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Anästhesiol Intensivmed Notfallmed Schmerzther 2000; 35(8): 487-502
DOI: 10.1055/s-2000-7079
ÜBERSICHT
© Georg Thieme Verlag Stuttgart · New York

Hyperbare Oxygenationstheapie (HBO): eine Standortbestimmung

Hyperbaric Oxygen Therapy (HBO): Current StandingC. Haltern1 , U. P. F. Siekmann1 , A. F. E. Rump2 , R. Rossaint1
  • 1Klinik für Anästhesiologie der RWTH Aachen, Aachen
  • 2Schiffahrtmedizinisches Institut der Bundesmarine, Kiel-Kronshagen
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Publikationsdatum:
31. Dezember 2000 (online)

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Zusammenfassung.

Seit mehr als dreißig Jahren gehört die hyperbare Oxygenationstherapie (HBO) zu dem therapeutischen, schulmedizinischen Repertoire bei speziellen Indikationen. Die Verbesserung der Gewebeoxygenierung, Stimulation wesentlicher am Wundheilungsprozeß beteiligter Vorgänge und Beeinflussung anderer Prozesse auf biochemischer und zellulärer Ebene durch die HBO sind wissenschaftlich belegt. Diese bilden die Rationale für die hyperbare Oxygenierung als Therapie der Wahl bei schwerer Kohlenmonoxid-Intoxikation, Dekompressionserkrankung und arterieller Gasembolie sowie als adjuvante Therapie zur Behandlung von Osteoradionekrosen, nekrotisierenden Weichteilinfektionen und kritischen Haut-/Muskeltransplantaten. Der Nutzen einer adjuvanten HBO-Therapie in der Behandlung des therapierefraktären diabetischen Fuß-Syndroms kann ebenfalls als gesichert gelten. Der therapeutische Benefit bei anderen Indikationen ist wissenschaftlich wenig untermauert und bedarf weiterer Klärung. Unter Beachtung der von den Fachgesellschaften festgelegten Standards ist die HBO bei ausgewählten Indikationen eine sichere und nebenwirkungsarme Therapie.

Hyperbaric Oxygen Therapy (HBO): Current Standing.

For more than thirty years hyperbaric oxygen therapy (HBO) has been an important and ultimate therapeutic tool in special indications. Hyperbaric oxygen improves tissue oxygenation, stimulates important mechanisms in wound healing and exerts beneficial effects on other biochemical and cellular processes. The properties of hyperbaric oxygen have built the rationale for its use as therapy of choice in patients with severe carbon monoxide poisoning, decompression sickness and arterial gas embolism, and as adjunctive therapy for the treatment of osteoradionecrosis, necrotizing fasciitis and compromised skin grafts and flaps. The efficacy of adjunctive hyperbaric oxygen in the treatment of lower extremity problem wounds in diabetic patients seems to be proven. There is little scientific support for other uses of hyperbaric oxygen and its therapeutical benefit should be further investigated. When used according to standard protocols hyperbaric oxygen treatment is a safe therapy with little adverse effects.

Schlüsselwörter:

Hyperbare Oxygenation - - Kohlenmonoxid-Intoxikation - - Dekompressionserkrankung - - Arterielle Gasembolie - - Clostridiale Myonekrose - - Wundheilung - - Problemwunde

Key words:

Hyperbaric oxygen - - Carbon monoxide poisoning - - Decompression sickness - - Arterial gas embolism - - Clostridial myonecrosis - - Wound healing - - Problem wound

