Senin, 29 November 2010

ibu Evi budiman

salam bu evi,

hiperbarik untuk penangan lebih lanjut terhadap kasus ibu saya belum dapat referensi. tetapi kasus yg ibu alami buka erupakan kontra indikasi untuk hiperbarik.
Kecantikan, kebugaran, vitalitas tetap dapat dilaksanakan untuk ibu.


terima kasih
Erick Supondha
Hyperbaric&Diving medicine consultant

Sabtu, 27 November 2010

HYPERBARIC MEDICINE CONSULTANT: Buku referensi yang perlu di ketahui untuk mengenal hiperbarik

HYPERBARIC MEDICINE CONSULTANT: Buku referensi yang perlu di ketahui untuk mengenal hiperbarik

Buku referensi yang perlu di ketahui untuk mengenal hiperbarik

1. ^ a b Gesell, Laurie B. (Chair and editor) (2008). Hyperbaric Oxygen Therapy Indications. The Hyperbaric Oxygen Therapy Committee Report (12 ed.). Durham, NC: Undersea and Hyperbaric Medical Society. ISBN 0930406230.
2. ^ Jørgensen TB, Sørensen AM, Jansen EC (April 2008). "Iatrogenic systemic air embolism treated with hyperbaric oxygen therapy". Acta Anaesthesiol Scand 52 (4): 566–8. doi:10.1111/j.1399-6576.2008.01598.x. PMID 18339163.
3. ^ The Cochrane Reviews. "The Cochrane Reviews". http://www.cochrane.org/. Retrieved 2008-05-16.
4. ^ "HBOT Proposal to Congress". http://www.hyperbaricmedicalassociation.org/337/text/436/files/Harch_HAC_D_TBI_Off_Label_Response_090306Combined.pdf.
5. ^ Harch, Paul. The Oxygen Revolution. Hatherleigh Press. ISBN 978-1-57826-237-3.
6. ^ "Indications for hyperbaric oxygen therapy". Undersea & Hyperbaric Medical Society. 2007. http://www.uhms.org/Default.aspx?tabid=270. Retrieved 5 February 2010.
7. ^ Textbook of Hyperbaric Medicine KK Jane, 5th Edition, 2010
8. ^ Undersea and Hyperbaric Medical Society. "Air or Gas Embolism". http://www.uhms.org/ResourceLibrary/Indications/AirorGasEmbolism/tabid/271/Default.aspx. Retrieved 2008-05-19.
9. ^ Undersea and Hyperbaric Medical Society. "Carbon Monoxide". http://www.uhms.org/ResourceLibrary/Indications/CarbonMonoxidePoisoning/tabid/272/Default.aspx. Retrieved 2008-05-19.
10. ^ Piantadosi CA (2004). "Carbon monoxide poisoning". Undersea Hyperb Med 31 (1): 167–77. PMID 15233173. http://archive.rubicon-foundation.org/4002. Retrieved 2008-05-19.
11. ^ Undersea and Hyperbaric Medical Society. "Cyanide Poisoning". http://www.uhms.org/ResourceLibrary/Indications/CarbonMonoxidePoisoning/CyanidePoisoning/tabid/284/Default.aspx. Retrieved 2008-05-19.
12. ^ Hall AH, Rumack BH (September 1986). "Clinical toxicology of cyanide". Ann Emerg Med 15 (9): 1067–74. doi:10.1016/S0196-0644(86)80131-7. PMID 3526995. http://linkinghub.elsevier.com/retrieve/pii/S0196-0644(86)80131-7. Retrieved 2008-05-19.
13. ^ Takano T, Miyazaki Y, Nashimoto I, Kobayashi K (September 1980). "Effect of hyperbaric oxygen on cyanide intoxication: in situ changes in intracellular oxidation reduction". Undersea Biomed Res 7 (3): 191–7. PMID 7423657. http://archive.rubicon-foundation.org/2888. Retrieved 2008-05-19.
14. ^ Undersea and Hyperbaric Medical Society. "Clostridal Myositis and Myonecrosis (Gas gangrene)". http://www.uhms.org/ResourceLibrary/Indications/ClostridalMyositisandMyonecrosis/tabid/273/Default.aspx. Retrieved 2008-05-19.
15. ^ Hart GB, Strauss MB (1990). "Gas Gangrene - Clostridial Myonecrosis: A Review". J. Hyperbaric Med 5 (2): 125–144. http://archive.rubicon-foundation.org/4428. Retrieved 2008-05-16.
16. ^ Zamboni WA, Riseman JA, Kucan JO (1990). "Management of Fournier's Gangrene and the role of Hyperbaric Oxygen". J. Hyperbaric Med 5 (3): 177–186. http://archive.rubicon-foundation.org/4431. Retrieved 2008-05-16.
17. ^ Undersea and Hyperbaric Medical Society. "Crush Injury, Compartment syndrome, and other Acute Traumatic Ischemias". http://www.uhms.org/ResourceLibrary/Indications/CrushInjury/tabid/274/Default.aspx. Retrieved 2008-05-19.
18. ^ Bouachour G, Cronier P, Gouello JP, Toulemonde JL, Talha A, Alquier P (August 1996). "Hyperbaric oxygen therapy in the management of crush injuries: a randomized double-blind placebo-controlled clinical trial". J Trauma 41 (2): 333–9. PMID 8760546. http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0022-5282&volume=41&issue=2&spage=333. Retrieved 2008-05-19.
19. ^ Undersea and Hyperbaric Medical Society. "Decompression Sickness or Illness and Arterial Gas Embolism". http://www.uhms.org/ResourceLibrary/Indications/DecompressionSickness/tabid/275/Default.aspx. Retrieved 2008-05-19.
20. ^ Brubakk, A. O.; T. S. Neuman (2003). Bennett and Elliott's physiology and medicine of diving, 5th Rev ed.. United States: Saunders Ltd.. p. 800. ISBN 0702025712.
21. ^ Acott, C. (1999). "A brief history of diving and decompression illness". South Pacific Underwater Medicine Society Journal 29 (2). ISSN 0813-1988. OCLC 16986801. http://archive.rubicon-foundation.org/6004. Retrieved 2008-03-18.
22. ^ Undersea and Hyperbaric Medical Society. "Enhancement of Healing in Selected Problem Wounds". http://www.uhms.org/ResourceLibrary/Indications/ProblemWounds/tabid/276/Default.aspx. Retrieved 2008-05-19.
23. ^ Zamboni WA, Wong HP, Stephenson LL, Pfeifer MA (September 1997). "Evaluation of hyperbaric oxygen for diabetic wounds: a prospective study". Undersea Hyperb Med 24 (3): 175–9. PMID 9308140. http://archive.rubicon-foundation.org/2279. Retrieved 2008-05-16.
24. ^ Kranke P, Bennett M, Roeckl-Wiedmann I, Debus S (2004). "Hyperbaric oxygen therapy for chronic wounds". Cochrane Database Syst Rev (2): CD004123. doi:10.1002/14651858.CD004123.pub2. PMID 15106239.
25. ^ Abidia A, Laden G, Kuhan G, et al. (June 2003). "The role of hyperbaric oxygen therapy in ischaemic diabetic lower extremity ulcers: a double-blind randomised-controlled trial". Eur J Vasc Endovasc Surg 25 (6): 513–8. doi:10.1053/ejvs.2002.1911. PMID 12787692.
26. ^ Kalani M, Jörneskog G, Naderi N, Lind F, Brismar K (2002). "Hyperbaric oxygen (HBO) therapy in treatment of diabetic foot ulcers. Long-term follow-up". J. Diabetes Complicat. 16 (2): 153–8. doi:10.1016/S1056-8727(01)00182-9. PMID 12039398. http://linkinghub.elsevier.com/retrieve/pii/S1056872701001829.
27. ^ Chen, J (2003). "The Effects of Hyperbaric Oxygen Therapy on Diabetic Retinopathy". Investigative Ophthalmology & Visual Science 44 (5): 4017–B720. http://abstracts.iovs.org/cgi/content/abstract/44/5/4017. Retrieved 16 December 2008.
28. ^ Chang, Yun-Hsiang et al; Chen, PL; Tai, MC; Chen, CH; Lu, DW; Chen, JT (006). "Hyperbaric oxygen therapy ameliorates the blood–retinal barrier breakdown in diabetic retinopathy". Clinical & Experimental Ophthalmology 34 (6): 584–589. doi:10.1111/j.1442-9071.2006.01280.x. PMID 16925707. http://www3.interscience.wiley.com/journal/118585162/abstract. Retrieved 16 December 2008.
29. ^ Basile C, Montanaro A, Masi M, Pati G, De Maio P, Gismondi A (2002). "Hyperbaric oxygen therapy for calcific uremic arteriolopathy: a case series". J. Nephrol. 15 (6): 676–80. PMID 12495283.
30. ^ Undersea and Hyperbaric Medical Society. "Exceptional Blood Loss - Anemia". http://www.uhms.org/ResourceLibrary/Indications/ExceptionalBloodLossAnemia/tabid/277/Default.aspx. Retrieved 2008-05-19.
31. ^ Hart GB, Lennon PA, Strauss MB. (1987). "Hyperbaric oxygen in exceptional acute blood-loss anemia". J. Hyperbaric Med 2 (4): 205–210. http://archive.rubicon-foundation.org/4352. Retrieved 2008-05-19.
32. ^ Undersea and Hyperbaric Medical Society. "Intracranial Abscess". http://www.uhms.org/ResourceLibrary/Indications/IntracranialAbscess/tabid/278/Default.aspx. Retrieved 2008-05-19.
33. ^ Lampl LA, Frey G, Dietze T, Trauschel M. (1989). "Hyperbaric Oxygen in Intracranial Abscesses". J. Hyperbaric Med 4 (3): 111–126. http://archive.rubicon-foundation.org/4352. Retrieved 2008-05-19.
34. ^ Undersea and Hyperbaric Medical Society. "Necrotizing Soft Tissue Infections". http://www.uhms.org/ResourceLibrary/Indications/NecrotizingSoftTissueInfections/tabid/279/Default.aspx. Retrieved 2008-05-19.
35. ^ Escobar SJ, Slade JB, Hunt TK, Cianci P (2005). "Adjuvant hyperbaric oxygen therapy (HBO2) for treatment of necrotizing fasciitis reduces mortality and amputation rate". Undersea Hyperb Med 32 (6): 437–43. PMID 16509286. http://archive.rubicon-foundation.org/4061. Retrieved 2008-05-16.
36. ^ Undersea and Hyperbaric Medical Society. "Refractory Osteomyelitis". http://www.uhms.org/ResourceLibrary/Indications/OsteomyelitisRefractory/tabid/280/Default.aspx. Retrieved 2008-05-19.
37. ^ Mader JT, Adams KR, Sutton TE (1987). "Infectious diseases: pathophysiology and mechanisms of hyperbaric oxygen". J. Hyperbaric Med 2 (3): 133–140. http://archive.rubicon-foundation.org/4339. Retrieved 2008-05-16.
38. ^ Kawashima M, Tamura H, Nagayoshi I, Takao K, Yoshida K, Yamaguchi T (2004). "Hyperbaric oxygen therapy in orthopedic conditions". Undersea Hyperb Med 31 (1): 155–62. PMID 15233171. http://archive.rubicon-foundation.org/4000. Retrieved 2008-05-16.
39. ^ Undersea and Hyperbaric Medical Society. "Hyperbaric Ocxgen Treatments for Complications of radiation Therapy". http://www.uhms.org/ResourceLibrary/Indications/DelayedRadiationInjury/tabid/281/Default.aspx. Retrieved 2008-05-19.
40. ^ Zhang, L. D.; J. F. Kang; H. L. Xue. (1990). "Distribution of lesions in the head and neck of the humerus and the femur in dysbaric osteonecrosis". Undersea Biomed. Res. 17 (4): 353–358. ISSN 0093-5387. OCLC 2068005. PMID 2396333. http://archive.rubicon-foundation.org/2570. Retrieved 2008-04-06.
41. ^ Lafforgue, P., Pathophysiology and natural history of avascular necrosis of bone. Joint Bone Spine, 2006. 73(5): p. 500–7.
42. ^ Undersea and Hyperbaric Medical Society. "Skin Grafts and Flaps Compromised". http://www.uhms.org/ResourceLibrary/Indications/SkinGraftsFlaps/tabid/282/Default.aspx. Retrieved 2008-05-19.
43. ^ McFarlane RM, Wermuth RE (May 1966). "The use of hyperbaric oxygen to prevent necrosis in experimental pedicle flaps and composite skin grafts". Plast. Reconstr. Surg. 37 (5): 422–30. doi:10.1097/00006534-196605000-00008. PMID 5327032.
44. ^ Undersea and Hyperbaric Medical Society. "Thermal Burns". http://www.uhms.org/ResourceLibrary/Indications/ThermalBurns/tabid/283/Default.aspx. Retrieved 2008-05-19.
45. ^ Cianci P, Lueders H, Lee H, Shapiro R, Sexton J, Williams C, Green B (1988). "Adjunctive Hyperbaric Oxygen Reduces the Need for Surgery in 40–80% Burns". J. Hyperbaric Med 3 (2): 97–101. http://archive.rubicon-foundation.org/4369. Retrieved 2008-05-16.
46. ^ Taylor RS, Simpson IN (September 2005). "Review of treatment options for lyme borreliosis". J Chemother 17 Suppl 2: 3–16. PMID 16315580. http://www.jchemother.it/cgi-bin/digisuite.exe/searchresult?range=pubmed&volume=17+Suppl+2&year=2005&firstpage=3. Retrieved 2008-08-06.
47. ^ Bennett MH, Wasiak J, Schnabel A, Kranke P, French C (2005). "Hyperbaric oxygen therapy for acute ischaemic stroke". Cochrane Database Syst Rev (3): CD004954. doi:10.1002/14651858.CD004954.pub2. PMID 16034959.
48. ^ Jain KK (1989). "Effect of Hyperbaric Oxygenation on Spasticity in Stroke Patients.". J. Hyperbaric Med 4 (2): 55–61. http://archive.rubicon-foundation.org/4394. Retrieved 2008-08-06.
49. ^ Singhal AB, Lo EH (February 2008). "Advances in emerging nondrug therapies for acute stroke 2007". Stroke 39 (2): 289–91. doi:10.1161/STROKEAHA.107.511485. PMID 18187678. http://stroke.ahajournals.org/cgi/pmidlookup?view=long&pmid=18187678. Retrieved 2008-08-06.
50. ^ Bennett MH, French C, Schnabel A, Wasiak J, Kranke P (2008). "Normobaric and hyperbaric oxygen therapy for migraine and cluster headache". Cochrane Database Syst Rev (3): CD005219. doi:10.1002/14651858.CD005219.pub2. PMID 18646121.
51. ^ Eftedal OS, Lydersen S, Helde G, White L, Brubakk AO, Stovner LJ (2004). "A randomized, double blind study of the prophylactic effect of hyperbaric oxygen therapy on migraine". Cephalalgia 24 (8): 639–44. doi:10.1111/j.1468-2982.2004.00724.x. PMID 15265052.
52. ^ Fife WP, Fife CE (1989). "Treatment of Migraine with Hyperbaric Oxygen.". J. Hyperbaric Med 4 (1): 7–15. http://archive.rubicon-foundation.org/4386. Retrieved 2008-08-06.
53. ^ Rossignol DA, Rossignol LW, Smith S et al. (2009). "Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial" (PDF). BMC Pediatrics 9: 21. doi:10.1186/1471-2431-9-21. PMID 19284641. PMC 2662857. http://www.biomedcentral.com/content/pdf/1471-2431-9-21.pdf. Lay summary – BBC News (2009-03-14).
54. ^ Baechli H, Schmutz J, Mayr JM (2008). "Hyperbaric oxygen therapy (HBO) for the treatment of an epidural abscess in the posterior fossa in an 8-month-old infant". Pediatr Neurosurg 44 (3): 239–42. doi:10.1159/000121383. PMID 18354266.
55. ^ Suzuki H, Fujimura T, Shiomori T, et al. (June 2008). "Prostaglandin E1 versus steroid in combination with hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss". Auris Nasus Larynx 35 (2): 192–7. doi:10.1016/j.anl.2007.06.003. PMID 17826927.
56. ^ Yoshida, Takahiro et al.; Kawashima, A; Ujike, T; Uemura, M; Nishimura, K; Miyoshi, S (2008). "Hyperbaric oxygen therapy for radiation-induced hemorrhagic cystitis". International Journal of Urology 15 (7): 639–641. doi:10.1111/j.1442-2042.2008.02053.x. PMID 18643783.
57. ^ Noyer, Charles M. et al.; Brandt, LJ (2004). "Hyperbaric oxygen therapy for perineal Crohn's disease". The American Journal of Gastroenterology 94 (2): 318–321. doi:10.1111/j.1572-0241.1999.00848.x. PMID 10022622.
58. ^ Atug, Ozlen et al.; Hamzaoglu, H; Tahan, V; Alican, I; Kurtkaya, O; Elbuken, E; Ozdogan, O; Tozun, N (2008). "Hyperbaric Oxygen Therapy Is as Effective as Dexamethasone in the Treatment of TNBS-E-Induced Experimental Colitis". Digestive Diseases and Sciences 53 (2): 481–485. doi:10.1007/s10620-007-9956-4. PMID 17934837.
59. ^ Ustundag, Aylin et al.; Duydu, Y; Aydin, A; Eken, A; Dundar, K; Uzun, G (2008). "Evaluation of the potential genotoxic effects of hyperbaric oxygen therapy". Toxicology Letters 180 (Supplement 1): S142. doi:10.1016/j.toxlet.2008.06.792.
60. ^ Mortensen, Christian Risby (2008). "Hyperbaric oxygen therapy". Current Anaesthesia & Critical Care (Elsevier) 19 (5–6): 333–337. doi:10.1016/j.cacc.2008.07.007.
61. ^ www.oxyhealth.com. "Portable Hyperbaric Chambers | Hyperbaric Oxygen Chamber | Hyperbaric Oxygen". Oxyhealth.com. http://www.oxyhealth.com/. Retrieved 2010-09-25.
62. ^ U.S. Navy Supervisor of Diving (2008). U.S. Navy Diving Manual. SS521-AG-PRO-010, revision 6. U.S. Naval Sea Systems Command. pp. 37–49. http://supsalv.org/pdf/DiveMan_rev6.pdf. Retrieved 2009-06-29.
63. ^ "Undersea and Hyperbaric Medical Society". Uhms.org. http://uhms.org/. Retrieved 2010-09-25.
64. ^ "Diving Physics". Rescuediver.org. http://www.rescuediver.org/med/phys.htm. Retrieved 2010-09-25.
65. ^ "Currently Accepted Applications of Hyperbaric Oxygen Therapy (HBOT)". HyperbaricsRx. http://www.hyperbaricsrx.com/accepted-applications-of-hbot.html. Retrieved 2010-09-25.
66. ^ Broome JR, Smith DJ (November 1992). "Pneumothorax as a complication of recompression therapy for cerebral arterial gas embolism". Undersea Biomed Res 19 (6): 447–55. PMID 1304671. http://archive.rubicon-foundation.org/2600. Retrieved 2008-05-23.
67. ^ a b Fitzpatrick DT, Franck BA, Mason KT, Shannon SG (1999). "Risk factors for symptomatic otic and sinus barotrauma in a multiplace hyperbaric chamber". Undersea Hyperb Med 26 (4): 243–7. PMID 10642071. http://archive.rubicon-foundation.org/2316. Retrieved 2008-05-23.
68. ^ Fiesseler FW, Silverman ME, Riggs RL, Szucs PA (2006). "Indication for hyperbaric oxygen treatment as a predictor of tympanostomy tube placement". Undersea Hyperb Med 33 (4): 231–5. PMID 17004409. http://archive.rubicon-foundation.org/5033. Retrieved 2008-05-23.
69. ^ Stein, L (2000). "Dental Distress. The ‘Diving Dentist’ Addresses the Problem of a Diving-Related Toothache" (PDF). Alert Diver (January/ February): 45–48. http://www.diversalertnetwork.org/membership/alert-diver/articles/public/AlertDiver_JF00_45-48.PDF. Retrieved 2008-05-23.
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73. ^ Gesell LB, Adams BS, and Kob DG (2000). "De Novo Cataract Development Following A Standard Course Of Hyperbaric Oxygen Therapy". Undersea Hyperb Med abstract 27 (supplement). http://archive.rubicon-foundation.org/6862. Retrieved 2008-06-01.
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[edit] Further reading

