Oxigenoterapia Hiperbarica para ayudar en el
Tratamiento De Gangrena Gaseosa

¿CON QUE PUEDE AYUDAR LA CÁMARA HIPERBÁRICA EN UNA GANGRENA GASEOSA
(miositis clostridial y mionecrosis)?

Feet, man feet, foot-2429438. Jpg

El tratamiento de la gangrena gaseosa con Oxigenoterapia Hiperbárica (OHB), utilizando presiones por arriba de los 2.0 ATA ofrece varios beneficios:

  1. Mejora la oxigenación: La OHB suministra oxígeno puro a altas presiones, lo que aumenta significativamente la cantidad de oxígeno disuelto en la sangre y los tejidos. Esto ayuda a combatir la infección y promueve la curación de los tejidos afectados.

  2. Combate infecciones: La gangrena gaseosa es causada por bacterias anaerobias que prosperan en entornos con poco oxígeno. La OHB crea un ambiente rico en oxígeno que es tóxico para estas bacterias, lo que ayuda a eliminar la infección.

  3. Para la cascada inflamatorio: La OHB puede reducir la inflamación en la zona afectada, aliviando el dolor y el edema.

  4. Acelera la curación de heridas: El oxígeno adicional promueve la formación de tejido de granulación y tejido de cicatrización, lo que acelera la cicatrización de las heridas y reduce la necesidad de amputaciones.

  5. Mejora la supervivencia de los tejidos: Al proporcionar oxígeno a los tejidos dañados, la OHB ayuda a preservar los tejidos afectados y reduce la extensión de la gangrena.

  6. Reduce la necesidad de amputaciones: La OHB puede disminuir la gravedad de la gangrena y, en algunos casos, evitar la necesidad de amputaciones. Usándose como tratamiento coadyuvante.

  7. Mejora la calidad de vida: Al reducir el daño tisular y las complicaciones, el tratamiento con OHB puede mejorar la calidad de vida de las personas con gangrena gaseosa.

LA TERAPIA HIPERBARICA PARA LA GANGRENA GASEOSA

a gangrena gaseosa es una infección grave y potencialmente mortal que se caracteriza por la muerte del tejido debido a bacterias anaerobias que producen gases. El tratamiento de la gangrena gaseosa con Oxigenoterapia Hiperbárica (OHB) ofrece beneficios significativos. Durante una sesión de OHB, los pacientes respiran oxígeno puro a presiones más altas que las condiciones normales, lo que aumenta la cantidad de oxígeno disuelto en la sangre y los tejidos. Este ambiente rico en oxígeno es tóxico para las bacterias anaerobias, lo que combate la infección y acelera la curación de las heridas. La OHB también reduce la inflamación, mejora la supervivencia de los tejidos afectados y puede disminuir la necesidad de amputaciones. 

En general, la OHB es una herramienta valiosa en el tratamiento de la gangrena gaseosa, que complementa otras intervenciones médicas, como ejemplo cirugía para eliminar el tejido muerto, administración de antibióticos y otros cuidados médicos. Esto puede mejorar significativamente las posibilidades de recuperación y supervivencia de los pacientes.

UHMS GANGRNA GASEOSA - PAGINA
Haz tu cita
Surgery, hospital, doctor-1822458. Jpg

CÓMO SIRVE LA TERAPIA EN CÁMARA HIPERBÁRICA PARA EL TRATAMIENTO COADYUVANTE DE LA GANGRENA GASEOSA

Mas detallado con estudios de soporte usando presiones entre 2.0 - 2.4 ATA
Investigaciónes y Fuentes

Undersea and Hyperbaric Medical Society. (2021). Indications for Hyperbaric Oxygen Therapy. Retrieved from https://www.uhms.org/resources/hbo-indications.html

Liceaga, D. E. (2014). GUÍAS CLÍNICAS DE DIAGNÓSTICO Y TRATAMIENTO DEL SERVICIO DE CÁMARA HIPERBÁRICA. Ciudad de Mexico: Hospital General de Mexico.