Literatur

  • 1 Almeling M, Welslau W (eds.) Hyperbare Sauerstofftherapie - Qualitätsstandards, GTÜM e. V. 2. Aufl. Archimedes Verlag Kiel; 1996
    Suche in Google Scholar
  • 2 Haux G. Wie aus der HB die HBO wurde. Archimedes Verlag 1997: 9-23
    Suche in Google Scholar
  • 3 Boerema I. et al . Life without blood.  J. Cardiovasc. Surg.. 1960;  (1) 133-146
    PubMedSuche in Google Scholar
  • 4 Nylander G. et al . Reduktion of the posteschemic edema with hyperbaric oxygen.  Surg.. 1986;  76 596-603
    PubMedSuche in Google Scholar
  • 5 Hunt T K. The physiology of wound healing.  Ann. Emerg. Med.. 1988;  17 1265-1273
    CrossrefPubMedSuche in Google Scholar
  • 6 Hunt T K, Pal M P. The effect of varying ambient oxygen tensions on wound metabolism and collagen synthesis.  Surg. Gynecol. Obstet.. 1979;  135 561-567
    PubMedSuche in Google Scholar
  • 7 Niinikoski J, Gottup F, Hunt T K. The role of oxygen in wound repair. In: Janssen H, Raaman R, Robertson JIS (Editors) Wound healing. Wrightson Biomedical Publishing 1991: 165-174
    Suche in Google Scholar
  • 8 Tompach P C, Lew D, Stoll J L. Cell response to hyperbaric oxygen treatment.  Int. J. Oral Maxillofac. Surg.. 1997;  22(2) 82-86
    PubMedSuche in Google Scholar
  • 9 Roberts G P, Harding K G. Stimulation of glycosaminoglycan synthesis in cultured fibroblasts by hyperbaric oxygen.  Br. J. Dermatol.. 1994;  131(5) 630-633
    PubMedSuche in Google Scholar
  • 10 Marx R E. et al . Relationship of oxygen dose to angiogenesis induction in irradiated tissue.  Am. J. Surg.. 1990;  160 519-524
    CrossrefPubMedSuche in Google Scholar
  • 11 Uhl E. et al . Hyperbaric oxygen improves wound healing in normal and ischemic skin tissue.  Plast. Reconstr. Surg.. 1994;  93 835-841
    CrossrefPubMedSuche in Google Scholar
  • 12 Allen D B. et al . Hypoxia and acidosis limit neutrophil bacterial killing mechanisms.  Arch. Surg.. 1997;  132(9) 991-996
    CrossrefPubMedSuche in Google Scholar
  • 13 Tibbles P M, Edelsberg J S. Hyperbaric-Oxygen Therapy.  N. Engl. J. Med.. 1996;  334 1642-1648
    CrossrefPubMedSuche in Google Scholar
  • 14 Zamboni W A. et al . Morphologic analysis of the microcirculation during reperfusion of ischemic skeletal muscle and the effect of hyperbaric oxygen.  Plast. Reconstr. Surg.. 1993;  91(6) 1110-1123
    CrossrefPubMedSuche in Google Scholar
  • 15 Thom S R. Leukocytes in carbon monoxide-mediated brain oxidative injury.  Toxicol. Appl. Pharmacol.. 1993;  123 234-237
    CrossrefPubMedSuche in Google Scholar
  • 16 Sirsjo A. et al . Hyperbaric oxygen treatment enhances the recovery of blood flow and functional capillary density in postischemic striated muscle.  Circ. Shock.. 1993;  40(1) 9-13
    PubMedSuche in Google Scholar
  • 17 Thom S R. et al . Inhibition of human neutrophil beta2-integrin-dependent adherence by hyperbaric O2.  Am. J. Physiol.. 1997;  272(3 Pt 1) C770-7
    PubMedSuche in Google Scholar
  • 18 Haapaniemi T. et al . Hyperbaric oxygen treatment attenuates glutathione depletion and improves metabolic restitution in postischemic skeletal muscle.  Free Radic. Res.. 1995;  23(2) 91-101
    PubMedSuche in Google Scholar