* Kindwall, Eric P; Whelan, Harry T (2008). Hyperbaric Medicine Practice, 3rd Edition. Flagstaff, AZ: Best Publishing Company. ISBN 978-1-930536-49-4.
* Mathieu, Daniel (2006). Handbook on Hyperbaric Medicine. Berlin: Springer. ISBN 1-4020-4376-7.
* Jain, KK; Baydin, SA (2004). Textbook of hyperbaric medicine. Cambridge, MA: Hogrefe & Huber. ISBN 0-88937-277-2.
* Harch, Paul G; McCullough, Virginia (2010). The Oxygen Revolution. Long Island City, NY: Hatherleigh Press. ISBN 1578263263.

[edit] External links

* Hyperbaric Oxygen Therapy from eMedicine
* Conditions treated by Hyperbaric Medicine

dr.erick supondha (dokter konsultan ahli hiperbarik)

Diabetes, Wound Healing, And Hyperbaric Oxygen Chamber Therapy

Diabetes, Wound Healing, And Hyperbaric Oxygen Chamber Therapy

According to the American Diabetes Association, diabetes is a disease in which the body does is not able to produce or properly use insulin. Insulin is a hormone that are bodies need to converts sugar, starches and other food into energy that we need for daily life. Although both genetics and environmental factors such as obesity and lack of exercise appear to play a role in having diabetes, the cause of diabetes continues to be a mystery.

There are about 23.6 million children and adults in the United States or 7.8% of the population ho suffer from diabetes. While there are an estimate of 17.9 million who have been diagnosed of diabetes, there are also 5.7 million people who are unaware that they have diabetes.

And example of how diabetes affects our bodies is diabetic foot wounds. Individuals who have diabetes suffer circulatory disorders that create inadequate levels of oxygen to support the healing of wounds. These wounds present major complications for modern health care and especially with the foot as it is a common site of infection. In Canada, there is an estimated 25% Canadians with diabetes who develop foot complications and 1 in 15 end up having a limb amputation during their lifetime.

Is diabetes a hopeless case? What could help in the cure for diabetes and wound healing? The answer to the first question is that diabetes is not a hopeless case, the second answer would be oxygen. Oxygen is one of the most powerful and versatile agents available to the modern medical practitioner today. The therapeutic use of oxygen under pressure has been used to assist in the healing of wounds for almost 40 years. This therapeutic use of oxygen under pressure is called hyperbaric oxygen chamber therapy (HBOT) and in the following paragraphs are its specific biological actions which can enhance diabetes and wound healing.

HBOT can be used successfully in hypoxic or ischemic wounds such as diabetic wounds,venous static ulcers, failing flaps and grafts, refractory osteomylitis and necrotising soft tissue infections. In wound healing, hypoxia delivers an insufficient supply of oxygen which prevents normal healing processes.

HBOT combats clinical infection such as gas gangrene by directly acting on the anaerobic bacteria, enhancing leukocyte and macrophage activity while potentiating the effects of antibiotics.

HBOT provides the oxygen needed to support and stimulate wound healing. HBOT is safe, non-invasive and a non-toxic therapy.

HBOT is also very much accessible. Single bag hyperbaric chambers are sold at $12,900 and double bag chambers are at $16,900. Single bag hyperbaric chambers can also be rented at $2,000 a month and $2,,675 for double bag chambers.

Both hyperbaric bag chambers measure over 34 inches in diameter and 105 inches long. These chambers can easily fit both adult and child at the same time.

Start spreading the word about HBOT and start helping lives as we

fr:Balanced Health Today

hiperbarik untuk diabetus/kencing manis (dr.erick supondha; dokter konsultan ahli hiperbarik)

Migraine Treated with Hyperbaric Oxygen Chambers

Migraine Treated with Hyperbaric Oxygen Chambers

Migrane is demonstrated as a severe periodic, unilateral, pulsatile headache associated with nausea, malaise, vomiting and photophobia. Factors that often precipitate attack are environmental stimuli such as emotional stress, strenuous physical exercise, too much sleep or sleep deprivation, some food (chocolate, aged cheese, nuts), alcohol (especially red wine), medical conditions and medication (antihypertensive drugs, contraceptive drugs, nitroglycerin).

In pathogenesis of migraine, vascular and biochemical changes play important role. First phase is vasospasm accompanied with reduction in blood flow causing ischemia and edema of intracranial vessels. Second phase is vasodilatation (extracranial vessels) with hyperemia (an increased amount of blood in a part or organ) and platelet aggregation that impairs microcirculation leading to pain.

There are reports of successful experimental use of hyperbaric oxygen therapy in migraine due to following HBO effects:

• HBO relieves pain by vasoconstriction of cerebral vessels

• HBO reduces hypoxia and increases oxygenation of brain

• HBO reduces swelling caused by inflammatory response in ischemic vessels

• HBO improves microcirculation by decreasing platelet aggregation

References:

1. Di Sabato F et al.: Effect of hyperbaric oxygen on the immunoreactivity to substance P in the nasal mucosal of cluster headache patients Headache, 1996,36: 221-223

2. Di Sabato F et al.: Hyperbaric oxygen therapy in cluster headache, Pain 1993, 52; 243-245

3. Di Sabato F et al.: Hyperbaric oxygen in chronic cluster headaches, Undearsea & Hyperbaric Medicine 1997, 24: 117-122

4. Fife WP et al.: Treatment of migraine with hyperbaric oxygen, Journal of Hyperbaric Med 4: 7-15; 1989.

5. Jain KK et al.: Hyperacute hyperbaric oxygen therapy for cerebral ischemia, Undearsea & Hyperbaric Medical Society 1998

6. Myers DE et al.: A preliminary report on hyperbaric oxygen in the relief of migraine headache, Headache, ,35: 197-199, 1995.

