Accuracy of portable infusers under hyperbaric oxygenation conditions.

Three types of portable infusers with different infusion mechanisms were evaluated with regard to their accuracy during a hyperbaric oxygenation protocoL The power driving the pump is provided by either a balloon, a spring or a vacuum mechanism. Performance during hyperbaric oxygenation (HBO) varied between the devices, probably due to the difference in driving mechanism. Flow delivery by the vacuum type infuser is substantially affected by HBO. Doubling the ambient pressure approximately doubled flow delivery from the vacuum type device. We suggest that other devices are more suitable for use in this clinical situation. We conclude that it is desirable to check the performance of any infuser intended for use during hyperbaric oxygenation and to be mindful of potential differences among such devices.

The accuracy and reliability of an infusion pump (STC-3121; Terumo Inst., Japan) during hyperbaric oxygenation.

We evaluated the accuracy of delivery of one type of infusion pump at three nominal flow rates under two environmental pressures (measured in atmospheres absolute, ATA), one of which is used for hyperbaric oxygenation. Overall, we observed significant differences between the two different pressures (1 ATA and 2 ATA). Changes in the rate of delivery of between about -4% and +2% were observed over the time course of hyperbaric oxygenation, and the inter-group difference was significant in the phases in which pressure was changing. The effect produced by 2 ATA was statistically significant but small, and its influence is likely to be negligible during practical hyperbaric oxygenation therapy. Thus, it would seem that this type of pump would deliver reliably at the nominal rate during hyperbaric oxygenation at these levels.

Hyperbaric oxygenation for rectovaginal fistula: a report of two cases.

A rectovaginal fistula after delivery is a rare complication, and its management can become difficult if infection occurs. In two such cases, we administered hyperbaric oxygenation (HBO) treatment against complicated infections, and we obtained a good outcome in each case.

Early post-operative hyperbaric oxygen therapy modifies neutrophile activation.

BACKGROUND/AIMS: To investigate the effect of acute hyperbaric oxygen therapy (HBOT) on post-operative sinusoidal endothelial cell (SEC) damage caused by activated neutrophils. METHODOLOGY: 12 non-cirrhotic patients (Group H), who underwent elective hepatectomy for liver cancer, were given 2 courses of HBOT: 2.0 atm with inhalation of 100% oxygen, for 60 min, at 3 hours and 24 hours after hepatectomy; they were then compared with the 12 patients (Group C) who had been treated to maintain normal hemodynamic values. RESULTS: In group H, peak levels of polymorphonuclear leukocyte elastase (PMNE) and thrombomodulin (TM) were clearly diminished and delayed compared to Group C. All subjects in Group C showed more than a 10% increase in CD18 12 hours after surgery; however, in Group H, the elevation of CD18 expression was clearly suppressed compared to Group C. No patient in Group H had post-operative hyperbilirubinemia or hepatic failure; however, 3 had post-operative hyperbilirubinemia and 1 had intraperitoneal infection in Group C. CONCLUSIONS: Our results provide direct evidence that HBOT, especially at 3 hours after hepatectomy, has favorable effects on the activation of neutrophiles decreasing SEC injury.

[Open-heart surgery without donor-blood transfusion--a clinical study].

Since October 1987, 80 patients underwent open-heart surgery without donor-blood transfusion. 50 (Group I) out of these 80 cases were selected to be paired with 50 patients (Group II) who underwent open-heart surgery with homologous blood transfusion in the same period. Twelve cases (Group III) underwent open-heart surgery without homologous blood transfusion but were transfused after surgery. To decrease the homologous blood requirements, ultra-filtration system as well as conservation and autotransfusion of autologous blood was employed. Peripheral blood count, blood chemistry for liver and renal function were analyzed and compared among these three groups. Although hematocrit of Group I was lower than that of Group II until the third postoperative day, there was no difference after the seventh postoperative day. The platelet count was more in Group I than in Group II or III on the first and the seventh postoperative day. The level of lactate dehydrogenase was higher in Group II than in Group I. Total bilirubin was more elevated in Group II than in Group I on the first and the fourteenth postoperative day. Direct bilirubin was also higher in Group II than in Group I till fourteenth postoperative day. Five cases in Group II fulfilled the criteria of the serum hepatitis. Blood urea nitrogen and creatinine were less in Group I than in Group II. The duration of the intra-tracheal intubation was shorter in Group I than in Group II or III. There was no difference in postoperative dosage or duration of catecholamines among three groups.(ABSTRACT TRUNCATED AT 250 WORDS)