https://www.uhms.org/3-clostridial-myositis-and-myonecrosis-gas-gangrene.html

Chapter 4: Clostridial Myonecrosis (Gas Gangrene)
Robert A. van Hulst, MD, PhD, FUHM, Capt Navy (ret ), Dirk J. Bakker MD, PhD, FUHM,
Benjamin Cherng MD, C.R. Soh MD
REFERENCES
1. Stevens DL. The pathogenesis of clostridial myonecrosis. Int J Med Microbiol. 2000;290(4-5):497-502.
2. Van Hulst RA, Bakker DJ. Selected aerobic and anaerobic soft-tissue infections. In: Whelan HT, Kindwall EP,
editors. Hyperbaric Medicine Practice. North Palm Beach, FL: Best Publishing Company; 2017. Pp. 435-63.
3. Lucey BP, Hutchins GM. William H. Welch, MD, and the discovery of Bacillus welchii. Arch Pathol Lab Med.
2004;128(10):1193-5.
4. Weinstein L, Barza MA. Gas gangrene. N Engl J Med. 1973;289(21):1129-31.
5. Bakker D. Clostridial myonecrosis. In: Bakker DJ, Cramer FS, eds. Hyperbaric surgery: perioperative care: Flagstaff,
AZ: Best Publishing Co.; 2002:283-316.
6. Srivastava I, Aldape MJ, Bryant AE, Stevens DL. Spontaneous C. septicum gas gangrene: A literature review.
Anaerobe. 2017;48:165-71.
7. Abella BS, Kuchinic P, Hiraoka T, Howes DS. Atraumatic Clostridial myonecrosis: case report and literature review.
J Emerg Med. 2003;24(4):401-5.
8. Sutton SS, Jumper M, Shah A, Edun B. Clostridium tertium Peritonitis and Concurrent Bacteremia in a Patient
With a History of Alcoholic Cirrhosis. J Investig Med High Impact Case Rep. 2017;5(3):2324709617731457.
9. Kelesidis T, Tsiodras S. Clostridium sphenoides bloodstream infection in man. Emerg Infect Dis. 2011;17(1):156-8.
10. Aldape MJ, Bryant AE, Stevens DL. Clostridium sordellii infection: epidemiology, clinical findings, and current
perspectives on diagnosis and treatment. Clin Infect Dis. 2006;43(11):1436-46.
11. Williamson ED, Titball RW. A genetically engineered vaccine against the alpha-toxin of Clostridium perfringens
protects mice against experimental gas gangrene. Vaccine. 1993;11(12):1253-8.
12. Stevens DL, Titball RW, Jepson M, Bayer CR, Hayes-Schroer SM, Bryant AE. Immunization with the C-Domain
of alpha -Toxin prevents lethal infection, localizes tissue injury, and promotes host response to challenge with
Clostridium perfringens. J Infect Dis. 2004;190(4):767-73.
13. Shreya D, Uppalapati SR, Kingston JJ, Sripathy MH, Batra HV. Immunization with recombinant bivalent chimera
r-Cpae confers protection against alpha toxin and enterotoxin of Clostridium perfringens type A in murine model.
Mol Immunol. 2015;65(1):51-7.
14. Titball RW. Clostridium perfringens vaccines. Vaccine. 2009;27 Suppl 4:D44-7.
15. McLeod JW. Variations in the periods of exposure to air and oxygen necessary to kill anaerobic bacteria. Acta Pathol
Microbiol Scand. 1930;3(suppl):255.
16. Shimizu T, Ohtani K, Hirakawa H, Ohshima K, Yamashita A, Shiba T, et al. Complete genome sequence of
Clostridium perfringens, an anaerobic flesh-eater. Proc Natl Acad Sci U S A. 2002;99(2):996-1001.
17. Benamar S, Cassir N, Caputo A, Cadoret F, La Scola B. Complete Genome Sequence of Clostridium septicum
Strain CSUR P1044, Isolated from the Human Gut Microbiota. Genome Announc. 2016;4(5).
18. Maclennan JD. The histotoxic clostridial infections of man. Bacteriol Rev. 1962;26:177-276.
19. Hitchcock CR, Demello FJ, Haglin JJ. Gangrene infection: new approaches to an old disease. The Surgical clinics of
North America. 1975;55(6):1403-10.
20. Heimbach RD. Gas gangrene. In: Kindwall EP, ed. Hyperbaric medicine practice: Flagstaff, AZ: Best Publishing
Co.; 1994:373-94.
21. Kiu R, Hall LJ. An update on the human and animal enteric pathogen Clostridium perfringens. Emerg Microbes
Infect. 2018;7(1):141.
22. Navarro MA, McClane BA, Uzal FA. Mechanisms of Action and Cell Death Associated with Clostridium
perfringens Toxins. Toxins (Basel). 2018;10(5).
23. Takehara M, Takagishi T, Seike S, Ohtani K, Kobayashi K, Miyamoto K, et al. Clostridium perfringens alpha-Toxin
Impairs Innate Immunity via Inhibition of Neutrophil Differentiation. Sci Rep. 2016;6:28192.