7. Pascual J et al.: Preventive effects of hyperbaric oxygen in cluster headache, Headache, 1995,35: 260-261

8. Robbins L et al.: Menstrual migraine with feature of cluster headache, Headache, 1996,36: 166-167

9. Thomsen LL et al.: Cerebral blood flow velocities are reduced during attacks of unilateral migraine without aura, Cephalalgia, 1995, 15: 77-78

10. Shalkevic VB et al.: Use of hyperbaric oxygenation in the therapy of transiet cerebral circulatory disturbances in the vertebro-basilar system, Abstracts of 7th international congress on HBO medicine.USSR Academy of Sciences, Moskow pp 294-295

11. Sukoff MH et al.: Hyperbaric oxygenation for the treatment of acute cerebral edema, Neurosurg 10 (1): 29-38

12. Weiss LD et al.: Treatment of cluster headaches in a hyperbaric chamber, Headache, 1989 29: 109-110

13. Wilson JR et al.: Hyperbaric oxygen in the treatment of migraine with aura, Headache: Feb 1998 , vol 38, 112-115.


fr:Balanced Health Today

hiperbarik untuk migraine (dr.erick supondha; dokter konsultan ahli hiperbarik)

Head Injuries Improved With Hyperbaric Oxygen Therapy

Head Injuries Improved With Hyperbaric Oxygen Therapy

The head trauma sustained during a motor vehicle accident is the most common killer among young adults, the aged and children. Getting medical treatments to this area of the body is paramount because the brain resides in this location and any brain function loss could mean loss of several motor skills as the minutes tick by. Injuries of the head and body were found to have improved significantly with hyperbaric oxygen therapy administered at local hospitals.

Patients are placed in a hyperbaric oxygen therapy chamber and infused with a moderate pressure environment that is filled with 100 percent pure oxygen. The patient can be conscious or unconscious when hyperbaric oxygen therapy is given. These treatments could continue at home while the patient is recovering from surgery and while at the hospital being treated by physicians for injuries sustained in any accident. Most people would associate hyperbaric treatments with diving accidents. Hyperbaric oxygen therapy will also prove beneficial for treatment of migraines, autism, Parkinson’s disease and a realm of other ailments.

Hyperbaric oxygen therapy chambers are available for rent through private vendors by the month or the oxygen therapy units can be purchased outright for long-term home care needs. Patients feel relief from many ailments after experiencing one treatment in the hyperbaric chamber. Patients are not tasked to perform but one function while in the chamber and that is to breathe.

Masks are worn while inside the hyperbaric oxygen therapy chamber in order to receive the influx of pure saturation of oxygen to the body. The overall experience achieved during and after the time in the hyperbaric oxygen therapy chamber will be excellent and previous users have stated that they felt elated and euphoric afterwards. Most of all, healing of the injuries was noted and pain levels had decreased. To those afflicted with head injuries that had received hyperbaric oxygen therapies, they felt that their head injuries had improved greatly. Hyperbaric oxygen therapy has improved many lives.

Patients with head injuries are in a debilitated state when they come out of surgery. Lots of healing must take place and the first location that many surgeons like to send their patients is to the hyperbaric oxygen treatment room. Organs are saturated with life healing oxygen and the brain is but one organ that benefits from this type of oxygen therapy first and foremost. The Food and Drug Administration has approved hyperbaric oxygen chamber therapy for any ailments and others will be added to the list in time.

Portable units of the hyperbaric oxygen therapy chamber feature no straps or buckles. They are lightweight and measure 36 inches in diameter. At 108 inches long, it can accommodate individuals of any height and the strong materials can accommodate a varying level of weight limits in the patients that use it. There are viewing windows on the hypobaric oxygen therapy system which makes it perfect for people who have visitors throughout the day. Head injuries take time to heal, and these units can speed that process along considerably.

fr:Balanced Health Today


hiperbarik untuk cedera kepala (dr.erick supondha; dokter konsultan ahli hiperbarik)

Cerebral Palsy and Hyperbaric Oxygen Therapy

Cerebral Palsy and Hyperbaric Oxygen Therapy

The term "cerebral palsy" is not a specific diagnosis, but is now generally applied to children who experience some forms of brain trauma either at the time of birth or shortly before. Typically, these children manifest some degree of cognitive impairment as well as physical impairment, often with weakness and spasticity of arms and legs. Typically treatment for children with cerebral palsy has been directed at the physical manifestations of the underlying problem. Most efforts are directed at increasing the ranges of motion, reducing spasticity, and increasing strength, along with specific therapies designed to enhance communication skills and academic performance.

Evidence from other countries is now providing strong support for the use of hyperbaric oxygen therapy to improve the underlying problem in children with cerebral palsy. Hyperbaric oxygen actually targets the abnormalities of brain function. This offers an exciting new approach for treatment.

Studies show that the effectiveness of hyperbaric oxygen therapy in children with cerebral palsy is linked to its enhancing the function of previously damaged neurons (brain/nerve cells). These neurons have been called "idling neurons" in that while they are still alive, they have been damaged to the extent that their function is compromised. Hyperbaric oxygen facilitates the restoration of these damaged neurons which improves brain function and the nervous system. The use of Hyperbaric oxygen to help children with cerebral palsy is becoming more widespread in the United States.

"I would like to thank you for all of your support in searching for help for our son Tim. Two years ago, Tim walked with a forearm crutch due to his cerebral palsy. Without his crutch he could walk very short distances typically in our house only. He could only stand without support for maybe 10-15 seconds if he was really lucky. The muscles in his legs were just way too tight and his balance was off. After years of therapy, botox treatments, oral baclofen and even muscle lengthening surgery, I was starting to lose hope that he would ever walk independently. You can imagine how disappointed we were after trying so many options that although he had made progress we just could not get rid of the reliance on an assistive device. Then, my mother-in-law recommended that we try hyperbaric oxygen therapy, HBOT. I was very skeptical. I thought if it really worked everyone would know about it and everyone would be using it. Despite my better judgment, we went ahead and tried it. I felt like it would be like opening our car window and throwing $4,000 away. After 40 treatments in 20 days, he could walk much farther without his crutch. Although he still fell often, his balance was definitely improved. He went from standing for only 10-15 seconds to 1-2 minutes. Another side benefit was he used to having a few times a day involuntary shudders, these had gone completely away. We really could not believe it!"
Thank you for everything!”

fr:Balanced Health Today
hiperbarik untuk cerebral palsy (dr.erick supondha/ dokter konsultan ahli hiperbarik)
Wounds and Hyperbaric Oxygen Therapy



Problem wounds are those which fail to respond to established medical and surgical management. Such wounds usually develop in patients with multiple local and systemic factors contributing to poor tissue healing. These include diabetic foot ulcers, compromised amputation sites, vascular insufficiency ulcers (ulcers with poor circulation) and non-healing traumatic wounds. All share the common problem of tissue hypoxia (low tissue oxygen levels), usually related to impaired circulation.

Diabetic foot wounds are one of the major complications of diabetes and an excellent example of the type of complicated wound which can be treated with hyperbaric oxygen. Many diabetics have impaired arterial circulation in their feet and have great difficulty with wound healing of foot ulcers.

The elevation in tissue oxygenation which occurs in the hyperbaric chamber induces significant changes in the wound repair process that promote healing. When the hyperbaric chamber is used in conjunction with standard wound care, improved results have been demonstrated in the healing of difficult or limb threatening wounds.

fr:Balanced Health Today
pengobatan luka dengan hiperbarik (dr.erick supondha;dokter konsultan ahli hiperbarik)

Alzheimer’s Hope To Be Had With Hyperbaric Oxygen Therapy

Alzheimer’s Hope To Be Had With Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy or HBOT is a painless procedure in which patients are exposed to increased pressure, allowing greater absorption of oxygen throughout body tissues that will result in many healing and therapeutic effectuation floods oxygen in areas in our body where it is oxygen starved thereby stimulating regeneration and cell growth.

HBOT is a US FDA approved treatment for 13 indications and is now widely used in the USA, UK and China. It is used for the treatment of such neurological disorders like Cerebral Palsy, Autism, Stroke, Alzheimer's disease, ADD/ADHD, immune dysfunction, spinal cord injury, anoxic brain injury, near drowning and other off-label indications.

HBOT started out as a medical treatment to speed up and enhance the body's natural ability to heal. Today it is now an approved modality that is most often used as an enhancement therapy for wide variety of medical conditions. It is a non-invasive method. It uses 100% oxygen under increased atmospheric pressure in a controlled hyperbaric chamber.

Alzheimer's, the most common form of dementia is diagnosed in people over 65 years of age. It is thought to be incurable, degenerative and a terminal disease. There is an estimated 26.6 million people worldwide that have Alzheimer's in the year 2006 and the number could quadruple by 2050.

And like you I don't want that number to quadruple in 2050. And HBOT maybe the answer to make those numbers dwindle. So please do help me spread the news about HBOT, help me spread the hope that this modern therapy may bring.

Single and double bag hyperbaric chambers that measure 34 inches in diameter and 105 inches long are already available. These hyperbaric chambers feature a proven strap and steel reinforcements system. Their high strength zippers and straps do take some 60 seconds or more to apply but there are Demo video in websites that make instructions more easier to understand.

These hyperbaric chambers also can fit both child and adult at the same time and their extra long zippers make entry and exit easy for those who have disabilities or injuries. Single bag chamber can be operated solo by anyone while the double bag chamber would need two hands to operate solo especially for people who are disabled or injured.

Hyperbaric chambers can be rented or bought. Rent for a month for single bag chambers cost at $2,000 and $2,675 for double bag chambers. The single bag chamber are sold at $12,000 and $16,900 for double bag chamber.

If you know someone close who is suffering from Alzheimer's try talking to them about HBOT. It may be able to cure their pains. It will also give them hope in life. Start talking about HBOT. Start helping lives.



fr:Balanced Health Today
Alzheimer’s dengan hiperbarik (dr.erick supondha;dokter konsultan ahli hiperbarik)

hyperbaric for Add / Adhd

Could Add / Adhd Be Caused By Lack Of Oxygen?

Here is something old, hyperbaric oxygen treatment or HBoT has been used by scuba and deep sea divers to relieve themselves of a fatal condition called decompression sickness or the bends. The bends is caused when deep sea divers come up to the surface too quickly. Afflicted divers are placed in a pressure vessel that replicates the pressures the body experiences underwater in a pure oxygen environment.

Here is something old, in the 1980s the king of pop Michael Jackson proclaimed to everybody that by getting hyperbaric oxygen treatment he would live up to 150 years old. He was seen as a quack by many back then and nothing has changed for Mr. Jackson.

But here is something new, hyperbaric oxygen treatment is now recognized as an effective treatment for other problems such as sores and wounds that are hard to heal. Here is something new still, Doctors and new-age therapist now recommend hyperbaric oxygen treatment as a cure for a wide range of problems including Attention-deficit hyperactivy disorder or ADD/ADHD.

Studies have already suggested that children who have ADD/ADHD have reduced regional cerebral blood flow. Studies also have shown that ADD/ADHD have been linked to environmental toxins that are known to aggravate the syptoms. And oxygen through HBOT will help in cleansing the body of these toxins.

HBOT with the use of oxygen will flush those toxins out and help cells and tissues to heal and regenerate form their harmful effects. HBOT will increase the availability of oxygen to the brain and enhance cognitive functioning. Brain scans have already proven this. There is a significant increase in brain function in patients who have undergone HBOT.

Parents also attest to this. Their children after taking HBOT have become more calmer, less mood swings, sleep better and have better bowel function. Their children also enjoy and look forward to their next schedule for the hyperbaric oxygen treatment. What's not to enjoy? HBOT is a safe, non-invasive and non toxic treatment. Hyperbaric chambers are also very spacious that adult and child can both fit at the same time. Parents even read books or play a game in the hyperbaric chamber with their child during the treatment. Some even watch movies on portable dvd players .The treatment also takes an hour. So what's not to enjoy about that?

So if you know someone who has got ADD/ADHD. It might help them to know that there are now alternative medicines in curing ADD/ADHD especially when conventional medicines have failed. By just talking about it you also get to help someone. Have a healthy life.


fr: Balanced Health Today

ADD/ADHD dengan hiperbarik (dr.erick supondha; dokter konsultan ahli hiperbarik)

hyperbaric for autism & CP

Hyperbaric Oxygen Therapy Shows Promising results for Autism

Autism is a mysterious disease-condition-behavior disorder which causes a complex neurological disorder that typically occurs within the first 3 years of life, that results in developmental disabilities.

Children will seemingly develop normally until 18 -24 months at which time an alarming regression in their development occurs and they may stop speaking and begin to lose interest in their surroundings and interactions with other people. Autism occurs two to four times more frequently in boys than in girls.

There are many theories as to the cause of Autism such as abnormal cerebral blood flow to areas of the brain, high fevers, birth trauma, brain injury, infections, reactions to vaccines (some reports implicate MMR) or lack of oxygen before, during or after delivery. Other theories suggest mineral deficiencies such as calcium, iron and zinc either in utero or after birth or fat and protein deficiencies.

The use of hyperbaric oxygen therapy (HBOT) for autism has been used in many countries worldwide. The results are varied and the individual reports from families and health professionals are encouraging. There are many testimonies on the net from families who have taken HBOT for their autistic child with varied results, mostly very encouraging.

HBOT increases the oxygen tissue concentration which increases cerebral blood flow to an area thus enabling the body to restore brain tissue metabolism of oxygen and nutrients, helping restoration of any areas which are suffering from hypoxia. New blood and oxygen begin to stimulate an area, especially one that has viable, recoverable brain cells that are "idling neurons" not knowing what to do instead of function normally.



