Hyperbaric Chamber Treatment in Burn Victims and the Diabetic Wound : Efficiency in its Delivery .

Hyperbaric Oxygen Therapy (HBOT) has been promoted as an effective treatment for diabetic foot wounds  , and the first controlled trial for this indication was reported in the 1960s (ADA,2018). HBOT reduces the risk of amputation with an odds ratio of 0.24 which are very good measure outcomes in Psychometric. The rational for indicating measures as being one involving Psychometric is because any treatment involving human maneuvering is measured as Psychometric.  In the seven studies performed using the Hyperbaric chamber which were published in the 1980s all tests were proven to aid in wound healing , including control trials pre study . But concerns related to cost efficiency were noted as being six hour treatments at a rate of 50,000 to health insurance and 200,000 to private pay . Hyperbaric Chamber Therapy is also useful in treating burn victims ,particularly those who have suffered from inhalation injury such as endobronchial debre , inhaled toxins , and chemical burns (Hart et al, 1985) .Brochial cast or acute endobronchial debris and exudate can cause obstruction of distal airways contributing to ventilation -perfusion mismatches and secondary infection ; in addition it a well known clinical fact that  smoke inhalation causes hemorrhages in small blood vessels  which is often not diagnosed in Emergency room departments when smoke inhalation victims are triashed .   The physiological process of inhalation injury is complex and involves a variable and often unpredictable degree of direct local thermal and chemical exposure reactive immune response , systemic effects of inhaled toxins ; accrual of endo trachial debres , and secondary infection . HBOT is a useful and  cost effective intervention with burn victims because of nutritional factors . To better understand this rational one would have to understand Cellular Respiration  and Boyles Law. . Cellular respiration involves the equation of a chemical process called   Covalence where atoms collide to elicit a chemical reaction, in the case of cellular respiration the atoms involved are O2 + C6 H2O 6 these are one oxygen and one glucose ; these atoms collide with CO2+ H20 + ATP or one Carbon Dioxide , one Oxygen , and one ATP or energy. The atoms co vales to form necessary states and enter into the cell with the assistance of the Mitochondria  Boyles Law states that at a constant temperature and at an atmospheric pressure of no more than 30 feet this covalence will not suffer any changes and thus tissue damage will not occur . Why is this important in the treatment of the diabetic patient and burn victim ? . Because the single most important factor in the success of the treatment are related to Nutritional status . This is true because ATP are micro molecules or glucose chains , and the burn victims sole issue in clinical practice are protein loss.  For this reason Nutritional stability need to be present in the individual being treated with the Hyperbaric Chamber as to permit convalece between the atoms , ATP and the mitochondria .

References

Lipski, B.A Berendt,A.B ( 2010) Hyperbaric Oxygen Therapy for Diabetic Foot Wounds . American Diabetic Association . Retrieved from http://www.care.diabetesjournals.org/content/33/5/1143

Hart,G.B ; Strauss , M.B ; Lemon,P.A & Daniel,D (1985) Treatment of Smoke Inhalation by Hyperbaric Oxygene . Journal of Emergency Medicine  vol 5 Issue 3