  • 19 Pace N, Strajman E, Walker E L. Acceleration of carbon monoxide elimination in man by high pressure oxygen.  Science. 1950;  111 652-654
    CrossrefPubMedSuche in Google Scholar
  • 20 Tibbles P M, Perotta P L. Treatment of carbon monoxide poisoning: a critcal review of human outcome studies comparing normobaric oxygen with hyperbaric oxygen.  Ann. Emerg. Med.. 1994;  24 269-276
    PubMedSuche in Google Scholar
  • 21 Weaver L K, Hopkins R O, Larson-Lohr V. Neuropsychologic and functional recovery from severe carbon monoxide poisoning without hyperbaric oxygen therapy.  Ann. Emerg. Med.. 1996;  27(6) 736-740
    PubMedSuche in Google Scholar
  • 22 Thom S R. Functional inhibition of leukocyte B2 integrins by hyperbaric oxygen in carbon monoxide-mediated brain injury in rats.  Toxicol. Appl. Pharmacol.. 1993;  123 248-256
    CrossrefPubMedSuche in Google Scholar
  • 23 Jiang J, Tyssebotn I. Cerebrospinal fluid pressure changes after acute carbon monoxide poisoning and therapeutic effects of normobaric and hyperbaric oxygen in conscious rats.  Undersea Hyperb. Med.. 1997;  24(4) 245-254
    PubMedSuche in Google Scholar
  • 24 Francis D JR. The Pathophysiology of Decompression Sickness. In: Bennet PB, Moon R (Editors) Diving Accident Management. UHMS/DAN Workshop Bethesda, MD, USA; 1990: 38-56
    Suche in Google Scholar
  • 25 Shastri K A, Logue G L, Lundgren C E. In vitro activation of human complement by nitrogen bubbles.  Undersea Biomed. Res.. 1991;  18 157-165
    PubMedSuche in Google Scholar
  • 26 Loewenherz J A. Clinical Features of Diving Accidents. In: Bennett PB, Moon RE (Editors) Diving Accident Management. UHMS/DAN Workshop Bethesda, MD, USA; 1990: 130-145
    Suche in Google Scholar
  • 27 Francis T JR. et al . Central nervous system decompression sickness: Latency of 1070 human cases.  Undersea Biomed. Res.. 1988;  15 403-419
    PubMedSuche in Google Scholar
  • 28 Ball R. Effect of severity, time to recompression with oxygen, and retreatment on outcome in fourty-nine cases of spinal cord decompression sickness.  Undersea Hyperb. Med.. 1993;  20 133-145
    PubMedSuche in Google Scholar
  • 29 Thalmann E D. Principles of US Navy Recompression Treatments for Decompression Sickness. In: Moon RE, Sheffield PJ (Editors) Treatment of Decompression Illness. UHMS/DAN ASMA Workshop Palm Beach, FL, USA; 1995: 75-95
    Suche in Google Scholar
  • 30 Vann R D. et al . Prognostic Factors in DCI in Recreational Divers. In: Moon RE, Sheffield PJ (Editors) Treatment of Decompression Illness. UHMS/DAN ASMA Workshop Palm Beach, FL, USA; 1995: 352-363
    Suche in Google Scholar
  • 31 Broome J R, Dick E J. Neurological Decompression Illness in Swine.  Aviat. Space Environm. Med.. 1996;  67 207-213
    PubMedSuche in Google Scholar
  • 32 Leitch D R, Hallenbeck J M. Oxygen in the Treatment of Spinal Cord Decompression Sickness.  Undersea Biomed. Res.. 1985;  12 269-289
    PubMedSuche in Google Scholar
  • 33 Wattel F, Mathieu D (eds.) European Committee for Hyperbaric Medicine: Proceedings of the 2nd European Consensus Conference on Treatment of Decompression Accidents in Recreational Diving. Marseille; 1996: 13-25
    Suche in Google Scholar
  • 34 Welslau W, et al. (eds.) Hyperbare Sauerstofftherapie. Archimedes Göttingen; 1998: 46-47
