Some Clinical and Experimental Applications of High Pressure Oxygen

Journal/Book: Reprinted from PROCEEDINGS OF THE ROYAL SOCIETY OF MEDICINE November 1963 VOI. 56 No. 11 pp. 999-1002 (Section of Anæsthetics pp. 31-34). 1963;

Abstract: DR. IAIN McA. LEDINGHAM (University Department of Surgery Western Infirmary Glasgow) Since about 1955 there has been a steadily increasing interest in the use of oxygen at pressures greater than atmospheric for a wide variety of human disorders. In London (Churchill-Davidson et al. 1955) single-patient chambers were designed for use in association with radiotherapy of cancer while in Amsterdam and Glasgow pressure vessels were constructed of a size large enough to house both patient and attendant medical and nursing staff (Boerema 1961 Illingworth et al. 1961). Only the patient breathes oxygen. The working pressure of the existing Glasgow chamber is twice atmospheric; when 100% oxygen is used in anæsthetized patients this has the effect of raising the arterial oxygen tension in practice to 1 350-1 400 mmHg. In unanæsthetized volunteers breathing oxygen through a standard BLB delivery mask with a flow rate of 8 litres per minute the arterial PO2 has been found to be about 750 mmHg. While greater arterial oxygen tensions could be achieved with higher ambient pressures two atmospheres absolute was chosen in order to minimize the dangerous effects of prolonged administration of oxygen. In fact this amount of oxygen has now been administered without untoward effect in several conscious patients for periods of up to three days. During these prolonged exposures the oxygen mask is removed from the patient for half an hour every four to six hours and at least once in twenty-four hours the chamber is decompressed to normal atmospheric pressure. These safety precautions are quite empirical bat neither cerebral nor pulmonary complications have been detected. Naturally with a new project of this variety many stones remain unturned and our experience in the treatment of anoxic anoxia is limited to some cases of pulmonary distress syndrome of the newborn. A few adult patients with respiratory collapse of various sorts have been treated in the pressure chamber bat attention has been mainly focused an stagnant and anæmic anoxia. Carbon monoxide poisoning is the most obvious example of the latter and while in Glasgow we have gained considerable experience of the treatment of this form of intoxication Dr M E Sluijter of Amsterdam will deal with this aspect of the work in detail. ... ___MH

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