24. Takagishi T, Takehara M, Seike S, Miyamoto K, Kobayashi K, Nagahama M. Clostridium perfringens alpha-toxin
impairs erythropoiesis by inhibition of erythroid differentiation. Sci Rep. 2017;7(1):5217.
25. Stevens DL, Troyer BE, Merrick DT, Mitten JE, Olson RD. Lethal effects and cardiovascular effects of purified
alpha- and theta-toxins from Clostridium perfringens. J Infect Dis. 1988;157(2):272-9.
26. Stevens DL, Bryant AE, Adams K, Mader JT. Evaluation of therapy with hyperbaric oxygen for experimental
infection with Clostridium perfringens. Clin Infect Dis. 1993;17(2):231-7.
27. Verherstraeten S, Goossens E, Valgaeren B, Pardon B, Timbermont L, Haesebrouck F, et al. Perfringolysin O: The
Underrated Clostridium perfringens Toxin? Toxins (Basel). 2015;7(5):1702-21.
28. Willis AT. Clostridia of wound infection. London: Butterworth; 1969:490.
29. Ohtani K. Gene regulation by the VirS/VirR system in Clostridium perfringens. Anaerobe. 2016;41:5-9.
Copyright © 2019 Undersea and Hyperbaric Medical Society, Inc.
30. Stevens DL, Bryant AE. The role of clostridial toxins in the pathogenesis of gas gangrene. Clin Infect Dis.
2002;35(Suppl 1):S93-S100.
31. Bryant AE, Stevens DL. Clostridial myonecrosis: new insights in pathogenesis and management. Curr Infect Dis
Rep. 2010;12(5):383-91.
32. Awad MM, Bryant AE, Stevens DL, Rood JI. Virulence studies on chromosomal alpha-toxin and theta-toxin
mutants constructed by allelic exchange provide genetic evidence for the essential role of alpha-toxin in Clostridium
perfringens-mediated gas gangrene. Mol Microbiol. 1995;15(2):191-202.
33. Eaton JT, Naylor CE, Howells AM, Moss DS, Titball RW, Basak AK. Crystal structure of the C. perfringens alphatoxin with the active site closed by a flexible loop region. J Mol Biol. 2002;319(2):275-81.
34. Stevens DL, Tweten RK, Awad MM, Rood JI, Bryant AE. Clostridial gas gangrene: evidence that alpha and theta
toxins differentially modulate the immune response and induce acute tissue necrosis. J Infect Dis. 1997;176(1):189-95.
35. Titball RW, Naylor CE, Basak AK. The Clostridium perfringens alpha-toxin. Anaerobe. 1999;5(2):51-64.
36. Van U. Inhibition of Toxin Production in Clostridium Perfringens in Vitro by Hyperbaric Oxygen. Antonie Van
Leeuwenhoek. 1965;31:181-6.
37. Kaye D. Effect of hyperbaric oxygen on Clostridia in vitro and in vivo. Proc Soc Exp Biol Med. 1967;124(2):360-6.
38. Hill GB, Osterhout S. Experimental effects of hyperbaric oxygen on selected clostridial species. II. In-vitro studies in
mice. J Infect Dis. 1972;125(1):26-35.
39. Muhvich KH, Anderson LH, Mehm WJ. Evaluation of antimicrobials combined with hyperbaric oxygen in a mouse
model of clostridial myonecrosis. J Trauma. 1994;36(1):7-10.
40. Demello FJ, Hashimoto T, Hitchcock CR, Haglin JJ. The effect of hyperbaric oxygen on the germination and toxin
production of Clostridium perfringens spores. In: Wada J, Iwa JT, editors. Proceedings of the fourth international
congress on hyperbaric medicine. Baltimore, MD: Williams and Wilkins, 1970. 270.
41. Schoemaker G. Oxygen tension measurements under hyperbaric conditions In: Boerema I, Brummelkamp WH,
Meijne NG, eds. Clinical application of hyperbaric oxygen: Amsterdam: Elsevier; 1964:330-5.
42. Kivisaari J, Niinikoski J. Use of silastic tube and capillary sampling technic in the measurement of tissue PO 2 and
PCO 2. Am J Surg. 1973;125(5):623-7.
43. Sheffield PJ. Tissue oxygen measurements. In: Davis JC, Hunt TK, eds. Problem wounds: the role of oxygen. New
York, NY: Elsevier; 1988:17-51.
44. Nora PF, Mousavipour M, Laufman H. Mechanisms of action of high pressure oxygen in Clostridium perfringens
exotoxin toxicity. In: Brown IW, Cox BG, eds. Hyperbaric medicine, publ 1404. Washington, DC: National
Academy of Science National Research Council; 1966:544-51.
45. Nora PF, Mousavipour M, Mittelpunkt A, Rosenberg M, Laufman H. Brain as target organ in Clostridium
