Yanıkta Hiperbarik Oksijen Tedavisi

Uzm. Dr. Selcen Yüsra Abaylı1
Uzm. Dr. Ahmet Uğur Avcı2

1SBÜ Gülhane EAH, Sualtı ve Hiperbarik Tıp ABD, Ankara, Türkiye T.C. Sağlık Bakanlığı, Ankara, Türkiye
2SBÜ Gülhane EAH, Hava ve Uzay Hekimliği ABD, Ankara, Türkiye

ÖZET

Hiperbarik oksijen tedavisi (HBO2) yanık vakalarında iyileşme sürecini hızlandıran ve komplikasyon riskini azal- tan etkili bir yardımcı tedavi yöntemidir. HBO2 yüksek basınç altında %100 oksijen solutulması esasına dayanır ve doku hipoksisini gidermesi sayesinde iyileşmeyi destekler. HBO2, özellikle geniş yüzey alanlı yanıklar ve yüz, el gibi hassas bölgelerde önemli faydalar sağlar. İyileşme sürecine katkıları arasında inflamasyonu baskılaması, ödemi azaltması ve enfeksiyon riskini düşürmesi sayılabilir. HBO2’nin yanıklardaki olumlu etkileri üzerine yapılan araştırmalar, tedavinin hastane yatış sürelerini kısalttığını, yara iyileşmesini hızlandırdığını ve mortalite oranlarını düşürdüğünü ortaya koymuştur. Ayrıca, fibroblast aktivitesini artırarak doku yenilenmesine katkı sağlar ve yara enfeksiyonlarının kontrolünde etkili rol oynar. Her ne kadar tedavi protokolleri arasında bir standardizasyon bulunmasa da literatürde HBO2’nin etkinliği geniş çapta kabul görmektedir. Özellikle ağır yanık vakalarında HBO2’nin standart tedaviye entegre edilmesi büyük fayda sağlayabilir.

Anahtar Kelimeler: Hiperbarik oksijen tedavisi; Hiperbarik oksijenasyon; Yanıklar; Yara iyileşmesi

