Normobaric hyperoxic therapy
Therapeutic use of gas mixtures with an increased oxygen partial pressure.
Treatment uses an oxygen–air mixture with increased oxygen content, up to 32%, at 1020–1100 hPa. Mixture temperature is 18–23 °C and volumetric delivery rate is 0.72 m³/hour.
Mechanisms of action
Breathing the oxygen–air mixture increases blood oxyhaemoglobin. With available oxidation substrates and normal haemodynamics, the resulting mild tissue hyperoxia eliminates hypoxaemia and tissue hypoxia. Increased blood oxygen partial pressure reduces carotid chemoreceptor excitation, decreasing alveolar ventilation, blood pressure, cardiac contractile function and heart rate. Pulmonary arterial hypertension and right ventricular failure, or cor pulmonale, diminish, and the normal balance of slow-wave and rapid-eye-movement sleep is restored.
Higher pO2 in the breathing mixture reduces alveolar ventilation, lowers heart rate and increases diastolic pressure. Increased air density also trains the respiratory system and raises its adaptive reserve. Under hyperoxia, activation of the pulmonary prooxidant system is balanced by stronger tissue antiradical defence. Increased antioxidants suppress the intensity of immune responses to exogenous and endogenous antigens and inhibit the release of endogenous bronchial spasmogens and other biologically active substances by neuroepithelial bodies. Oxygen breathing reduces tracheobronchial secretion and sputum production by ciliated bronchial epithelial cells and enhances tracheal mucociliary clearance from 2–3 to 4–5 cm/min.
Under hyperoxia, body systems shift to a lower, more economical functional level: breathing and heart rate slow, cardiac output decreases, and red blood cell content and coagulation activity fall, while leukocyte and lymphocyte levels increase. Excess tissue oxygen causes reflex arteriolar spasm and higher blood pressure. At the same time, pulmonary blood supply to a pathological lesion increases, producing hyperaemia, the Robin Hood syndrome. Increased sarcolemmal permeability to Ca2+, together with activation of Ca2+-ATPase, strengthens right ventricular contraction and restores pulmonary artery blood flow. A course of oxygen barotherapy produces an adaptive structural and functional trace, responsible for high nonspecific resistance to environmental factors.
Reduced adrenal catecholamine excretion decreases metabolic acidosis and enhances hepatic microsomal antitoxic activity and renal excretion. Tissue lipid peroxidation decreases significantly and anabolic processes intensify.
In cerebrovascular disease, exhaled CO2 gradually decreases, activating oxidative metabolism and brain tissue microcirculation. After the course, weather sensitivity and the likelihood of cardiovascular catastrophes decrease.
Effects are immunostimulatory, reparative and regenerative, detoxifying and vasopressor.
Indications and contraindications
Indications: musculoskeletal diseases and injuries, persistently nonhealing wounds, trophic ulcers, burns, thyrotoxicosis, diabetes mellitus, neurasthenia and chronic inflammatory diseases of the female genital organs.
Contraindications: stage II circulatory insufficiency, stage I–II hypertensive disease, uterine fibroids, acute ENT disease and acute or chronic inflammatory respiratory diseases, including bronchitis, tracheitis and exudative or dry pleurisy.
Methods and equipment
The hyperoxic mixture is delivered through a mask into the patient’s airways. Two main techniques are used. In interval hyperoxic therapy, brief breathing of a 30–32% oxygen–air mixture for three minutes is followed by three minutes of atmospheric air and then the mixture again. Alternating cycles of different gas mixtures are repeated over eleven minutes. In the second technique, periodic hyperoxic therapy, patients continuously breathe a 30% oxygen mixture for 10–15 minutes.
Equipment includes HYPO-OXY-1 (Oxyterra) and the oxygen chambers Oxysys 4000, Oxysys 4500, O2one-H750 and O2one-H810.
Oxygen barotherapy is combined with local barotherapy, carbogen therapy and aerosol therapy.
Dosage is determined by oxygen partial pressure in the pressure chamber and compression and decompression rates.
Daily sessions last 20–40 minutes in total, with seven to ten sessions per course. A repeat course is given after two to three months.
Age restriction: children aged five years and over.
Prescription example
Interval normobaric hyperoxic therapy. Mixture containing 32% O2 for three minutes, atmospheric air for three minutes. Three cycles, daily, ten sessions.
References
Full main-text translation of: Пономаренко Г.Н. Физические методы лечения. Справочник. Раздел «Нормобарическая гиперокситерапия». С. 82–84.
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