperbaric oxygen can reduce oxygen debt decisively in the
polar clinical extremes of exsanguination with cardiopulmonary arrest all the way
to resuscitation of the severely anemic patient who cannot be transfused with red
blood cells for religious reasons, immunologic reasons, or blood availability
problems. A hyperbaric oxygen treatment is equivalent in wholesale cost to a unit
of packed red blood cells in the western world. By controversy, but true,
hyperbaric oxygen provides a low-technology, cost-competitive means of
pharmacologically reducing accumulated oxygen debt in the anemic, injured or
critically ill patient with little side effect. To address severe anemia in
trauma or illness, the future may well afford the use of hyperbaric oxygen
therapy in the military far-forward, in pre-hospital EMS settings, in trauma
center emergency departments, in operative and recovery units, and in intensive
care units of hospitals.
PMID: 23045922 [Indexed for MEDLINE]