perfringens exotoxin toxicity. Arch Surg. 1966;92(2):243-6.
46. Roggentin T, Kleineidam RG, Majewski DM, Tirpitz D, Roggentin P, Schauer R. An immunoassay for the
rapid and specific detection of three sialidase-producing clostridia causing gas gangrene. J Immunol Methods.
1993;157(1-2):125-33.
47. Scheven M. [Detection of Clostridium perfringens in mixed infection patient samples using a modified reverse
CAMP test]. Z Gesamte Hyg. 1991;37(2):90-1.
48. Hirn M. Hyperbaric oxygen in the treatment of gas gangrene and perineal necrotizing fasciitis. A clinical and
experimental study. Eur J Surg Suppl. 1993(570):1-36.
49. Demello FJ, Haglin JJ, Hitchcock CR. Comparative study of experimental Clostridium perfringens infection in
dogs treated with antibiotics, surgery, and hyperbaric oxygen. Surgery. 1973;73(6):936-41.
50. Kelley HG, Jr., Pace WG, 3rd. Treatment of Anaerobic Infections in Mice with Hyperpressure Oxygen. Surg Forum.
1963;14:46-7.
51. Klopper PJ. Hyperbaric oxygen treatment after ligation of the hepatic artery in rabbits. In: Boerema I,
Brummelkamp WH, Meijne NG, eds. Clinical application of hyperbaric oxygen. Amsterdam: Elsevier; 1964:31-5.
52. Schott H. [Gas gangrene (principles of treatment, results)]. Hefte Unfallheilkd. 1979;138:179-86.
53. Nier H, Kremer K. [Gas gangrene–still a diagnostic and therapeutic problem]. Zentralbl Chir. 1984;109(6):402-17.
54. Pailler JL, Labeeu F. [Gas gangrene: a military disease?]. Acta Chir Belg. 1986;86(2):63-71.
55. Erttmann M, Havemann D. [Treatment of gas gangrene. Results of a retro- and prospective analysis of a
traumatologic patient sample over 20 years]. Unfallchirurg. 1992;95(10):471-6.
56. Brummelkamp WH, Hogendijk J, Boerema I. Treatment of anaerobic infections (clostridial myositis) by drenching
the tissues with oxygen under high atmospheric pressure. Surgery. 1961;49:299-302.
57. Brummelkamp WH. Considerations on Hyperbaric Oxygen Therapy at Three Atmospheres Absolute for Clostridial
Infections Type Welchii. Ann N Y Acad Sci. 1965;117:688-99.
Copyright © 2019 Undersea and Hyperbaric Medical Society, Inc.
58. Bakker DJ. The use of hyperbaric oxygen in the treatment of certain infectious diseases, especially gas gangrene and
acute dermal gangrene. Wageningen, Holland: Drukkerij Veenman BV; 1984.
59. Hart GB, Lamb RC, Strauss MB. Gas gangrene. J Trauma. 1983;23(11):991-1000.
60. Holland JA, Hill GB, Wolfe WG, Osterhout S, Saltzman HA, Brown IW, Jr. Experimental and clinical experience
with hyperbaric oxygen in the treatment of clostridial myonecrosis. Surgery. 1975;77(1):75-85.
61. Van Zijl JJW. Discussion of hyperbaric oxygen. In: Brown IW, Cox BG, eds. Hyperbaric medicine. publ 1404.
Washington, DC: National Academy of Science National Research Council; 1966:552-4.
62. Heimbach RD. Gas gangrene. Review and update. HBO Rev. 1980;1:41-6.
63. Peirce EC. Gas gangrene: a critique of therapy. Surg Rounds. 1984;7:17-25.
64. Marroni A, Longobardi P, Cali-Corleo R. Cost-Effectiveness Evaluation of HBO Therapy. In: Mathieu D, ed.
Handbook on Hyperbaric Medicine. Dordrecht, The Netherlands: Springer; 2006:674-7.
65. Kindwall EP, chairman. Hyperbaric oxygen therapy committee report. UMS Report Number 5-23-77; 1977:4.
66. Evidence-Based Medicine Working G. Evidence-based medicine. A new approach to teaching the practice of
medicine. JAMA. 1992;268(17):2420-5.
67. Haynes RB, Devereaux PJ, Guyatt GH. Clinical expertise in the era of evidence-based medicine and patient choice.
Evid Based Med. 2002;7:36-8.
68. Tibbles PM, Edelsberg JS. Hyperbaric-oxygen therapy. N Engl J Med. 1996;334(25):1642-8.
69. Mitton C, Hailey D. Health technology assessment and policy decisions on hyperbaric oxygen treatment. Int J
Technol Assess Health Care. 1999;15(4):661-70.
70. Yang Z, Hu J, Qu Y, Sun F, Leng X, Li H, et al. Interventions for treating gas gangrene. Cochrane Database Syst
Rev. 2015(12):CD010577.
71. 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. Diving Hyperb
Med. 2017;47(1):24-32