Referanslar

  1. Jain KK. Textbook of Hyperbaric Medicine. In: Textbook of Hyperbaric Medicine. Springer International Publishing; 2017:79-84. [Crossref]
  2. Çimşit M. Hiperbarik Tıp. İstanbul Tıp Kitabevi; 2009.
  3. Huang ET, ed. UHMS Hyperbaric Medicine Indications Manual. 15th ed. Best Publishing Company; 2023. [Link]
  4. Camporesi EM, Bosco G. Mechanisms of action of hyper- baric oxygen therapy. Undersea Hyperb Med J Undersea Hyperb Med Soc Inc. 2014;41(3):247-252. [PubMed]
  5. Thom SR. Hyperbaric oxygen: its mechanisms and efficacy. Plast Reconstr Surg. 2011;127 Suppl 1(Suppl 1):131S-141S. [Crossref]  [PubMed]  [PMC]
  6. Rothfuss A, Speit G. Investigations on the mechanism of hyperbaric oxygen (HBO)-induced adaptive protection against oxidative stress. Mutat Res. 2002;508(1-2):157-165. [Crossref]  [PubMed]
  7. Huang ET, ed. Adjunctive Hyperbaric Oxygen Therapy in the Treatment of Thermal Burns. In: UHMS Hyperbar- ic Medicine Indications Manual. 15th ed. Best Publishing Company; 2023:305-336. [Link]
  8. Jain KK. HBO Therapy in Wound Healing, Plastic Sur- gery, and Dermatology. In: Textbook of Hyperbaric Med- icine. Springer International Publishing; 2017:183-204. [Crossref]
  9. Demling RH. The burn edema process: current concepts. J Burn Care Rehabil. 2005;26(3):207-227. [Link]
  10. Boykin JV, Eriksson E, Pittman RN. In vivo microcircula- tion of a scald burn and the progression of postburn der- mal ischemia. Plast Reconstr Surg. 1980;66(2):191-198. [Crossref]  [PubMed]
  11. Smolle C, Auinger D, Lindenmann J, Smolle J, Smolle- Juettner FM, Kamolz LP. Hyperbaric oxygen (HBO2) ther- apy in thermal burn injury revisited. Pressure does matter. Review. Undersea Hyperb Med J Undersea Hyperb Med Soc Inc. 2024;51(2):115-127. [PubMed]
  12. Cianci P. Advances in the treatment of the diabetic foot: Is there a role for adjunctive hyperbaric oxygen thera- py? Wound Repair Regen Off Publ Wound Heal Soc Eur Tissue Repair Soc. 2004;12(1):2-10. [Crossref]  [PubMed]
  13. Smolle C, Lindenmann J, Kamolz L, Smolle-Juettner FM. The History and Development of Hyperbaric Oxygen- ation (HBO) in Thermal Burn Injury. Med Kaunas Lith. 2021;57(1):49. [Crossref]  [PubMed]  [PMC]
  14. Villanueva E, Bennett MH, Wasiak J, Lehm JP. Hyperbar- ic oxygen therapy for thermal burns. Cochrane Database Syst Rev. 2004;2004(3):CD004727. [Crossref]  [PubMed]  [PMC]
  15. Nylander G, Lewis D, Nordström H, Larsson J. Reduction of postischemic edema with hyperbaric oxygen. Plast Re- constr Surg. 1985;76(4):596-603. [Crossref]  [PubMed]
  16. Thom SR, Mendiguren I, Hardy K, et al. Inhibition of hu- man neutrophil beta2-integrin-dependent adherence by hyperbaric O2. Am J Physiol. 1997;272(3 Pt 1):C770-777. [Crossref]  [PubMed]
  17. Hills BA. A role for oxygen-induced osmosis in hyperbar- ic oxygen therapy. Med Hypotheses. 1999;52(3):259-263. [Crossref]  [PubMed]
  18. Alexander JW, Meakins JL. A physiological basis for the development of opportunistic infections in man. Ann Surg. 1972;176(3):273-287. [Crossref]  [PubMed]  [PMC]
  19. Alexander JW, Wixson D. Neutrophil dysfunction and sep- sis in burn injury. Surg Gynecol Obstet. 1970;130(3):431-438. [PubMed]
  20. Church D, Elsayed S, Reid O, Winston B, Lindsay R. Burn wound infections. Clin Microbiol Rev. 2006;19(2):403-434. [Crossref]  [PubMed]  [PMC]
  21. Barber RC, Aragaki CC, Rivera-Chavez FA, Purdue GF, Hunt JL, Horton JW. TLR4 and TNF-alpha polymorphisms are associated with an increased risk for severe sepsis fol- lowing burn injury. J Med Genet. 2004;41(11):808-813. [Crossref]  [PubMed]  [PMC]
  22. Deitch EA, Wheelahan TM, Rose MP, Clothier J, Cotter J. Hypertrophic burn scars: analysis of variables. J Trau- ma. 1983;23(10):895-898. [Crossref]  [PubMed]
  23. Gupta S, Laskar N, Kadouri DE. Evaluating the Effect of Oxygen Concentrations on Antibiotic Sensitivity, Growth, and Biofilm Formation of Human Pathogens. Microbiol Insights. 2016;9:37-46. [Crossref]  [PubMed]  [PMC]
  24. Wada J, Ikeda T, Kamata K. Oxygen hyperbaric treatment for carbon monoxide poisoning and severe burn in coal mine gas explosion. Igakounoaymi. 1965;5:53-57. [Link]
  25. Ikeda K, Ajiki H, Nagao H, et al. Experimental and Clin- ical Use of Hyperbaric Oxygen in Burns. In: Proceedings of the 4th International Congress on Hyperbaric Medicine Sapporo, Japan, 2-4 September 1969. [Link]
  26. Hart GB, O'Reilly RR, Broussard ND, Cave RH, Goodman DB, Yanda RL. Treatment of burns with hyperbaric oxy- gen. Surg Gynecol Obstet. 1974;139(5):693-696. [PubMed]
  27. Grossman AR. Hyperbaric oxygen in the treatment of burns. Ann Plast Surg. 1978;1(2):163-171. [Crossref]  [PubMed]
  28. Niu AKC, Yang C, Lee HC. Burns treated with adjunc- tive hyperbaric oxygen therapyy: A comparative study in humans. J Hyperb Med. 1987;2:75-85. [Link]
  29. Cianci P, Lueders HW, Lee H, et al. Adjunctive hyper- baric oxygen therapy reduces length of hospitalization in thermal burns. J Burn Care Rehabil. 1989;10(5):432-435. [Crossref]  [PubMed]
  30. Cianci P, Williams C, Lueders H, et al. Adjunctive hyperbaric oxygen in the treatment of thermal burns. An eco- nomic analysis. J Burn Care Rehabil. 1990;11(2):140-143. [Crossref]  [PubMed]
  31. Rasmussen VM, Borgen AE, Jansen EC, Rotbøll Nielsen PH, Werner MU. Hyperbaric oxygen therapy attenuates central sensitization induced by a thermal injury in humans. Acta Anaesthesiol Scand. 2015;59(6):749-762. [Crossref]  [PubMed]
  32. Chen KL, Wu CJ, Tseng WS, Lee HC, Tsai TP, Huang WS. Improvement of satisfaction in burn patients receiv- ing adjuvant hyperbaric oxygen therapy. Formos J Surg. 2018;51(5):184-191. [Crossref]
  33. Waisbren BA, Schutz D, Collentine G, Banaszak E, Stern M. Hyperbaric oxygen in severe burns. Burns Incl Therm Inj. 1982;8(3):176-179. [Crossref]  [PubMed]
  34. Brannen AL, Still J, Haynes M, et al. A randomized pro- spective trial of hyperbaric oxygen in a referral burn center population. Am Surg. 1997;63(3):205-208. [PubMed]
  35. Chong SJ, Kan EM, Song C, Soh CR, Lu J. Character- ization of early thermal burns and the effects of hyper- baric oxygen treatment: a pilot study. Diving Hyperb Med. 2013;43(3):157-161. [PubMed]
  36. Mathieu D, Marroni A, Kot J. Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment. In: Diving and Hyperbaric Medicine. Vol 47. ; 2017:24-32. [Crossref]  [PubMed]  [PMC]
  37. Sosyal Güvenlik Kurumu Sağlık Uygulama Tebliği. Mevzuat Bilgi Sistemi. Accessed September 13, 2024. [Link]