HBOT reduces swelling or excess fluid in the brain that might be pressing on centres of the brain which cause "confusion" in their function ability. HBOT has been demonstrated to exert positive objective changes from a safe, adjunctive therapy that has been overlooked by most healthcare professionals. Parents are encouraged to educate themselves on this new dynamic use of HBOT so they can make informed decisions for the future of their child.

The following study, testimony and article is just an example of the information one can obtain from the internet. The testimony is from one of our patients treated here at Reimer Hyperbaric.


Hyperbaric Oxygen Therapy (HBOT) adjunctive role in the treatment of Autism — Trish Planck, Hyperbaric Clinical Director

Autism is a complex neurological disorder that typically occurs within the first three years of life that results in usually severe developmental disability. Its incidence in the population is estimated to be 1 in 500 with a prevalence of boys to girls of 4 to 1. The ensuing effects of the disease result in severe impairment in areas of social interaction and communication and in some individuals self- injurious behavior may occur.

Presently there are no effective cures for this disease as little is known as to the etiology. Diet, psychotropic medications and other regimens have been tried with mixed and often disappointing results. Recently a therapy that has been in and out of favor has been shown to be of possible benefit in the treatment of this disease.

Initial results were objective improvements in a variety of diverse phenomenon. Each child demonstrated global reduction in aggressive behavior. Parental summaries all stated substantial decrease in tendency to rage or exhibit tantrums. All children were reported to be easier to engage when the parent wished to initiate communication with marked improvement of direct eye contact.



All three children enrolled in a school program displayed higher achievement with better performance and less instruction in classroom assignments. All children were improved with regard to understanding verbal commands. Reasoning abilities were noticeably enhanced in all individuals.

Clinical improvement was substantiated by pre and post treatment SPECT SCAN brain imaging which displayed enhanced neurophysiologic function in at least one of the members of this study.

The aim of hyperbaric oxygen therapy as an adjunct therapy was to evaluate the efficacy of the treatment in a series of 40 initial treatments, one or twice daily at 1.5 ata to 1.75 ata using a monoplace Sechrist chamber on 100% oxygen for a total time of 60 minutes per treatment.



Patients were treated for 5 days consecutively with two days off. HBOT has been demonstrated to exert positive objective changes on a limited cohort of autistic children as evidenced by subjective and objective parameters. HBOT would seem to be useful and safe adjunctive therapy in the treatment of Autism.



B. M.
Autistic and Cerebral Palsy


Thirteen year old boy hearing impaired, mentally delayed and non-verbal. 3 Spect Scan images were taken of the brain at baseline, mid and after the 115th treatment:

* Progress while undergoing hyperbaric oxygen therapy:
* Major improvement in interactions with family members.
* Plays with family pets.
* Major improvements in understanding verbal commands.
* Beginning to verbally communicate.
* Responds to knocks at the door and answers the door in a normal manner
* Major improvements in balance, especially when he starts to fall, he is able to regain his balance with a faster response. He cross patterns down the steps without holding on.
* He is no longer raging/destructive of things in the home.
* Sits through movies with more understanding.
* Better understanding of public surroundings.
* When music is played he responds in singing tones.
* Hearing has improved and is no longer required to wear hearing devices.
* Responds to things/awareness-like waiting for the school bus in the morning through the window.
* Plays with various types of toys with more understanding.
* Loves to work in the house and yard with Dad.
* Mimics everything you ask him to do.
* Is able to dress himself, is caring for himself in a independent manner.
* Doing better in school with his assignments.
* Happier child and smiles more.

Z. M.
Eleven year old boy with profound autism, who is non-verbal, and is still in diapers. Progress since undergoing hyperbaric oxygen therapy:

* Major increase in understanding.
* More eye contact.
* Behavioral changes are easier to handle and function in public place, less aggressive, raging stopped and is much happier.
* New ability to mimic simple vocal sounds-of major importance as pre-language sounds he makes have more tone and syllables.
* Shows more interest and contact with his brother, increase in all interactions with others.
* Accepts new people, places and situations easier.
* Plays with a wide range of toys, instead of only one object.
* Less sound sensitive.
* Higher functioning in all ways.

Z. M. never noticed people let along mimic anything they did. He now mimics vocal tones and tuning forks and is more aware of sounds and things that people do. Parent gives credit to hyperbaric oxygen therapy.

L.S.
Autistic
Ten year old boy, high functioning with verbal skills and mimics.

* Exhibiting receptive manner
* Easier to engage.
* Exhibiting great internalization of emotions.
* Less tantrums.
* Classroom achievement improved.
* Completing work without re-direction and accuracy improving daily.
* Easier to reason with especially in the home environment.
* Open to re-direction with rages.
* Great willingness to work and stay focused through all classroom assignments.
* Much better transitioning, and flexible, open to variety of mediums with little assistance needed.
* Much improved relatedness in sharing his emotions.

Abnormal Regional Cerebral Blood Flow In Childhood Autism

Takashi Ohmishi, Heroshi Matsuda, Toshiaki Hashimoto, Toshiyuki Kunihirok, Masami Nishidawa, Takeshi Uema and Masayuki Sasaki

Departments of Radiology, Psychiatry and Child Neurology, National Center Hospital of Mental, Nervous, and Muscular Disorders, National Centre of Neurology and Psychiatry, Kodaira City, Tokyo, Japan

Correspondence to: Takeshi Ohmishi, Department of Radiology, 4-1-1 Ogawa higashi, Kodairs City, Tokyo, Japan 197-0031

Neuroimaging studies of autism have shown abnormalities in the limbic system and cerebellar circuits and additional sites. These finding are not, however, specific or consistent enough to build up a coherent theory of the origin and nature of the brain abnormality in autistic patients.



Twenty-three children with infantile autism and 26 non-autistic controls matched for IQ and age were examined using brain-perfusion single photon emission computed tomography (SPECT) with technetium-99m ethyl cysteinate dimer. In autistic subjects, we assessed the relationship between regional cerebral blood flow(rCBF) and symptom profiles. Images were anatomically normalized, and voxel-by-voxel analyses were performed.



Decreases in rCBF in autistic patients compared with the control group were identified in the bilateral insula, superior temporal gyri and left prefrontal cortices. Analysis of the correlations between syndrome scores and rCBF revealed that each syndrome was associated with a specific pattern of perfusion in the limbic system and the medical prefrontal cortex.



The results confirmed the association of (i) impairments in communication and social interaction that are thought to be related to deficits in the theory of mind (ToM) with altered perfusion in the medial prefrontal cortex and anterior cingulate gyrus, and (ii) the obsessive desire for sameness with altered perfusion in the right medial temporal lobe. The perfusion patterns suggest possible locations of abnormalities of brain function underlying abnormal behavior patterns in autistic individuals.

5 year old boy treated at Reimer Hyperbaric (testimony)
We miss you !!!! Time has flown since we returned from Canada. We had such a nice time while we were there and will always be most grateful for your friendship and hospitality.

Things at home are going well, it took a little time to get settled in again, the children adapted very easily to the changes, although they miss all of you too. The changes in Christian are wonderful! He continues to speak much more often and in a "conversational" manner, which we are so thankful for.

For your records, I will give you a little background information on Christian and the changes that have occurred as a result of hyperbaric oxygen therapy.

Christian was 2 weeks overdue, and as a result, labour was induced. The procedure did not progress well and the labour and subsequent emergency C-section were very difficult. Christian was deprived of oxygen before & during delivery. The hospital records stated he suffered "mild to moderate hypoxia" and fetal distress. His apgars were ok and he did have a birth cry. He had suffered lung damage (double pneumothorax) as well as oxygen deprivation.

He lost a lot of weight in the hospital and we stayed 4 days. He was released and we went home - thinking everything was fine. Christian was breast fed and he did very well except that he seemed to have "colic", although it wasn't the normal colic, he never outgrew it (usually happens at 4 months).



He was an extremely happy baby, even though he was in pain a lot. He never slept well and was awake most of the 24 hours of the day. At 4 months he suddenly developed "clenched fists" first one, then the other. They were severely clenched with thumbs out. He had an EEG - no seizures activity noted. He has a MRI, which showed no tumours or abnormalities.

The hands stayed clenched until about 16 months of age, where it sort of "wore itself out". He never developed proper use of his hands and fingers for fine motor. His "pointer" fingers are stunted in growth and usually icy cold.

Christian was never able to tolerate food, solid or other until I forced him to eat around 2 years of age. It was devastating to do so, but I had no choice. He had many sensory difficulties, noise was devastating to him, clothes were intolerable, smells made him gag.



He didn't develop speech although he walked at 8 months, sat unassisted at 4 months and was running - fast at 1 year old. He was still very happy and friendly although as he got older his eye contact considerably lessened. He would connect for a very brief period and run away. In a group setting he would go to be on his own, preferably in a room by himself.

He was very physical and ran, climbed and jumped all the time. He was constantly in motion. He developed "eye ticks".

We were told that he had:

(1) a definite neurological disorder
(2) possibly autism
(3) possibly tourettes syndrome
(4) definitely sensory integration disorder
(5) definitely receptive (less) and expressive (more) language disorder

We were told - this is it, he will never be "normal" teach him sign language and get on with your life - don't try to "fix" him, it won't happen.

We never gave up on Christian and more importantly, Christian never gave up on Christian. Through much very hard work, tolerance, acceptance and love, Christian did progress. We found what we needed and we did it, simple as that. When he was 5, we decided he needed hyperbaric oxygen therapy and we were right, he did need it and these are the changes that occurred as a result.

(1) Although his sensory difficulties were already decreased, they did so even more after HBO- (we did 40 treatments). What occurred that is really wonderful is that his internal thermostat (which was defective especially in his fingers) has stabilized! His fingers are not icy cold anymore and his has completely stopped biting his nails and fingertips. There were always raw and bleeding.



The tissue is healed and he doesn't bite them at all anymore. His hands look more normal and less stunted in growth. This is not wishful thinking, its really true. He also grew 1 whole inch from Dec. to Feb..

(2) His receptive ability is so much better. He understands consequences and can follow directions so much better. He doesn't seem "confused" like he did before.

(3) His expressive ability with language is outstanding. He actually talks on the phone and carries on a two-way conversation. His replies are no longer just one word. His desire to use language is much more pronounced. His teachers are amazed and very happy with the changes. They report that he is much better at "talking with" the other children and interacting in general.

(4) Although Christian was always a loving child, he is much more demonstrative now. he hugs and kisses his friends, spontaneously runs into Grandma's arms and tells her he loves her. He has more access into "our" world and is happier because of it.

Christian has overcome so very much in his life, many times thru very painful and difficult and frightening aspects. He has always remained loving, trusting and open. He deserved the chance to overcome his difficulties thru a non-invasive, pleasant atmosphere, where he doesn't have to work so hard. HBOT gave him this. We will always be so grateful for the opportunity to help him thru this method and grateful for the wonderful people who have allowed it to happen thru their hard word and dedication. That's you guys.

Sincerely,
J., G., C., & C

fr: Balanced Health Today
autis dan cerebral palsy dengan hiperbarik (dr.erick supondha; dokter konsultan ahli hiperbarik)

Stroke, Traumatic Brain Injury, and Hyperbaric Oxygen Therapy

Stroke, Traumatic Brain Injury, and Hyperbaric Oxygen Therapy

Testimonial

My husband suffered strokes in August 2006 that resulted in total loss of short-term memory, slurred speech, and difficulty walking. The doctors said he may never recover, and if he did it would take at least two years. Now, after only two months of hyperbaric therapy his memory is back, and his speech and walking are normal. His energy has improved. Dr. Saft is one of the most caring individuals we have ever met. We can't thank him enough for what he has done for us. Marge H.

Conditions that harm the brain have a wide reach. Whether from a stroke (vascular accident) or a traumatic brain injury, the results impair the whole family.
The loss, or potential loss, of hopes, dreams, and expected joys and accomplishments is a loss suffered by all of those who care.

Brain damage has a wide reach; it damages the whole family.

Hyperbaric Oxygen Therapy is not a cure . . . . but it can often help.

Following is a MUST SEE video from the Montel Williams Show.

Even though science now knows better, the “old-school” idea still often remains: that once an area of the brain has been damaged by a stroke, TBI (traumatic brain injury), or near drowning, that nothing or very little can be done to restore the function of that area.

Recent scientific research has demonstrated that while the core-area of the damaged brain tissue may be irreversibly damaged, there is an area surrounding this tissue that hyperbaric oxygen therapy can restore and these neurons (brain/nerve cells) can re-establish their function.

The majority of tia, stroke and brain injuries are caused by blood vessel obstructions, such as a blood clot, that cuts off blood flow and oxygen to parts of the brain. This results in the death of nerve cells within a very short time. These dying brain cells begin to swell due to their cell walls breaking down, allowing fluid to move into the cells. As these cells swell, they begin to expand into the surrounding tissues. This causes constriction of the blood vessels in the surrounding tissues, which then causes a lack of oxygen to these previously normal cells. These surrounding cells then begin to swell as well. This gradually increasing, damaged, hypoxic tissue surrounding the original injury is called the "ischemic penumbra," and contributes up to 85% of the disability resulting from a stroke. The cells in this secondary area have the potential of being restored to near-normal, and sometimes normal function.

The neuroscientist Dr. Cyril B. Courville wrote, "crippled nerve cells may persist in the margins of wounds of the brain for many years." Astrup, Siesjo and Symon suggested that within these damaged margins, idling neurons are present. They are metabolically lethargic and are non-functional, because of low oxygen levels and secondary damage. But they remain viable and are subject to being revived with hyperbaric oxygen therapy.

