Textbook of Hyperbaric Medicine

This is a seminal textbook for understanding the medical and scientific facts of hyperbaric medicine, as well as implementing hyperbaric medical technologies to patient care. HBO has widely varied disease and condition applications with a commonality of pressure technology.

Medical Economics
In the modern world of medical economics, HBO can save Third Party Payers significant costs on patient treatments while delivering significantly improved outcomes and quality of life.

HBO is one of those medical sub-specialties that is left behind by the biases of modern medical economics and science. Modern medicine is primarily based on pharmaceutical economics. Significant research investments are powered by the manufacturing and distribution economics of successful drugs. This is a great and tremendous system, delivering research, understanding and successful treatments that unquestionably alleviate disease and conditions on a broad basis. But, this system is not perfect and is not without isolated failings.

HBOT cannot be packaged into a pill, has minimal manufacturing economies, and high ongoing service costs and high overhead, while associated with nominal patient volumes, and nominal billing rates. These economics have long held back this very promising technology (HBO) and its successful applications. Further, double blind studies are virtually impossible - patients perceive pressure changes, or lack thereof, technicians are required to implement pressurization, and oxygen delivery systems may not be able to deliver less than 100% oxygen.

Ironically, HBO can power pharmaceutical and surgical applications to higher levels of treatment success bringing cures where partial successes were the norms. (Chapters 9, 13 14, 15, 23, 24, 27, 33).

Controversially, HBO has demonstrated good clinical success on incurable diseases and conditions, including Crones Disease, stroke, CP, MS, and others. While modern medicine debates the etiologies and optimal treatment protocols, curative HBO applications can be given today. These applications (esp. Crones, and MS) can further illuminate etiologies therefore, furthering and accelerating alternative and supportive therapies.

HBOT supports diabetic wound healing, preventing amputations; enhances infectious disease therapies, saving lives and reducing hospital stays; is used for various poisonings; can provide accelerated surgical recoveries (up to 30-40% faster); and can ameliorate strokes and brain injuries by up to 40% when applied within 4 hours of injury.

Medical Physics
Simply, under pressure, oxygen dissolves in blood serum, and therefore can diffuse to poorly supported disease areas, or injuries. Further, HBO acts as an immuno-suppressant, relieving acutely injured tissues of oedema, preventing further injuries (if applied on a timely basis), as well as supporting the natural healing process.

Angiogenesis occurs within 15 - 20 minutes of HBO. It is not known if angiogenesis is initiated by the increased pressure effects, or by the oxygen dissolved in the serum. However, angiogenesis is felt to be a factor supporting accelerated healing in injuries, chronic wounds, and surgical recoveries. Further, little is known about these growth factors and their involvement with healing.

Neurological Applications
The chapters on neurological applications are some of the most significant in this text and should be required reading for all neurologists because they hold the greatest single promise to modern healthcare. These chapters are steeped with extensive (and largely ignored) animal and human research papers, extensive clinical studies with supportive SPECT scans and associated clinical outcomes.

The brain remains the final frontier of science and brain injuries are the most destructive and expensive to society (#1 killer of children and teenagers, #1 birth defect, #2 killer for adults).

We do not understand the brain's response to injury, or disease, much less detail its response to treatments and recoveries. But, we can accept the overwhelming clinical observations made by trained physicians world-wide of positive outcomes to HBO when applied to brain injuries, and cerebral palsy patients.

Hopefully, one day we will be able to manufacture a drug, or drug regimen that can replace HBO treatments for brain injuries. However, that day is probably 50 years from today. Therefore, today, we need to apply HBO to brain injuries, note the clinical outcomes, optimize the treatments, and develop ancillary supportive therapies.

Diagnostic Imaging is propelling objective clinical research for neurological applications of HBO by demonstrating underlying metabolic activity changes in brain tissues with HBO. Clinical observations significantly correlate with SPECT scan changes. (SPECT using HMPAO have become the scan of choice.) Chapter 18 written by Dr.'s Neubauer and Harch provide an excellent foundation for understanding and support for using HBO for brain injuries and CP.

Table of Contents

Forward: by Edward Teller, Director Emeritus Lawrence Livermore National Laboratories

(In a personal communication to me, Dr. Teller assures the empirical physics of HBO, and is convinced that HBO enabled him to recover from a serious stroke. Dr. Teller is also convinced that his daily HBO regimen has enabled him to continue working full time at 93 years of age).

Part I:Basic Aspects
1History of HBO
2Physical, Physiological and Biochemical Aspects
3Effects of Diving and High Pressure on Human Bodies
4Physical Exercise under HBO
5Hypoxia
6Oxygen Toxicity
7HBO Chambers, Equipment, Techniques, Safety
8Indications, Contraindications, and Complications
9Drug Interactions

Part II: Clinical Applications
10Decompression Sickness
11Cerebral Air Embolisms
12Carbon Monoxide and other Tissue Poisons
13Infections
14Wound Healing, Plastic Surgery, Dermatology
15Radionecrosis
16Neurological disorders
17Stroke
18Global Ischemia / Anoxia and Coma
19Neurosurgery
20Multiple Sclerosis
21Headache
22Cardiovascular Diseases
23Hematology and Immunology
24Gastroenterology
25Endocrinology
26Pulmonary Disorders
27Pediatric Surgery
28Traumatology and Orthopedics
29Otolaryngology
30Opthamology
31Obstetrics and Neonatology
32Geriatrics
33As Adjuvant in Rehabilitation and Sports Medicine
34Cancer Radiosensitivity
35Anesthesia
36Emergency Medicine
37HBO as a Speciality: Training, Practice and Research
38HBO Around the World
39HBO in Japan

Part III: Appendix, Bibleography, Index
40Appendix: Diagnostic: Imaging and HBOT
41Bibliography
42Index