    Suche in Google Scholar
  • 35 Plafki C, Welslau W, Almeling M. Die Bedeutung des persistierenden Foramen ovale (PFO) für das Risiko von Dekompressionsunfällen und neurologischen Langzeitshcäden bei Tauchern.  Dt. Zeischr. Sportmed.. 1998;  3 88-92
    PubMedSuche in Google Scholar
  • 36 Moon R E. Gas Embolism. In: Oriani G, Marroni A, Wattel F (Editors) Handbook on Hyperbaric Medicine. Springer 1996: 229-249
    Suche in Google Scholar
  • 37 Moloff A L. Delayed Onset of Arterial Gas Embolism.  Aviat. Space Environm. Med.. 1993;  64 1040-1043
    PubMedSuche in Google Scholar
  • 38 Dutka A J. A review of the pathophysiology and potential application of experimental therapies for the treatment of cerebral arterial gas embolism.  Undersea Biomed. Res.. 1985;  12 403-421
    PubMedSuche in Google Scholar
  • 39 McDermott J J. et al . Effects of an increased pO2 during recompression therapy for the treatment of experimental cerebral arterial gas embolism.  Undersea Biomed. Res.. 1992;  19(6) 403-413
    PubMedSuche in Google Scholar
  • 40 Bitterman H, Melamed Y. Delayed hyperbaric treatment of cerebral air embolism.  Isr. J. Med. Sci.. 1993;  29(1) 22-26
    PubMedSuche in Google Scholar
  • 41 Kindwall E P. Use of Short Versus Long Tables in the Treatment of Decompression Sickness and Air Embolism. In: Moon RE, Sheffield PJ (Editors) Treatment of Decompression Illness. UHMS/DAN ASMA Workshop Palm Beach, FL, USA; 1995
    Suche in Google Scholar
  • 42 Gorman D. The Treatment of Arterial Gas Embolism. In: Moon RE, Sheffield PJ (Editors) Treatment of Decompression Illness. UHMS/DAN/ASMA Workshop Palm Beach, FL, USA; 1995: 96-100
    Suche in Google Scholar
  • 43 Tirpitz D. HBO-Therapie in der Behandlung nekrotisierender Weichteilinfektionen. In: Almeling M, Böhm, Welslau W (Editors) Handbuch der Tauch- und Hyperbarmedizin. Ecomed Verlags-GmbH Landsberg/Lech; 1998: 1-26
    Suche in Google Scholar
  • 44 Camporesi EM (ed.) Clostridial myonecrosis (gas gangrene). In: Hyperbaric Oxygen Therapy: A Committee Report. Undersea And Hyperbaric Medical Society Kensington; 1996: 11-13
    Suche in Google Scholar
  • 45 Bakker D J, van der Klij A J. Clostridial Myonecrosis. In: Oriani G, Marroni A, Wattel F (Editors) Handbook on Hyperbaric Medicine. Springer 1996: 362-385
    Suche in Google Scholar
  • 46 Roggenthin T. et al . An immunoassay for the rapid and specific detection of three sialidase producing clostridia causing gas gangrene.  J. Immunol. Meth.. 1993;  157 125-133
    CrossrefPubMedSuche in Google Scholar
  • 47 van Unnik A JM. Inhibition of toxin production in Clostridium perfringens in vitro by hyperbaric oxygen.  Antonie Van Leeuwenhoek. 1965;  31 360-366
    PubMedSuche in Google Scholar
  • 48 Kaye D. Effect of hyperbaric oxygen on Clostridia in vitro and in vivo.  Proc. Soc. Exp. Biol. Med.. 1967;  124 360-366
    PubMedSuche in Google Scholar
  • 49 Holland J A. et al . Experimental and clinical experience with hyerbaric oxygen in the treatment of clostridial myonecrosis.  Surgery. 1975;  77(1) 75-85
    PubMedSuche in Google Scholar
  • 50 Demello F J, Haglin J J, Hitchcock C R. Comparative study of experimental Clostridium perfringens infection in dogs.  Surgery. 1973;  73 936-941