Proof of this dormant life of the brain’s cells has been demonstrated with the use of SPECT brain scans done before and after a series of hyperbaric oxygen therapy. In the journal Stroke, Dr. Richard Neubauer, a pioneer in the use of this therapy for treating various neurological diseases, reported outstanding results in a group of 122 stoke patients treated with HBOT. In one case, significant functional improvement was noted when Hyperbaric Oxygen Therapy was used 14 years after the initial stroke.

These studies by Dr. Richard Neubauer conclusively demonstrate the development of new blood vessels to the rim of tissue surrounding the area of the brain that had been damaged.

These newly formed blood vessels resulting from the hyperbaric oxygen therapy can then bring fresh blood (oxygen) and nutrients to the damaged tissue. The tissue begins to repair itself and returns to normal or near-normal. These "resuscitated" neurons gradually reconnect to the rest of the brain. These revived neurons and their connections help to return the use of lost cerebral and bodily functions.

Hyperbaric therapy does not resurrect dead brain tissue, but it can facilitate the functioning of those dormant, idling nerve cells that have suffered secondary damage by stroke due to diminished oxygen. Oftentimes, the brain area suffering secondary damage is a larger part of the brain than that which suffered the primary damage. This area of secondary damage to the brain (the ischemic penumbra) is the area that HBOT helps.

Improvements have been achieved, gains have been made, even with patients who are more than a decade post-stroke.

Note: TIA: Transient Ischemic Attack, is a "mini stroke", or "warning stroke" that often produces mild stroke-like symptoms but usually no lasting damage. A TIA is often a forecast of a full-fledged stroke on the horizon, which makes this a good indicator for beginning this therapy.

Day after day, patients are overcoming the bleak forecasts about recovery from their stroke or traumatic brain injury, using Hyperbaric Oxygen Therapy

fr: Balanced Health Today
stroke dengan hiperbarik (dr.erick supondha; dokter konsultan ahli hiperbarik)

Hyperbaric Oxygen Therapy (HBOT)

Hyperbaric Oxygen Therapy (HBOT) is a procedure where a patient is placed into a module called a hyperbaric chamber and subjected to high pressure 100% oxygen, with the intention of stimulating healing for certain medical problems. Even though it’s considered for payment as a therapeutic procedure, there’s still a lot of controversy involved in its use.

Using atmospheric pressure to treat patients isn’t new. The process was actually introduced in the 1600s by a British clergyman. Oxygen didn’t become the gas of choice until the 1930s, when the military got into it. It was found that oxygen saturates the hemoglobin in the blood, and can help patients with routine wounds heal faster.

The overall issue with hyperbaric oxygen therapy is that there aren’t a lot of medical schools that actually teach physicians about it because the equipment is too expensive. Truth be told, not many hospitals have it for the same reason, although there are some companies in major cities that have portable machines and offer them as rentals for hospitals. These reasons make it so many doctors are unfamiliar with the practice and how it works, this may be why some doctors do not trust its effectiveness all that much.

Another issue is that it’s not 100% safe. Any time a patient is put under artificial pressure, problems can occur. Some people have suffered minor injury to their lungs, their eyes, and their nasal airways; most of the time, the injuries are temporary. On rare occasions, patients suffer temporary blindness.

Hyperbaric Oxygen Therapy is not recommended to be used on patients who are suffering from things such as asthma, high fever, and seizures; pregnant women should also avoid this type of therapy. One last thing that sometimes happens is known as decompression sickness, which occurs when the pressure is being released. The symptoms seem to be similar to what someone who does underwater diving sometimes experiences after they come back to the surface.

There are also some maladies that hyperbaric oxygen therapy has been said to help with such as autism, diabetic neuropathy, inflammatory bowel disease, and multiple sclerosis. None of those have been proven by significant studies, but suffice it to say that the practitioners who use this therapy are always trying to find new things that it can help with.

fr: Balanced health today
hiperbarik oksigen terapi (dr.erick supondha; dokter konsultan ahli hiperbarik)

Selasa, 07 September 2010

Diabetic avoids legs amputation with Hyperbaric Oxygen - Paciente diabética evita amputacion

Hyperbaric Oxygen Therapy & Diabetic Wounds And Ulcers

Healing Pressure

Hyperbaric Oxygen Chamber Therapy and Stroke

HBOT for Stroke

Stroke And Hyperbaric Chambers

Stroke And Hyperbaric Chamber Therapy

Hyperbaric Chamber for Treatment of Stroke & Traumatic Brain Injuries

Hyperbaric Oxygen Chamber Therapy, Athletic Performance Enhanced and Slower Aging

Hyperbaric Healing

Hiperbarik oksigen terapi (HBOT) Memperbaiki Mutu Sperma dan Kulit

Hiperbarik oksigen terapi (HBOT)
Memperbaiki Mutu Sperma dan Kulit



Pengobatan dengan terapi oksigen hiperbarik telah ada di Indonesia sejak 1960-an yang dipelopori oleh PT PAL Surabaya yang kemudian dikembangkan oleh TNI-AL, namun hingga kini belum banyak dokter yang memanfaat Hiperbarik Oksigen Terapi sebagai pengobatan terhadap pasien pasien mereka. Padahal terapi ini sudah berkembang secara pesat di negara maju dan beberapa jenis penyakit terbukti dapat disembuhkan.

Terapi oksigen hiperbarik (HBOT) merupakan metode pemberian oksigen murni didalam ruangan bertekanan tinggi lebih dari 1 atmosfer. Dengan oksigen hiperbarik, darah lebih diperkaya dengan oksigen (O2), tetapi oksigen dalam darah akan jenuh dengan konsentrai 97% (astrand) tetapi dengan HBOT oksigen dapat banyak larut dalam plasma, cairan tubuh, jaringan dan organ organ tubuh secara langsung.
Dasar dari terapi hiperbarik sedikit banyak mengandung prinsip fisika. Teori Toricelli yang mendasari terapi digunakan untuk menentukan tekanan udara 1 atm adalah 760 mmHg. Dalam tekanan udara tersebut komposisi unsur-unsur udara yang terkandung di dalamnya mengandung Nitrogen (N2) 79 % dan Oksigen (O2) 21%. Dalam pernafasan kita pun demikian. Pada terapi hiperbarik oksigen ruangan yang disediakan mengandung Oksigen (O2) 100%. Terapi hiperbarik juga berdasarkan teori fisika dasar dari hukum-hukum Dalton, Boyle, Charles dan Henry.

Sedangkan prinsip yang dianut secara fisiologis adalah bahwa tidak adanya O2 pada tingkat seluler akan menyebabkan gangguan kehidupan pada semua organisme. Oksigen yang berada di sekeliling tubuh manusia masuk ke dalam tubuh melalui cara pertukaran gas. Fase-fase respirasi dari pertukaran gas terdiri dari fase ventilasi, transportasi, utilisasi dan diffusi. Dengan kondisi tekanan oksigen yang tinggi, diharapkan matriks seluler yang menopang kehidupan suatu organisme mendapatkan kondisi yang optimal.
terdapat dua jenis dari terapi hiperbarik, efek mekanik dan fisiologis. Efek fisiologis dapat dijelaskan melalui mekanisme oksigen yang terlarut plasma. Pengangkutan oksigen ke jaringan meningkat seiring dengan peningkatan oksigen terlarut dalam plasma.

HBOT memiliki mekanisme dengan memodulasi nitrit okside (NO) pada sel endotel. Pada sel endotel ini HBOT juga meningkatkan intermediet vaskuler endotel growth factor (VEGF). Melalui siklus Krebs terjadi peningkatan NADH yang memicu peningkatan fibroblast. Fibroblast yang diperlukan untuk sintesis proteoglikan dan bersama dengan VEGF akan memacu kolagen sintesis pada proses remodeling, salah satu tahapan dalam penyembuhan luka.

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Penyakit tuli mendadak bisa disembuhkan dengan terapi pengobatan tunggal dengan terapi oksigen hiperbarik. Namun demikian, pada jenis penyakit lainnya bisa juga dilakukan terapi ini seperti untuk luka bakar, koreng akibat penyakit gula, tetanus, keracunan karbon monoksida, stroke, kelainan infeksi tulang.

"Contohnya koreng akibat dari penyakit gula jika tidak diberikan terapi oksigen hiperbarik ini kesembuhannya hanya 30-40 persen. Dengan terapi oksigen hiperbarik tingkat kesembuhannya bisa mencapai 90 persen."

Dr Johannes Soedjono SpAnd mengatakan terapi oksigen hiperbarik ini bisa meningkatkan kualitas sperma. Kualitas sperma dipengaruhi banyak faktor, misalnya genetik hormonal, varikokel dan berbagai penyakit lainnya.
Namun demikian, saat ini ada penurunan kualitas sperma yang penyebabnya belum diketahui karena masih terbatasnya sarana diagnostik. Karena itu pengobatannya dilakukan secara empirik. Salah satu penyebab yang diduga ikut berperan dalam kelompok idiopatik ini adalah spesies oksigen reaktif (SOR).
Oksigen hiperbarik dapat menjadi terapi komplementer pada pria infertil dengan hasil analisa sperma astenozoospermia yang kemungkinan disebabkan oleh paparan SOR. Terapi ini sebaiknya dimulai H-5 dari masa subur pasangan jika tidak ditemukan kelainan pada pihak pasangan.

Kecukupan oksigen dalam tubuh ternyata juga bisa menghambat proses penuaan lebih dini. Dengan kecukupan oksigen tersebut, seluruh organ tubuh akan melakukan fungsinya dengan baik. Termasuk organ kulit yang begitu tipis dan merupakan organ luar dari tubuh. Kulit tetap bisa diremajakan bila tubuh mendapat pasokan oksigen yang cukup setiap harinya. Sel-sel dalam jaringan tubuh yang kekurangan oksigen membuat seseorang merasa mudah lelah dan kurang bergairah. Untuk mencegah berbagai penyakit yang menyerang manusia bisa dilakukan oleh tubuh yang kecukupan oksigen. Semua itu harus didukung oleh kelancaran sirkulasi darah yang mengantarkan oksigen.

Tentu semua orang khususnya wanita ingin dapat mempertahankan tubuh dengan tetap tampil awet muda. Namun, seiring dengan bertambahnya usia, secara perlahan-lahan tubuh akan mengalami perubahan dan penurunan fungsi. Perubahan itu dapat dilihat dari kulit yang tadinya mulus dan lembut menjadi keriput.

Penelitian menunjukkan bahwa penyebab utama dari proses penuaan dini adalah penurunan aktivitas sel dalam jaringan tubuh akibat kekurangan oksigen. Oksigen dalam tubuh diangkut oleh darah dalam sistem pembuluh darah. Dengan bertambanya usia, otomatis pembuluh darah akan menjadi lebih kaku akibat penumpukan-penumpukan beberapa zat terutama lemak yang disebabkan oleh pola dan gaya hidup yang tidak sehat serta masalah polusi lingkungan.
Lalu apa hubungannya dengan oksigen? Endapan pada pembuluh darah itu mengakibatkan peredaran darah kurang lancar, padahal darah merupakan sarana pengantar oksigen ke sel-sel tubuh agar dapat melaksanakan fungsinya. Kecukupan oksigen dalam tubuh adalah melindungi pembuluh darah dari kerusakan.

Untuk memperoleh kulit yang sehat dan cantik, tubuh memerlukan oksigen yang cukup untuk mempertahankan dirinya, bereproduksi dan membentuk lapisan baru. Kulit yang kering dan kusam mengurangi kecantikan seseorang. Penampilan yang cantik terlihat dari penampilan kulit juga.

Kebiasaan buruk sering mengganggu dan berpengaruh terhadap kulit. Sering beraktivitas di luar rumah penuh asap dan debu atau tidur terlalu malam akan memengaruhi kulit. Makanan juga sangat berpengaruh terhadap kulit demikian pula dengan penyakit. Seperti pada organ - organ tubuh lainnya yang membutuhkan oksigen, kulit juga sangat membutuhkan oksigen.

Kekurangan oksigen bisa membuat pori-pori bermasalah dan mengakibatkan pori-pori tersumbat. Sehingga sirkulasi menjadi tidak lancar, pembuangan kotoran dan lemak menjadi terhambat, akhirnya muncullah penyakit kulit yang ditakuti oleh sebagian besar wanita, mislnya di antara jerawat, komedo dan noda hitam pada wajah akibat paparan sinar matahari. Kecukupan oksigen dalam tubuh membuat sel dan jaringan kulit dapat terbangun kembali.

Rabu, 18 Agustus 2010

HOTLINE SERVICE HYPERBARIC OXYGEN THERAPY (HBOT)

HOTLINE SERVICE HYPERBARIC OXYGEN THERAPY (HBOT)

Jika anda memerlukan bantuan pelayanan hiperbarik di jakarta
anda dapat menghubungi nomor telp dibawah ini 24 jam (Emergency : khusus kasus penyelaman, luka bakar, keracunan karbon monoksida (CO), sianida).
Kami akan bantu anda memberikan pelayanan hiperbarik oksigen terapi
(HBOT) pada rumah sakit terdekat dengan rumah tinggal anda.


hotline service hiperbarik (021) 990 700 50

untuk informasi lebih jelas ttg hiperbarik dapat mengunjungi

group KEDOKTERAN HIPERBARIK INDONESIA di FACEBOOK dng alamat
http://www.facebook.com/group.php?gid=94515609378
atau
http://www.hbotconsultan.co.cc

Senin, 16 Agustus 2010

SERBA-SERBI TERAPI HIPERBARIK

SERBA-SERBI TERAPI HIPERBARIK

Terapi ini bisa dijadikan terapi utama atau juga sebagai pengobatan tambahan.

Apa sih beda terapi oksigen dengan oksigen yang kita hirup setiap saat? Terapi oksigen hiperbarik adalah suatu cara pengobatan dimana pasien menghirup oksigen murni pada tekanan udara lebih besar daripada tekanan udara atmosfer normal. Pasien masuk atau berada dalam ruangan khusus yang disebut Recompression Chamber atau Ruang Udara Bertekanan Tinggi (RUBT) selama 60 atau 90 menit. Terapi hiperbarik bisa dijadikan sebagai terapi utama (drug of choice) atau juga sebagai pengobatan tambahan.

MEKANISME TERAPI

Sebelum menjalani terapi, yang paling utama adalah pasien harus menjalani pemeriksaan, berikut di antaranya:

* Menyebutkan atau mengisi riwayat kesehatan pasien.

Hal ini penting dilakukan untuk menghindari terjadinya kontraindikasi dan komplikasi.

* Melakukan pemeriksaan foto toraks (rontgen).

Tujuannya untuk mendeteksi apakah jantung dan paru-paru dalam kondisi baik atau sebaliknya. Jika ternyata mengalami tuberkolusis, misalnya konsultasikan pada ahli paru agar diobati. Bila perlu pasien dianjurkan membeli masker sendiri untuk menghindari penularan penyakit itu pada orang lain.

Intinya pemeriksaan ini bertujuan mengetahui secara persis kondisi keseluruhan si pasien dan untuk mencari faktor penyebab penyakit. Sekali lagi, upaya tersebut dilakukan semata-mata untuk menghindari kemungkinan efek samping yang terjadi.

Namun, adakalanya saat atau setelah menjalani terapi, si kecil mengalami berbagai kendala seperti ini:

* Barotrauma telinga

Terkadang pasien sebenarnya sedang flu. Namun memaksakan diri masuk ke RUBT. Akibatnya, telinga terasa tersumbat dan lama-kelamaan terasa sakit. Tak heran kalau anak kemudian menangis. Karena itu anak yang sedang mengalami flu tak diperbolehkan mengikuti terapi ini sampai penyakitnya sembuh.

* Keracunan oksigen

Si kecil terlalu "bersemangat" menghirup oksigen sehingga mengalami keracunan oksigen. Dia merasa mual dan ingin muntah. Seperti halnya jika makan terlalu banyak, tentunya perut akan terasa enggak enak. Upaya penanganannya adalah segera membuka masker, niscaya dalam beberapa menit, rasa kurang enak itu akan hilang. Setelah itu, pergunakan lagi masker untuk melanjutkan terapi.

INDIKASI MEDIS

Ada sejumlah indikasi medis yang dapat dirujuk untuk mendapatkan perawatan hiperbarik, yaitu:

* Autis

Anak yang mengalami autis dapat menjalani terapi hiperbarik. Tentunya bukan sebagai terapi utama, melainkan terapi tambahan. Seperti diketahui, anak autis cenderung memiliki imunitas tubuh yang menurun. Lantaran itu, faktor alergi dan terkena infeksi cukup tinggi. Nah, terapi hiperbarik dapat mengurangi gangguan alergi yang dialami. Selain itu, terapi ini dapat membantu mengatasi gangguan metabolisme otaknya menuju perkembangan yang lebih baik. Memang tetap harus dilakukan juga terapi-terapi lain dan dengan ditambah terapi hiperbarik hasilnya akan menjadi lebih baik. Namun perlu diingat, hasil yang didapat anak autis tentu akan berbeda satu dengan lainnya.

* Cerebral palsy (CP)

Dalam hal ini, terapi hiperbarik juga sebagai pengobatan tambahan. Kelumpuhan atau kekakuan yang biasanya dialami anak dengan kondisi CP secara berangsur-angsur dapat dihilangkan melalui terapi hiperbarik. Demikian pula dengan gangguan kejang, setidaknya dapat diminimalkan. Jadi memang terapi hiperbarik dapat membantu mempercepat proses pemulihan.

* Cedera atau trauma kepala

Pada kasus anak terkena benturan dan sebagainya, dapat dibantu penyembuhannya melalui terapi hiperbarik. Membantu menghindari terjadinya penyumbatan aliran darah di kepala sehingga mengurangi risiko dampak yang lebih parah.

* Patah tulang

Untuk kondisi patah tulang, terapi hiperbarik membantu mempercepat pemulihan. Dapat pula merangsang pertumbuhan pembuluh darah baru.

* Luka bakar

Dengan terapi hiperbarik, luka yang terjadi pun jadi cepat sembuh. Pertumbuhan jaringan kulit akan mudah terbentuk. Pembuluh darah yang rusak akan terbentuk kembali. Udara bertekanan tinggi yang dipergunakan pada terapi hiperbarik, bisa mempercepat regenerasi sel-sel tubuh.

KOMPLIKASI DAN KONTRAINDIKASI

Sekali lagi, tak semua anak boleh mendapatkan terapi hiperbarik. Terutama bagi mereka yang kondisi kesehatannya sedang buruk. Perlu disadari bahwa penggunaan terapi hiperbarik dapat menyebabkan komplikasi dan kontraindikasi. Dengan kata lain, terapi hiperbarik, seperti halnya pengobatan lain, disamping memberikan faedah juga mungkin menimbulkan komplikasi dan kontraindikasi.

1. KONTRAINDIKASI

* Kontraindikasi absolut

Yang tak boleh sama sekali menjalani terapi hiperbarik yaitu pasien dengan kondisi pneumothoraks karena dapat menimbulkan kematian.

* Kontraindikasi relatif

- Demam tinggi
Demam dapat memicu terjadinya keracunan oksigen sehingga menimbulkan kejang. Maka sebelum menjalani terapi hiperbarik, upayakan menunggu suhu badan anak turun sampai kondisinya normal.

- Infeksi Saluran Napas Atas (ISNA)

Anak dengan kondisi ISNA dikhawatirkan akan mengalami barotrauma telinga dan gangguan sinus.

- Fobia ruangan tertutup

Anak yang takut atau fobia terhadap ruangan tertutup bisa saja panik sehingga proses terapi tak berjalan dengan baik.

- Kejang

Anak yang mengalami gangguan kejang, saat menjalani terapi hiperbarik dapat saja kambuh.

- Lesi asimtomatik pada paru
Terapi hiperbarik sebaiknya tidak dilakukan jika foto rontgen dada menunjukkan ada gambaran lesi, yaitu sesuatu/massa yang tumbuh seperti tumor.

- Riwayat pernah bedah toraks/dada dan telinga
Pasien harus menjalani evaluasi menyeluruh sebelum terapi hiperbarik.

-Tumor

Konon, terapi hiperbarik dapat memicu pertumbuhan tumor lebih jauh. Hal ini masih menjadi perdebatan di kalangan ahli medis.

2. KOMPLIKASI

Berikut ini beberapa komplikasi akibat terapi hiperbarik:

* Barotrauma telinga

Gangguan ini paling sering terjadi. Salah satu penyebab adalah ketidakseimbangan tekanan antara udara telinga tengah dengan udara luar pada saat terapi dilakukan.

* Sinusitis

Sinus adalah rongga-rongga fisiologis di sekitar tulang wajah. Sinusitis banyak terjadi karena ISNA. Jika hal ini terjadi, terapi hiperbarik harus ditunda. Antibiotik dan nasal decongestan bisa diberikan.

* Miopia dan katarak

Miopia atau rabun jauh merupakan komplikasi yang biasanya terjadi saat awal pengobatan hiperbarik. Sedangkan katarak merupakan komplikasi akibat pengobatan jangka panjang.

* Barotrauma Paru

Terapi hiperbarik dapat memicu terjadinya robek paru (lung rupture), emboli udara, atau pneumotorax. Tanda terjadinya robek paru yaitu nyeri dada dan sesak napas. Jika hal ini terjadi, hentikan terapi hiperbarik.

Terapi hiperbarik seperti halnya pengobatan lain sama-sama harus diberikan dengan dosis tertentu, disertai indikasi dan kontraindikasi, serta komplikasi dan lain-lain. Dengan diketahuinya hal-hal tersebut diharapkan dapat dilakukan langkah-langkah pencegahan sehingga tak terjadi sesuatu yang tak diinginkan.
AWALNYA HANYA UNTUK PENYELAM

Semula terapi ini hanya digunakan untuk membantu para penyelam yang mengalami penyakit dekompresi. Jika menyelam dengan kedalaman 10 meter atau lebih maka tekanan udara semakin meningkat. Nah, seiring dengan meningkatnya tekanan udara, nitrogen akan bertambah banyak dan larut dalam pembuluh darah. Alhasil, penyelam mengalami gangguan yang disebut dekompresi.

Penyakit ini menunjukkan berbagai gejala seperti pegal, tuli, nyeri otot sendi dan tulang bahkan kelumpuhan. Inti masalahnya adalah karena gelembung-gelembung udara di dalam pembuluh darah menyumbat aliran darah ke berbagai aliran tubuh. Melalui terapi ini akhirnya banyak penyelam yang dapat diselamatkan atau disembuhkan karena larutnya gelembung nitrogen tersebut dan kadar oksigennya meningkat lagi sehingga pembuluh darah pun kembali lancar. Nah, seiring perjalanan waktu, terapi ini rupanya berguna juga untuk membantu mengobati berbagai penyakit.

sumber dari : Tabloid NAKITA
Hilman Hilmansyah. Foto: Agus/NAKITA

AWET MUDA DI RUANGAN BERTEKANAN UDARA TINGGI

AWET MUDA DI RUANGAN BERTEKANAN UDARA TINGGI

KLIK - DetailTabung menyerupai kapal selam ini awalnya diperuntukkan bagi para penyelam yang terkena dekompresi. Seiring berjalannya waktu, alat yang disebut tabung hiperbarik ini ternyata juga bisa dipakai untuk pengobatan dan kecantikan.

Sejak tahun 60-an, mesin hiperbarik sudah mulai digunakan secara terbatas untuk kasus-kasus akibat penyelaman. Menurut dr. Susan H.M. Ms. dari Klinik Udara Bertekanan Tinggi (KUBT) RSAL dr. Mintohardjo Jakarta dan Letkol. dr. Janti Undari, Kasubdep KUBT, perintisnya di Indonesia adalah Angkatan Laut di Surabaya.

Waktu itu hanya terbatas untuk para penyelam. Penyelam yang bekerja terlalu lama di bawah air dan naik ke permukaan tak sesuai prosedur penyelaman, bisa terkena penyakit yang dinamakan dekompresi. Penyakit ini timbul dengan berbagai gejala, dari pegal-pegal sampai tuli, buta hingga lumpuh. "Penyebabnya, gelembung udara di dalam pembuluh darah menyumbat aliran darah ke beberapa bagian tubuh," kata Janti.

Darah bak minuman bersoda, yang dalam pembuatannya diberi gas dengan tekanan tinggi. "Begitupun darah manusia. Udara dari tabung yang dibawa akan larut di dalam air, tapi jika dia naik ke permukaan tak sesuai prosedur, udara yang dihirupnya akan berubah menjadi gelembung dan menyumbat pembuluh darah."

Untuk melencarkan kembali pembuluh darah yang tersumbat, dibutuhkan tekanan tinggi. "Jawabannya adalah dengan terapi hiperbarik. Dengan hiperbarik, kita memberikan tekanan kembali, sehingga diharapkan gelembung mengecil dan larut dalam darah," jelas Janti.

PERCEPAT PERTUMBUHAN JARINGAN
Dari berbagai penelitian terungkap, hiperbarik mempunyai manfaat lebih, tak cuma untuk penyelam semata. Dengan memanfaatkan tekanan oksigen murni itu, berbagai penyumbatan yang tak hanya disebabkan gelembung udara, dapat ditembus oksigen. Normalnya, kita menghirup udara yang kemudian diproses paru-paru untuk diambil oksigennya saja. Oksigen tersebut akan diikat hemoglobin dalam sel darah merah dan diantarkan ke seluruh tubuh.

Dengan bertambahnya usia dan berbagai faktor, misalnya terdapat luka yang menyebabkan pembuluh darah terputus, membuat sel darah merah tidak dapat mengantarkan oksigen dengan baik. "Dengan terapi hiperbarik, oksigen ditekan sehingga larut di plasma darah. Jadi, dia bisa meresap ke seluruh tubuh tanpa bantuan pembuluh darah," ucap Susan.

Menurut penelitian, pada tahun 1959, seekor babi dapat bertahan hidup tanpa sel darah. Seorang dokter di Belanda membuat percobaan dengan mengambil semua sel darah babi dan hanya meninggalkan plasmanya. Darah sendiri terdiri dari sel darah merah, sel darah putih, butir pembeku dan plasma. Oksigen harus dibawa sel darah merah. Setelah dimasukkan ke dalam hiperbarik, babi itu ternyata tetap hidup. Lewat penelitian itu terbukti bahwa dengan hiperbarik, oksigen dapat tersebar dengan baik ke seluruh tubuh meski tidak dibawa oleh sel darah merah.