    PubMedSuche in Google Scholar
  • 51 Erttmann M, Havemann D. Ergebnisse einer retro- und prospektiven Analyse des unfallchirurgischen Krankenguts aus 20 Jahren.  Unfallchirurg. 1992;  95 471-476
    PubMedSuche in Google Scholar
  • 52 Hart G B, Strauss M B. Gas Gangrene - Clostridial Myonecrosis: A Review.  J. Hyperbaric Medicine. 1990;  5(2) 131-144
    PubMedSuche in Google Scholar
  • 53 Mader J. Mixed anaerobic and aerobic soft tissue infections. In: Davis JC, Hunt TK (Editors) Problem Wounds: The Role of Oxygen. Elsevier New York; 1988: 153-172
    Suche in Google Scholar
  • 54 Bakker D J. Selected aerobic and anaerobic soft tissue infections. In: Kindwall EP (Editor) Hyperbaric medicine practice. Best Publishers Flagstaff; 1999
    Suche in Google Scholar
  • 55 Chanteleau E, Kleinfeld H, Paetow P. Das Syndrom des diabetischen Fußes - Neue therapeutische und diagnostische Aspekte.  Diabetes und Stoffwechsel. 1992;  1 18-23
    PubMedSuche in Google Scholar
  • 56 Reike H, Angelkort B. Einteilung und Epidemiologie des diabetischen Fußsyndroms. In: Reike H (Editor) Das diabetische Fußsyndrom. Upjohn Medical 1993
    Suche in Google Scholar
  • 57 Caputo G M. et al .Assessment and Management of Foot Disease in Patients with Diabetes. N. Engl. J. Med. 1994 : 854-860
    Suche in Google Scholar
  • 58 Wagner F W. Treatment of the diabetic foot.  Compr. Ther.. 1984;  10 29
    PubMedSuche in Google Scholar
  • 59 Stiegler H. et al . Failure of reducing lower extremity amputations in diabetic patients: result of two subsequent population based surveys 1990 and 1995 in Germany.  VASA. 1998;  27 10-14
    PubMedSuche in Google Scholar
  • 60 Welslau W, et al. (eds.) Hyperbare Sauerstofftherapie. Archimedes Verlag Göttingen; 1998: 96-97
    Suche in Google Scholar
  • 61 Doctor N, Pandya S, Supe A. Hyperbaric oxygen therapy in diabetic foot.  J. Postgrad. Md.. 1992;  38(3) 111-114
    PubMedSuche in Google Scholar
  • 62 Faglia E. et al . Adjunctive systemic hyperbaric oxygen therapy in treatment of severe prevalently ischemic diabetic foot ulcer. A randomised study.  Diabetes Care. 1996;  19(12) 1338-1343
    CrossrefPubMedSuche in Google Scholar
  • 63 Baroni G. et al . Hyperbaric oxygen in diabetic gangrene treatment.  Diabetes Care. 1987;  10 81-86
    PubMedSuche in Google Scholar
  • 64 Oriani G. et al . Hyperbaric oxygen therapy in diabetic gangrene. In: Proc. of the 10th Int. Congress on Hyperbaric Medicine. Best Publishers Amsterdam; 1990
    Suche in Google Scholar
  • 65 Oriani E, Faglia F. Hyperbaric oxygen treatment in the diabetic gangrene.  Undersea Hyperb. Med.. 1995;  22 (Suppl.) 11
    PubMedSuche in Google Scholar
  • 66 Zamboni W A. et al . Evaluation of hyperbaric oxygen for diabetic wounds: a prospective study.  Undersea Hyperb. Med.. 1997;  24(3) 175-179
    PubMedSuche in Google Scholar
  • 67 Cianci P, Hunt T K. Long-term results of aggressive management of diabetic foot ulcers suggest significant cost effectiveness.  Wound Rep. Reg.. 1997;  5 141-146
    PubMedSuche in Google Scholar
  • 68 Brown G L. et al . Enhancement of wound healing by topical treatment with epidermal growth factor.  N. Engl. J. Med.. 1989;  321 76-79