Hiperbarik diketahui juga dapat mempercepat pertumbuhan jaringan. Beberapa tahun lalu, RSAL dr. Mintohardjo pernah menangani sebuah kasus transplantasi. "Jari seorang pasien terpotong lalu disambung. Sesaat setelah operasi, pasien dimasukkan hiperbarik. Ternyata penyembuhannya lebih cepat, dan sel-sel baru pun tumbuh lebih cepat," ujar dokter berkacamata itu. Hiperbarik merangsang pertumbuhan pembuluh darah baru. Dengan hiperbarik, pembuluh darah yang rusak atau tersumbat akan terbentuk sampai 30 kali.

PRIA LEBIH SUBUR
Hiperbarik ternyata juga bisa digunakan dalam hal kecantikan. Fungsi lain ini ditenmukan secara tak sengaja. Awalnya, beberapa pasien merasakan perubahan pada kulit mereka, menjadi lebih baik dari sebelumnya. "Ternyata, dengan terapi hiperbarik, jaringan kolagen menjadi lebih elastis, sehingga membuat kulit lebih kenyal dan lembab. Bahasa sederhananya, sel-sel itu diberi lebih banyak oksigen, sehingga merangsang pertumbuhan kolagen menjadi lebih baik."

Selain kulit, perubahan yang sangat terlihat terjadi pada pertumbuhan rambut. Bagi yang sudah beruban, terapi hiperbarik akan membantu mereka tak lagi mengecat hitam rambutnya, karena berkurangnya jumlah uban. “Rambut jadi sehat, tak lagi rontok. Yang sudah botak bisa tumbuh kembali," aku Janti.

Bagi mereka yang ingin menjaga kecantikan dan kebugaran, terapi hiperbarik terbukti sangat membantu. Namun perlu diingat, hasil yang didapat akan berbeda satu dengan lainnya. Untuk mendapatkan hasil maksimal, terapi paling tidak dilakukan sebanyak 10 kali.

Untuk menjalankan terapi tersebut, pertama harus ada booster. Awalnya, 5 atau 6 kali berturut-turut setiap hari. “Maksudnya untuk mengusir radikal bebas dari dalam tubuh.” Selanjutnya semakin berkurang, misalnya 3 kali seminggu, terus 2 kali seminggu sampai hanya tinggal sebulan dua kali.

Ini mengikuti prinsip pertumbuhan sel kulit yang selalu beregenerasi setiap tiga minggu. "Jadi, kalau dioksigenasi sebulan dua kali, sebelum tumbuh sel baru dia akan mendapat oksigen yang baik sehingga pertumbuhannya menjadi lebih baik. Apalagi di kota besar seperti Jakarta, tingkat polusinya sudah tinggi sekali," ujar wanita berambut pendek ini.

Bagi lelaki, selain berfungsi sebagai penjaga kebugaran, terapi hiperbarik ternyata mampu meningkatkan kesuburan sperma. "Penelitian di Surabaya menunjukkan, gerakan sperma jadi lebih cepat dan jumlahnya pun bertambah. Dan itu sudah terlihat hanya dengan 5 kali berturut-turut menjalani terapi ini."

Melihat perkembangan yang terbaru, terapi hiperbarik ternyata juga mempercepat penyembuhan penderita autisme. "Di luar negeri, terapi hiperbarik sudah disarankan bagi penderita autis.” Di RSAL sendiri pernah ada anak autis yang menjalani terapi hiperbarik. “Ternyata, setelah menjalani terapi, kondisinya membaik. Memang harus ditambah terapi lain, tapi dengan hiperbarik hasilnya menjadi lebih cepat."

Namun, terapi hiperbarik ternyata juga mempunyai beberapa efek negatif. Karena menggunakan penekanan, beberapa pasien bisa terkena penyakit yang disebut barotrauma, seperti tuli. "Mestinya enggak terjadi, tapi terkadang pasien tak bilang kalau ia sedang flu. Akibatnya, saluran pendengarannya mampet dan jadi budek, lama-lama sakit bahkan sampai keluar darah," terang Susan.

Selain itu, penggunaan hiperbarik yang terlalu sering juga dapat mencetuskan kanker. "Karena yang dipakai adalah oksigen murni, maka jika terlalu banyak, bisa menjadi radikal bebas juga. Nah, radikal bebas itu bisa menyebabkan kanker."

DARI VERTIGO HINGGA KANKER
Sejak tahun 1970, setelah RSAL dr. Mintohardjo memiliki tabung hiperbarik, penggunaannya meluas tak hanya untuk penyelam atau prajurit TNI. Tahun 1998, RSAL mendapat tambahan dua lagi, yaitu vertical dan horizontal chamber. Keduanya multiplace chambers, bisa untuk banyak orang.

Sejak itu pula, tabung tersebut sudah dimanfaatkan untuk berbagai penyembuhan penyakit. "Dari sakit kepala seperti vertigo sampai penyembuhan gangren pada penderita diabetes dan pasca-stroke serta pemulihan habis operasi. Bahkan, baru-baru ini untuk mengobati kanker," terang Janti.

Khusus untuk penderita kanker, pihak KUBT sebelumnya bekerjasama dengan beberapa dokter radioterapi, sesuai sifat dasar hiperbarik yang mempercepat pertumbuhan sel atau jaringan. Jadi, pasien harus menjalani radioterapi dan hiperbarik. “Radioterapi merusak jaringan seputar kanker, nah tugas hiperbarik adalah memperbaiki jaringan yang rusak tersebut. Tetapi tak bisa dengan hiperbarik saja, karena dikhawatirkan sel kankernya tumbuh cepat, ibarat tanaman yang diberi pupuk," jawab Janti.

JAUH LEBIH HEMAT
Dibandingkan biaya yang harus dikeluarkan untuk menangani penyakit tanpa hiperbarik, terapi hiperbarik memang relatif lebih murah. Lama tinggal di rumah sakit juga jauh berkurang.

Sekali menggunakan hiperbarik, pasien dikenakan biaya Rp 150 ribu. Biaya yang lumayan murah dibandingkan terapi yang sama di negara berbeda. Di Amerika, biayanya 4 ribu US dolar. Biaya tersebut sebenarnya tak sesuai dengan biaya yang harus dikeluarkan pihak rumah sakit untuk perawatan mesin. “Oli dan suku cadangnya belum diproduksi di dalam negeri. Jadi, harus pesan di luar negeri. Seliter oli harganya Rp 300 ribu rupiah dan perlu diganti setiap seribu jam putaran. Belum lagi filternya yang harus diganti setiap tahun, yang harganya Rp 300 juta. Biaya perawatannya memang tinggi,” jelas Janti.

Itulah kenapa, RSAL dr. Mintohardjo tidak melayani pasien hingga sore hari. “Takut mesinnya rusak," ujar Janti setengah bercanda. Namun, "Untuk kasus-kasus, kita bekerja 24 jam, kok,” sambungnya.

Tak semua orang bisa mendapatkan terapi hiperbarik. Oleh karena itu, sebelum menjalani terapi, pasien harus mendapatkan pemeriksaan laboratorium, seperti foto torax (foto paru-paru, Red.). Maksudnya untuk melihat apakah paru-paru pasien sehat. "Jadi kita tahu apakah pasien itu mempunyai kanker atau tidak. Atau apakah paru-parunya bocor. Apa jadinya kalau paru-paru bocor terus ditekan udara tinggi?" Yang jelas, anak kecil dan wanita hamil tak diperbolehkan menggunakan hiperbarik.

Hasil laboratorium tersebut berguna untuk mengetahui kondisi keseluruhan pasien. "Misalnya dia menderita TBC. Nah, agar tak menular, penderita kita sarankan untuk membeli masker sendiri. Atau bila pasien menderita flu enggak boleh masuk, soalnya bisa terganggu telinganya."

Indikasi yang tepat untuk rujukan hiperbarik:
1. Penyakit Dekompresi
2. Emboli Udara
3. Keracunan Gas : CO, HCN, H2S, CC14
4. Infeksi Gangren, Osteomyelitis, Lepra, Mikosis
5. Bedah Plastik Dan Rekonstruksi
6. Luka yang sulit sembuh
7. Luka bakar
8. Operasi reimplantasi
9. Operasi cangkok jaringan

dikutip dari tabloid Nova tahun 2001
Copyright © 2001 www.tabloidnova.com
All rights reserved.

Sabtu, 14 Agustus 2010

WARNING! NOT ALL HYPERBARIC CHAMBERS ARE THE SAME!

PERKEMBANGAN HIPERBARIK DI INDONESIA

Terapi hiperbarik mungkin baru segelintir orang yang mengenalnya. Di Indonesia, pemanfaatna HBOT pertama kali oleh Lakesla yang bekerja sama dengan RS Angkatan Laut Dr. Ramelan, Surabaya, tahun 1960. Hingga saat ini fasilitas tersebut masih merupakan yang paling besar di Indonesia. Sementara di tempat lain telah tersedia pula fasilitas terapi oksigen hiperbarik, diantaranya adalah RSAL Dr Mintohardjo Jakarta,RS. JAKARTA, RSAL Halong Ambarawa, RSAL Midiato, RSP Balikpapan, RSP Cilacap, RSU Makasar, RSU Manado, RSU Sangla Denpasar, dan Diskes Koarmabar.

Dasar dari terapi hiperbarik sedikit banyak mengandung prinsip fisika. Teori Toricelli yang mendasari terapi digunakan untuk menentukan tekanan udara 1 atm adalah 760 mmHg. Dalam tekanan udara tersebut komposisi unsur-unsur udara yang terkandung di dalamnya mengandung Nitrogen (N2) 79 % dan Oksigen (O2) 21%. Dalam pernafasan kita pun demikian. Pada terapi hiperbarik oksigen ruangan yang disediakan mengandung Oksigen (O2) 100%. Terapi hiperbarik juga berdasarkan teori fisika dasar dari hukum-hukum Dalton, Boyle, Charles dan Henry.

Sedangkan prinsip yang dianut secara fisiologis adalah bahwa tidak adanya O2 pada tingkat seluler akan menyebabkan gangguan kehidupan pada semua organisme. Oksigen yang berada di sekeliling tubuh manusia masuk ke dalam tubuh melalui cara pertukaran gas. Fase-fase respirasi dari pertukaran gas terdiri dari fase ventilasi, transportasi, utilisasi dan diffusi. Dengan kondisi tekanan oksigen yang tinggi, diharapkan matriks seluler yang menopang kehidupan suatu organisme mendapatkan kondisi yang optimal.

Terapi oksigen hiperbarik (HBOT) adalah terapi medis dimana pasien dalam suatu ruangan menghisap oksigen tekanan tinggi (100%) atau pada tekanan barometer tinggi (hyperbaric chamber). Kondisi lingkungan dalam HBOT bertekanan udara yang lebih besar dibandingkan dengan tekanan di dalam jaringan tubuh (1 ATA). Keadaan ini dapat dialami oleh seseorang pada waktu menyelam atau di dalam ruang udara yang bertekanan tinggi (RUBT) yang dirancang baik untuk kasus penyelaman maupun pengobatan penyakit klinis. Individu yang mendapat pengobatan HBOT adalah suatu keadaan individu yang berada di dalam ruangan bertekanan tinggi (> 1 ATA) dan bernafas dengan oksigen 100%. Tekanan atmosfer pada permukaan air laut sebesar 1 atm. Setiap penurunan kedalaman 33 kaki, tekanan akan naik 1 atm. Seorang ahli terapi hiperbarik, Laksma Dr. dr. M. Guritno S, SMHS, DEA yang telah mendalami ilmu oksigen hiperbarik di Perancis selama 5 tahun menjelaskan bahwa terdapat dua jenis dari terapi hiperbarik, efek mekanik dan fisiologis. Efek fisiologis dapat dijelaskan melalui mekanisme oksigen yang terlarut plasma. Pengangkutan oksigen ke jaringan meningkat seiring dengan peningkatan oksigen terlarut dalam plasma.

Mekanisme HBOT

HBOT memiliki mekanisme dengan memodulasi nitrit okside (NO) pada sel endotel. Pada sel endotel ini HBOT juga meningkatkan intermediet vaskuler endotel growth factor (VEGF). Melalui siklus Krebs terjadi peningkatan NADH yang memicu peningkatan fibroblast. Fibroblast yang diperlukan untuk sintesis proteoglikan dan bersama dengan VEGF akan memacu kolagen sintesis pada proses remodeling, salah satu tahapan dalam penyembuhan luka.

Mekanisme di atas berhubungan dengan salah satu manfaat utama HBOT yaitu untuk wound healing. Pada bagian luka terdapat bagian tubuh yang mengalami edema dan infeksi. Di bagian edema ini terdapat radikal bebas dalam jumlah yang besar. Daerah edema ini mengalami kondisi hipo-oksigen karena hipoperfusi. Peningkatan fibroblast sebagaimana telah disinggung sebelumnya akan mendorong terjadinya vasodilatasi pada daerah edema tersebut. Jadilah kondisi daerah luka tersebut menjadi hipervaskular, hiperseluler dan hiperoksia. Dengan pemaparan oksigen tekanan tinggi, terjadi peningkatan IFN-γ, i-NOS dan VEGF. IFN- γ menyebabkan TH-1 meningkat yang berpengaruh pada B-cell sehingga terjadi pengingkatan Ig-G. Dengan meningkatnya Ig-G, efek fagositosis leukosit juga akan meningkat. Sehingga dapat disimpulkan bahwa pada luka, HBOT berfungsi menurunkan infeksi dan edema..

Adapun cara HBOT pada prinsipnya adalah diawali dengan pemberianO2 100%, tekanan 2 – 3 Atm . Tahap selanjutnya dilanjutkan dengan pengobatan decompresion sickness. Maka akan terjadikerusakan jaringan, penyembuhan luka, hipoksia sekitar luka. Kondisi ini akan memicu meningkatnya fibroblast, sintesa kolagen, rasio RNA/DNA, peningkatan leukosit killing, serta angiogenesis yang menyebabkan neovaskularisasi jaringan luka. Kemudian akan terjadi peningkatan dan perbaikan aliran darah mikrovaskular. Densitas kapiler meningkat sehingga daerah yang mengalami iskemia akan mengalami reperfusi. Sebagai respon, akan terjadi peningkatan NO hingga 4 – 5 kali dengan diiringi pemberian oksigen hiperbarik 2-3 ATA selama 2 jam. Hasilnya pun cukup memuaskan, yaitu penyembuhan jaringan luka. Terapi ini paling banyak dilakukan pada pasien dengan diabetes mellitus dimana memiliki luka yang sukar sembuh karena buruknya perfusi perifer dan oksigenasi jaringan di distal.

Indikasi-indikasi lain dilakukannya HBOT adalah untuk mempercepat penyembuhan penyakit, luka akibat radiasi, cedera kompresi, osteomyelitis, intoksikasi karbonmonoksida, emboli udara, gangren, infeksi jaringan lunak yang sudah nekrotik, Skin graft dan flap, luka bakar, abses intrakranial dan anemia.

Prosedur pemberian HBOT yang dilakukan pada tekanan 2-3 ATA-90 dengan O2 intermitten akan mencegah keracunan O2. Menurut Paul Bert, efeksamping biasanyaakan mengenai sistem saraf pusat seperti timbulnya mual, kedutan pada otot muka dan perifer serta kejang. Sedang menurut Lorrain Smith, efek samping bisamengenai paru-paru yaitu batuk, sesak dan nyeri substernal.

HBOT Meningkatkan Sensitivitas Radioterapi
Penanganan kanker pada umumnya melalui tahapan terapi operasi, radioterapi, kemoterapi dan hormonal. Seiring perkembangan ilmu dan teknologi, oksigen hiperbarik dan herbal merupakan salah satu pilihan untuk meningkatkan sensitifitas efek radioterapi sehingga dapat membantu menekan angka kematian dan meningkatkan angka harapan hidup. Rumkital Dr. Ramelan Surabaya telah memiliki Instalasi Radioterapi dan Oksigen yang merupakan bagian dari unggulan fasilitas kesehatan.

Penelitian hubungan tekanan oksigen dengan radioterapi pada manusia sudah dimulai sejak tahun 1910 oleh Deche. Sedangkan menurut Guritno, yang pada saat diwawancarai masih menjabat sebagai direktur RSAL Dr Ramelan Surabaya, HBOT bermanfaat untuk meningkatkan sensitivitas sel tumor pada radioterapi. Karena pada kondisi hipoksia sensitifitas sel tumor menurun, sehingga dengan HBOT yang meningkatkan perfusi. Dengan demikian akan tercipta kondisi hiperoksia yang menyebabkan sensitifitas sel tumor meningkat. HBOT tentunya juga akan bermanfaat pada healing injury post radioterapi.

Studi dan telaah dilakukan seorang ahli HBOT muda, dr. Arie Widiyasa Sp.OG, Kabag KESLA RSAL Ilyas Tarakan, mengenai pengaruh HBOT terhadap kanker serviks. Kombinasi antara radiasi baik eksternal atau brachiterapi atau keduanya yang dikombinasikan dengan pemberian HBOT akan meningkatkan radiosensitivitas sel kanker serviks. Salah satu modalitas yang dapat dikembangkan saat ini adalah terapi dengan menggunakan oksigen bertekanan tinggi diberikan dengan tekanan 2,0 ATA, 2,4 ATA atau 3 ATA sebanyak 20 – 30 kali dapat dipertimbangkan walau harus tetap mempertimbangkan untung ruginya tindakan tersebut. HBOT dapat memperbaiki sensitivitas sel tumor, meningkatkan persentase angka survival rate, tak jelas dapat mencegah rekurensi atau menurunkan angka kematian. Dengan demikian komplikasi pemberian radioterapi dosis tinggi dapat dicegah sebelum kerusakan menjadi berat dan irreversibel.

Manfaat pada Pasien Post Radioterapi
Dewasa ini terapi radiasi dinilai cukup efektif untuk menangani beberapa kasus kanker yang tidak operable. Namun efek samping radiasi yang bersifat sistemik agaknya sulit untuk dihindari. Contohnya pada radioterapi pelvis yang akan menyebabkan rusaknya epitel, parenkim, stroma, vaskuler rektum dan berujung pada terbentuknya striktur dan fistula. Sayangnya pula terapi yang dilakukan terhadap efek samping tersebut sering tidak berhasil sehingga akan terjadi kerusakan komplek serta terbentuknya mediator yang menyebabkan vasodilatasi, peningkatan permeabilitas pembuluh darah, kemotaksis, demam, rasa sakit dan kerusakan jaringan. American Society for Therapeutic Radiology and Oncology membuat sistem scoring efek samping akut dan efek samping lama.

Menurut Dr. dr. Suyanto Sidik Sp.PD, ahli HBOT dari RSAL Dr. Mintohardjo, radioterapi akan memberikan efek samping seperti rusaknya epitel, parenkim, dan vaskuler dari tubuh. Manifestasi yang paling sering adalah timbulnya struktur dan fistel. Pada umumnya setelah 6 bulan akan terjadi hipoksia, hipovaskuler dan hiposeluler pada jaringan yang terpapar radiasi. Celakanya terapi efek samping ini seringkali gagal karena kerusakan komplek pada jaringan. Terdapat gangguan permeabilitas pembuluh darah, kemotaksis yang disertai manifestasi klinis demam dan nyeri. Terapinya tentu saja adalah dengan meningkatkan aliran darah ke daerah yang hipovaskuler tersebut. Jadi mekanisme penyembuhan luka untuk post radiasi adalah meningkatkan vaskularisasi, memperbaiki fungsi epitel, meningkatkan VEGF, mengatur sintesis dan lisis kolagen. HBOT meningkatkan aktivasi arginin yang berefek pada kolagen sintesis, dan mensupport kontraksi otot.

Sebagai contoh pengobatan HBOT pada injury radiasi dengan proktitis radiasi sebagai model. Efek samping dari terapi radiasi pada karsinoma rongga pelvis adalah proktitis radiasi. Efek samping ini bermanifestasi tergantung dari dosis, fraksinasi, luas dan teknik radiasi. Adanya riwayat radioterapi pelvis biasanya ditandai dengan gejala : sakit perut, diare, anorexia, dan mual. Pada pemeriksaan rekto-sigmoidokopi didapatkan erythema, edema, teleangiektasis, erosi, bahkan ulkus. Pada pemeriksaan PA diketahui adanya sebukan sel radang diikuti gambaran histologik lamina propia terhialinisasi, sub mucosa fibrotik, ektasia vaskuler, nekrosis fibrinoid yang dibandingkan dengan pembuluh darah fibroblas atipik. Gejala yang merupakan manifestasi dari efek samping akut ini biasanya muncul dengan frekuensi 50 – 70 %. Sedangkan efek samping lanjutan umumnya bermanfest dengan sakit perut, tenesmus, dan hematochezia. Gejala efek samping jenis ini biasanya hanya timbul 2,5 – 25 %. Efek yang lebih berat lagi apabila gejala efek samping tersebut disertai dengan diare lendir dan darah.

Pada kanker nasofaring yang mendapat radioterapi, HBOT dapat berguna untuk pencegahan terjadinya mandibular necrosis. Pada kanker leher rahim dan kanker prostat yang mendapat radioterapi HBOT bisa untuk prevensi radiosistitis. Pasien Face-off, Lisa, yang sempat menghebohkan dunia bedah plastik sebelum ini, sempat membuat pusing para dokter yang merawatnya karena kecenderungan nekrosis flap hasil pemindahan. Atas saran Guritno, Lisa akhirnya diterapi HBOT, dan hasilnya cukup baik. Kulit yang sebelumnya ditakutkan akan nekrosis menjadi pulih kembali.


Oksigen Hiperbarik
Ketika oksigen dihirup pada konsentransi yang lebih tinggi dari yang ditemukan dalam atosfir, udara pada keadaan ini pertimbangkan sebagai obat. Berdasarkan definisi ini oksigen hiperbarik kemudian dipastikan sebagai obat dan dapat dipergunakan dalam suatu terapi. (1)
Terapi oksige hiperbarik merupakan bentuk pengobatan, penderita harus berada dalam ruangan bertekanan dan bernafas dengan oksigen murni (100%) pada tekanan udara lebih besar daripada udara atmosfir normal, yaitu sebesar 1 atm (760 mmHg). Keadaan ini dapat dialami oleh seseorang pada waktu menyelam atau berada dalam ruangan udara bertekanan tinggi (hyperbaric chamber) yaitu suatu ruang kedap udara terbuat dari perangkat keras yang mampu diberikan tekanan lebih besar dari 1 atm (ruang kompresi) beserta sumber oksigen dan sistem penyalurannya ke dalam ruang rekompresi tersebut.
Dua efek penting yang mendasar pada terapi oksigen hiperbarik adalah: (11) Efek mekanik meningkatnya tekanan lingkungan atau ambient yang memberikan manfaat penurunan volume gelembung gas atau udara seperti pada terapi penderita dekompresi akibat kecelakaan kerja penyelaman dan gas emboli yang terjadi pada beberapa tindakan medis rumah sakit. Efek peningkatan tekanan parsial oksigen dalam darah dan jaringan yang memberikan manfaat terapeutik: bakteriostatik pada infeksi kuman anaerob, detoksikasi pada keracunan karbon monoksida, sianida dan hidrogensulfida, reoksigenasi pada kasus iskemia akut, crush injury, compartment syndrome maupun kasus iskemia kronis, luka yang tidak sembuh, nekrosis radiasi, skin graft preparation dan luka bakar.
Pembahasan
Terapi oksigen hiperbarik untuk pertama kalinya digunakan pada penyakit dekompresi (DeCompression Ilnes), yaitu suatu penyakit yang dialami oleh penyelam dan pekerja tambang bawah tanah akibat penurunan tekanan saat naik ke permukaan secara mendadak. Dari berbagai penelitian terungkap bahwa oksigen hiperbarik mempunyai manfaat lebih, tidak terbatas pada kasus-kasus penyelaman saja. Satu contoh terapi oksigen hiperbarik yang berhasil, digunakan dalam mempercepat proses penyembuhan luka. Terapi oksigen hiperbarik sebenarnya merupakan terapi penunjang pada proses penyembuhan luka, Sedangkan perawatan utamanya sendiri adalah debridement dan penjahitan jika diperlukan.
Namun demikian oksigen hiperbarik dapat mempercepat proses penyembuhan luka, sehingga jaringan yang hipoksia memperlihatkan hasil yang baik pada terapi oksigen hiperbarik. (1) Yusman (13) menyatakan bahwa luka yang sulit sembuh dan luka bakar merupakan indikasi yang tepat untuk rujukan terapi oksigen hiperbarik. Hal ini ditegaskan dalam hasil konfrensi kedokteran hiperbarik tahun 1991 di Ancona Italia, bahwa luka yanga sulit sembuh (delayed wound healing) termasuk dalam kelompok Accepted chronic indication untuk terapi oksigen hiperbarik. (11)
Fisher pada tahun 1969 untuk pertama kali menggunakan oksigen hiperbarik pada 32 pasiennya yang mengalami ulser pada kaki. Penelitian serupa dilakukan pada tahun 1975 pada pasien lainnya. Oksigen dialirkan dan dipertahankan selama 41 menit, terapi dilakukan dua kali sehari dan setiap sesi dilakukan sedikitnya 2-3 jam. Hasil penelitiannya menunjukkan banyak ulkus yang sembuh dengan baik, walau demikian iksogen hiprbarik gagal pada kasus-kasus iskemia hebat.
Ignacio et.al pada 18 pasien denga jenis ulcer yang berbeda dan hasilnya cukup memuaskan. Heng memberikan terapi oksigen hiperbarik secara topikal pada 6 pasien denga 27 ulser (5 dari 6 pasien Penyembuhan terjadi pada hari 6 sampai dengan 21 hari, sedangkan 10 ulser tanpa terapi oksigen hiperbarik tidak terjadi proses penyembuhan pada periode waktu yang sama. (1) Terapi oksigen hiperbarikselain dapat mempercepat proses penyembuhan pada luka diketahui juga dapat mempercepat pertumbuhan jaringan, seperti kasus yang dilakoprkan di RSAL Mintohardjo Jakarta. Kasus transplantasi jari pasien sesaat setelah operasi, pasien terapi denhanoksigen hiperbarik ternyata penyembuhan berjalan lebih cepat dan sel tumbuh lebih cepat. (13) Berikut ini diperlihatkan kasus yang pernah diterapi dengan oksigen hiperbarik di RSAL Dr. Ramelan Surabaya.