    CrossrefPubMedSuche in Google Scholar
  • 69 Zhao L L. et al . Total reversal of hypoxic wound healing deficit by hyperbaric oxygen plus growth factors.  Am. Coll. of Surgeons. 1993;  43 711-714
    PubMedSuche in Google Scholar
  • 70 Marx R E. Radiation injury to tissue. In: Kindwall PE (Editor) Hyperbaric medicine practice. Best Publishers Flagstaff, Ariz.; 1994: 447-504
    Suche in Google Scholar
  • 71 Mustoe T A, Porras-Reyes B H. Modulation of wound healing response in chronic irradiated tissues.  Clin. Plast. Surg.. 1993;  20 465-472
    PubMedSuche in Google Scholar
  • 72 Ehler W J, Marx R E, Peleg M J. Oxygen as a drug: a dose response curve for radiation necrosis.  Undersea Hyperb. Med.. 1993;  20 (Suppl.) 44-45
    PubMedSuche in Google Scholar
  • 73 Bevers R FM, Bakker D J, Kurth K H. Hyperbaric oxygen treatment for hemorrhagic radiation cystitis.  Lancet. 1995;  346 803-805
    CrossrefPubMedSuche in Google Scholar
  • 74 Favre C. et al . Hyperbaric oxygen therapy in a case of post-total body irradiation colitis.  Bone Marrow Transplant.. 1998;  21(5) 519-520
    CrossrefPubMedSuche in Google Scholar
  • 75 Woo T C, Joseph D, Oxer H. Hyperbaric oxygen treatment for radiation proctits.  Int. J. Radiat. Oncol. Biol. Phys.. 1997;  38(3) 619-622
    PubMedSuche in Google Scholar
  • 76 Colombel F J. et al . Hyperbaric oxygenation in severeperineal Crohn's disease.  Dis. Colon Rectum. 1995;  38(6) 609-614
    PubMedSuche in Google Scholar
  • 77 Lavy A. et al . Hyperbaric oxygen for perineal Crohn's disease.  J. Clin. Gastroenterol.. 1994;  19(3) 202-205
    PubMedSuche in Google Scholar
  • 78 Sterling D L. et al . Hyperbaric oxygen limits infarct size in ischemic rabbit myocardium in vivo.  Circulation. 1993;  8(4 Pt 1) 1931-1936
    PubMedSuche in Google Scholar
  • 79 Shandling A H. et al . Hyperbaric oxygen and thrombolysis in myocardial infarction: the “HOT MI” pilot study.  Am. Heart J.. 1997;  134(3) 544-550
    PubMedSuche in Google Scholar
  • 80 Radice S. et al . Hyperbaric oxygen worsens myocardial low flow ischemia-reperfusion injury in isolated rat heart.  Eur. J. Pharmocol.. 1997;  320(1) 43-49
    PubMedSuche in Google Scholar
  • 81 Mink R B, Dutka A J. Hyperbaric oxygen after global cerebral ischemia in rabbits reduces brain vascular permeability and blood flow.  Stroke. 1995;  26(12) 2307-2312
    PubMedSuche in Google Scholar
  • 82 Krakowsky M. et al . Effect of hyperbaric oxygen therapy on survival after global cerebral ischemia in rats.  Surg. Neurol.. 1998;  49(4) 412-416
    PubMedSuche in Google Scholar
  • 83 Neubauer R A, Jamesy P. Cerebral oxygenation and the recoverable brain.  Neurol. Res.. 1998;  20 (Suppl. 1) S33-S36
    PubMedSuche in Google Scholar
  • 84 Nighoghossian N, Trouillas P. Hyperbaric oxygen in the treatment of acute ischemic stroke: an unsettled issue.  J. Neurol. Sci.. 1997;  150(1) 27-31
    CrossrefPubMedSuche in Google Scholar
  • 85 Plafki C. et al . Komplikationen der HBO-Therapie bei elektiven Indikationen.  Caisson, Mitteilungen der Gesellschaft für Tauch- und Überdruckmedizin e. V.. 1997;  12 116-122
    PubMedSuche in Google Scholar
  • 86 Clark J M. Oxygen toxicity. In: Kindwall EP (Editor) Hyperbaric medicine practice. Best Publishers Flagstaff; 1994: 33-43
    Suche in Google Scholar
  • 87 Chavko M, Harabin A L. Regional lipid peroxidation and protein oxidation in rat brain after hyperbaric oxygen exposure.  Free Radic. Biol. Med.. 1996;  20(7) 973-978
    CrossrefPubMedSuche in Google Scholar
  • 88 Wood J D. GABA and oxygen toxicity: a review.  Brain Res. Bull.. 1980;  5 777-780
    CrossrefPubMedSuche in Google Scholar
  • 89 Kindwall E P, Goldmann R W. Oxygen toxicity. In: Kindwall EP, Goldmann RW (Editors) Hyperbaric medical procedures. Milwaukee; 1995: 118-126
    Suche in Google Scholar
  • 90 Bert P. La pression barometrique; recherche de physiologie experimental. Libraire de l¿academie de Medicine Paris; 1878
    Suche in Google Scholar
  • 91 Smith J L. The pathological effects due to increase of oxygen tension in air breathed.  J. Physiol.. 1899;  24 19-35
    CrossrefPubMedSuche in Google Scholar
  • 92 Clark J M, Lambertson C J. Pulmonary oxygen toxicity: a review.  Pharmocol. Rev.. 1971;  23 37-133
    PubMedSuche in Google Scholar
  • 93 Palmquist B M, Philipson B, Barr P O. Nuclear cataract and myopia during hyperbaric oxygen therapy.  Br. J. Ophthalmol.. 1984;  68 113-117
    CrossrefPubMedSuche in Google Scholar
  • 94 Longobardi P. et al . The Italian National Health Service and the Use of Hyperbaric Oxygen Therapy in Italy.  Pressure. 1999;  28(6) 18-20
    PubMedSuche in Google Scholar
  • 95 Welslau W, et al. (eds) Hyperbare Sauerstofftherapie. Archimedes Göttingen; 1998: 249-264
    Suche in Google Scholar
  • 96 Breinbauer B. et al . Indications for hyperbaric oxygenation in chronic deseases.  Anaesthesiol. Intensivmed. Notfallmed. Schmerztherap.. 1996;  31(2) 102-105
    PubMedSuche in Google Scholar
  • 97 Hipp R. et al . Technical prerequisites, required personnel and practical implementation of hyperbaric oxygenation.  Anaesthesiol. Intensivmed. Notfallmed. Schmerztherap.. 1996;  31(2) 108-110
    PubMedSuche in Google Scholar
  • 98 Hipp R, Kochs E. Hyperbaric oxygen therapy - principles and indications.  Anaesthesiol. Intensivmed. Notfallmed. Schmerztherap.. 1996;  31(2) 96-97
    PubMedSuche in Google Scholar
  • 99 Mielke L. et al . Indications for primary or initial use of hyperbaric oxygenation.  Anaesthesiol. Intensivmed. Notfallmed. Schmerztherap.. 1996;  31(2) 100-102
    PubMedSuche in Google Scholar
  • 100 Mielke L. et al . Expanding indications for hyperbaric oxygenation - current development and status of clinical evaluation.  Anaesthesiol. Intensivmed. Notfallmed. Schmerztherap.. 1996;  31(2) 106-108
    PubMedSuche in Google Scholar
  • 101 Rump A FE, Siekmann U, Kalff G. Effects of Hyperbaric and Hyperoxic Conditions on the Disposition of Drugs: Theoretical Considerations and a Review of the Literature.  Gen. Pharmac.. 1999;  32(1) 127-133
    PubMedSuche in Google Scholar
  • 102 Stahl W, Calzia E, Radermacher P. Function of different ICU ventilators under hyperbaric conditions.  Undersea Hyperb. Med.. 1998;  25 15
    PubMedSuche in Google Scholar
  • 103 Moon R. Ask the expert. Pressure 1999 28(1)
    Suche in Google Scholar

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